Unit 7: Physical Health

Question 1

What is LIFE EXPECTANCY, and how have these changed over the last 100 years?

Answer 1

the length of time a person is expected to live

1900 = 46.3 for men, 48.3 for women
2016 = 76.1 for men, 81.1 for women

Question 2

What are MORTALITY and MORBIDITY?

Answer 2

Mortality = death
Morbidity = illness

Question 3

What is the primary reason for the significant increase in life expectancies over the last 100 years?

Answer 3

longevity has increased with the development of vaccines and treatments for common diseases; refrigeration; insect control

however, “diseases of old age” have now replaced infectious diseases among the top causes of death (heart disease, cancer, Alzheimers)

Question 4

What are the current sex statistics regarding causes of death?

Answer 4

Men = for every one of the top causes of death, except Alzheimers, men die at higher rates; suffer life threatening conditions more often than women

Women = tend to suffer from chronic, nonfatal, debilitating conditions more often than men (arthritis, osteoporosis, autoimmune)

Question 5

What is the MORTALITY-MORBIDITY PARADOX?

Answer 5

a phenomenon in which women tend to have higher rates of morbidity (sickness) than men, but men tend to experience mortality (death) earlier than women

Question 6

What is one of the proposed reasons that women self-report poorer health?

Answer 6

the traditional role of women as caretaker contributes to their poorer health bc being a caretaker can increase stress and make people vulnerable to various debilitating conditions

Question 7

What is one of the proposed reasons that females, in both human and non-human species, have a longer lifespan?

Answer 7

Having 2 X chromosomes may be a health advantage > sex chromosomes sometimes carry genetic mutations that code for diseases > most sex-linked diseases are passed down through the X chromosome (more genes than the Y) > among people with 2 X chromosomes, if they carry an abnormal, disease producing gene on one X chromosome, the normal gene on the other can override the abnormal gene and prevent expression of the disease

THUS: men are more vulnerable to X-linked diseases than women

Question 8

What is a TELOMERE and how are these related to lifespan?

Answer 8

TELOMERE: disposable DNA sequences at the end of chromosome strands that protect the remaining genes on the chromosomes during cell-division

telomeres get shorter each time a cell divides, until eventually the cell dies when it can no longer divide

telomeres of men and women are the same length at birth, male telomeres seem to shorten faster than women’s, suggesting their cells age faster

Question 9

Describe testosterone influences on longevity.

Answer 9

high doses of experimentally administered testosterone decreased “good” cholesterol (HDL) and increased “bad” cholesterol (LDL), increasing risk of cardiovascular disease

testosterone suppresses the immune system, which can help explain why women have more robust immune systems

Question 10

Describe estrogen influences on longevity.

Answer 10

women who have high levels of estrogen (premenopausal) have less cardiovascular disease and lower blood pressure than age-matched men

estrogen increases cardiac output during the menstrual cycle, mimicking the effect of exercise

increases the expression of longevity associated genes

can increase risk of certain forms of cancer (breast, uterine, ovarian)

Question 11

How has evolution potentially affected longevity in men?

Answer 11

men evolved to pursue a “live hard, die young” strategy bc this results in more offspring, even if it means earlier average age of death

men’s higher concentration of testosterone may reflect evolutionary pressures on men to compete aggressively for mates, but increases vulnerability to infection

testosterone is good for reproduction, bad for long-term health and survival

Question 12

How has evolution potentially affected longevity in women?

Answer 12

women’s bodies contribute more directly to healthy fetal growth and infant nourishment, evolved to invest more energy into fighting disease and repairing damaged cells > slows the aging process

^ may reflect an adaptation to evolutionary pressures on women to gestate and bear healthy, viable children

Question 13

What was the most prevalent link to leading causes of death in 2015, and what is relevant about this regarding sex differences?

Answer 13

to some extent, an individuals behaviours (diet, exercise, alcohol, smoking, drug use)

the more behaviour contributes to a given cause of death, the larger the sex difference in rates of death from that cause

Question 14

Describe the relevance of risky behaviour in men’s health and longevity.

Answer 14

accidental deaths are the 4th leading cause of death for men in the US (7th for women)

workplace injuries, risky tasks at home, more accident-prone leisure activities, more likely to own a gun, more likely to drive recklessly

Question 15

How is HIV related to men’s health and longevity?

Answer 15

in the US, 81% of annual new cases of HIV occur among men (though globally, women account for about half of all cases)

among men, most cases of transmission occur during same-sex activity (However trans women are included in this group)

Question 16

What is a RISK NETWORK?

Answer 16

extended networks of individuals with whom people have sexual contact or engage in other risky practices (IV drug use) that can transmit disease

Question 17

What are HIGHLY ACTIVE ANTIRETROVIRAL THERAPIES (HAARTs)?

Answer 17

drug treatments, usually consisting of a combination of at least 3 drugs, that suppress HIV replication

not everyone in the world can afford or access these

have an ironic consequence of increasing people’s risky sex tendencies

Question 18

What are the effects of smoking on men’s longevity?

Answer 18

5x as many men as women smoke globally
8.5x as many men are “hardcore smokers”

smoking is declining globally, as are the sex differences

women have a harder time quitting smoking > more likely to be using it to control weight

Question 19

What are the effects of alcohol use on male longevity?

Answer 19

the sex difference has narrowed in recent years, though still favours men

more men drink than women, globally

men are more likely to binge drink, and become dependent on alcohol

men in the US account for 77% of alcohol related deaths

Question 20

How does diet affect male longevity?

Answer 20

on average, men eat more meat, high fat, and salty foods

could be due to powerful cross-cultural stereotypes about food and diets > masculinity is associated with red meat, alcohol; men might view eating healthy, low-fat foods as insufficiently masculine

Question 21

How does physical activity influence longevity and health for each of the sexes?

Answer 21

boys and men tend to demonstrate more physical activity

women are slightly more likely to be classified as inactive by not meeting minimum activity guidelines

inactivity is related to the income of a country > wealthier nations tend to be more industrialized, technologically advanced, people’s jobs involve less physical labour, more public transit is available

inactivity increases with age

Question 22

How do personality traits relate to longevity and health for each of the sexes?

Answer 22

people high in agentic traits tend to have fewer physical symptoms and better adjustments to illnesses than those lower in agency

people who display stronger preferences for male-typical occupations are more likely to die at any given age

Question 23

What is UNMITIGATED AGENCY and how does it relate to health and longevity?

Answer 23

a tendency to focus on the self to the neglect of others

people high in this trait behave inappropriately with others, have a mistrusting and negative view&raquo_space; interpersonal conflict, difficult to rely on others for social support

engage in more negative health behaviours like smoking, drinking, and drug use
lack healthy social skills
correlate with negative physical health outcomes like depression, hostility and tension

Question 24

What is UNMITIGATED COMMUNION and how does it relate to health and longevity?

Answer 24

a tendency to focus others to the neglect of the self

prone to physical and psychological symptoms of illness, including depression and anxiety

exerting lots of energy over supporting others is stressful, taxing, compromises the immune system
compounds stress and worry
avoid focusing on themselves and ignore their own health

Question 25

What is important to remember about unmitigated agency and communion?

Answer 25

the correlation with sex for either of these traits is not perfect; both men and women can be high in either trait and these tendencies sometimes override sex in predicting health problems

Question 26

Describe the sex differences we observe in accessing/seeking health care.

Answer 26

men do not attend to routine health care needs as conscientiously as women; sex and gender also influence the quality of health care that people receive from doctors

women are more likely to visit the doctor in the US, more likely to have a personal physician or regular place to receive healthcare ; more likely to schedule regular checkups even when they are well

Question 27

What are some of the possible implications regarding sex differences in seeking/accessing healthcare?

Answer 27

women are possibly sicker, which aligns with the self-report tendency of poorer health

women could be using routine doctor visits to address reproductive needs

people expect men to be stoic, not seek help, which may discourage them from seeking health-related help

men who endorse more traditional beliefs about masculinity are more likely to postpone seeking medical help

men are more likely to choose male doctors, though they communicate more openly with female doctors

Question 28

Describe the self-reinforcing cycle of men attending the doctor.

Answer 28

the less men attend the doctor, the less comfortable they will feel, and the less their health problems will be addressed

Question 29

What is IMPLICIT PHYSICIAN BIAS?

Answer 29

automatic, nonconscious judgements and behaviours exhibited by doctors that are elicited by patients’ sex, race, age, sexual orientation and social class

Question 30

What are some examples of how implicit physician bias affects health care and outcomes?

Answer 30

a doctor might be more likely to diagnose a woman presenting with stress, lack of appetite, and fatigue with depression than men due to stereotypes linking women to depression more often than men&raquo_space; men’s depression goes untreated

women’s reports of chronic pain are sometimes met with skepticism, doctors assume the cause is psychological, compared with men

Question 31

How does the sex of a physician potentially influence health care practices?

Answer 31

female primary care physicians tend to have longer visits with their patients, engage in more patient-centred communication&raquo_space; men who have male physicians may not benefit from this type of approach

Question 32

What trends do we observe regarding health status and illness behaviours in the Israeli Kibbutz societies?

Answer 32

work and social roles reflect socialist principles, community members pursue gender-egalitarian lifestyles

studies find no sex differences in health status or illness behaviours like doctors visits and medication use; much small sex differences in life expectancy, which is also reflected in communities of nuns and monks

social behaviours and lifestyles can influence the size of sex differences in health and longevity BUT women still have the advantages, so biology also maintains a role

Question 33

What is the FEMINIZATION OF POVERTY?

Answer 33

the global tendency for women to experience the disproportionate rates of poverty

Question 34

How are women affected by the feminization of poverty?

Answer 34

face acute reproductive health obstacles that can perpetuate low socioeconomic status

use contraception less often, receive less education in preventing STDs, less access to maternal health services

frequently become mothers under the age of 18, which reduces the changes that they will get an education, obtain financial autonomy, and move out of poverty

Question 35

What is MINORITY STRESS THEORY?

Answer 35

a theory that proposes that belonging to a stigmatized group can create stressors that are unique to the minority experience

increases people’s reliance on unhealthy coping behaviours
overburdens the body’s stress response and immune system

Question 36

How are LGBTQ+ people specifically affected by minority stress theory in the healthcare system?

Answer 36

report more chronic worry and tension, exhibit more risky health behaviours

less likely to have health insurance bc of historical ignorance of same-sex partnerships

doctors may lack an understanding of the unique health needs

concerns about disclosing personal information to doctors due to stigma and internalized homo/transphobia

Question 37

What is GYNECOLOGY?

Answer 37

the branch of medicine that studies female health, with a particular focus on reproductive health

Question 38

What is ANDROLOGY?

Answer 38

the branch of medicine that studies men’s health, with a particular focus on the sexual/reproductive organs and urinary system

Question 39

What is RETT SYNDROME?

Answer 39

a neurological disorder linked to a mutation on the X chromosome and characterized by seizures, language impairments, and difficulty breathing and mobility

male embryos that carry this syndrome typically die in utero and female embryos will survive with a less severe form of the disease

Question 40

What sex differences to we see in regards to cancer?

Answer 40

men are more likely to be diagnosed with and die from cancer

the efficacy and toxicity of several commonly used chemotherapy drugs can differ by sex, doctors need to consider these when developing treatment plans

both men and women can develop breast cancer, but rates are significantly higher in women; bc it is perceived as a female disease, men might avoid seeking help when receiving a diagnosis or indicator

Question 41

What is PMS?

Answer 41

a diagnosable illness consisting of a number of symptoms that occurs monthly before the onset of menstruation

Question 42

What has been the result of medicalizing PMS?

Answer 42

it is normal for women to experience these and other changes as the natural fluctuation of hormone levels in the body occurs during menstruation

75% of women would meet the diagnostic criteria for PMS if they sought a diagnosis

labeling a woman’s normal reproductive cycle as an illness encourages a view of women’s bodies as regularly sick and unable to function

Question 43

What contemporary trends and effects do we observe around C-Sections?

Answer 43

rates of c-sections are increasing worldwide

c-sections carry the risks of any major surgery, involve painful recovery

women have less satisfaction with the birth experience, take longer to bond with infants, less likely to breastfeed, and interact less with their infants when they return home

Question 44

What are some relevant statistics regarding C-Sections, contemporarily?

Answer 44

rates have risen from 20% in 1996 to around 33% currently

WHO recommends a rate of 15%; Canada and the US both trying to reduce rates

Question 45

What are possible reasons for the rise in C-Section use?

Answer 45

the birthing process has moved to the hospital and the hands of doctors rather than midwives, as was done historically

many women now fear childbirth due to its portrayal in the media as painful and risky, and wish to pass that process off to their doctors to determine

Question 46

What other birthing related medical procedures are often performed more than necessary and what are the consequences of this?

Answer 46

labour induction, fetal heart monitoring, ultrasound exams, epidural analgesia, episiotomies

costly and increasing risk of harm and medical complications