Sex differences in child and adolescent physical morbidity: cohort study

Abstract

BackgroundEvidence on sex differences in physical morbidity in childhood and adolescence is based largely on studies employing single/few physical morbidity measures and different informants. We describe sex differences in a wide range of parent/carer-reported physical morbidity measures between ages 4 and 13 years to determine evidence for a generalised pattern of an emerging/increasing female ‘excess’.MethodsParents/carers (approximately 90% mothers) of the population-based UK ALSPAC cohort provided data on general health, physical conditions/symptoms and infections in their child approximately annually between ages 4 and 13. Logistic regression analyses determined the odds of each morbidity measure being reported in respect of females (vs males) at each age and the sex-by-age interaction, to investigate any changing sex difference with age.ResultsSix measures (general health past year/month, high temperature, rash, eye and ear infections) demonstrated an emerging female ‘excess’, and six (earache, stomach-ache, headache, lice/scabies, cold sores, urinary infections) an increasing female ‘excess’; one (breathlessness) showed a disappearing male ‘excess’. Just two showed either an emerging or increasing male ‘excess’. Most changes were evident during childhood (prepuberty). Six measures showed consistent female ‘excesses’ and four consistent male ‘excesses’. Few measures showed no sex differences throughout this period of childhood/early adolescence.ConclusionSex differences are evident for a wide range of parent-reported physical morbidity measures in childhood and early adolescence. Far more measures showed an emerging/increasing female ‘excess’ than an emerging/increasing male ‘excess’. Further studies are required to examine whether patterns differ across sociodemographic/cultural groups, and to explain this generalised pattern.

Self-protection as an adaptive female strategy

“…44, 1.88, 2.70], stomachaches [ORs=1.64, 2.00, 2.31], and backaches [ORs=1.16, 1.24, 1.28] (Cavallo et al, 2006). Likewise, the English ALSPAC study found that beginning with the youngest children in their study (age 4 years), girls reported more headaches, stomachaches and earaches than boys did (Sweeting et al, 2017). Chronic pain also was reported in childhood by females more than males (Fillingim et al, 2009).…”

“…In a large study of Norwegian adolescents (n=10,000, ages 17-19 years), 47% of girls versus 21% of boys [OR=3.34] reported at least one weekly health complaint (Myrtveit Saether et al, 2018) (Cavallo et al, 2006). Likewise in the Avon Longitudinal Study of Parents and Children (ALSPAC) (n>13,900), pregnant women in 1991-1992 in Southwestern England were recruited and later asked to report symptoms experienced by their 4-13 year-old children (Sweeting et al, 2017). From 4 years onwards, more girls than boys experienced colds, cold sores, tonsillitis, urinary infections, earaches, headaches, stomachaches, worm infections, head lice or scabies, constipation, and eczema.…”

An expanded “staying alive” theory (SAT) underplays complexity in Homo sapiens

“…The WHO HBSC study in 32 countries in Europe, North America, and Israel (n > 150,000) found that more girls than boys experienced headaches at age 11, 13, and 15 years respectively (ORs = 1.44, 1.88, 2.70), stomachaches (ORs = 1.64, 2.00, 2.31), and backaches (ORs = 1.16, 1.24, 1.28) (Cavallo et al, 2006). Likewise, the English ALSPAC study found that beginning with the youngest children in their study (age 4 years), girls reported more headaches, stomachaches, and earaches than boys did (Sweeting et al, 2017). Chronic pain also was reported in childhood by females more than males .…”

“…Employing the Health Behaviour in School-Aged Children (HBSC) scale, a WHO study in 32 countries in Europe and North America plus Israel (n = 1,500 each nation at ages 11, 13, and 15 years, n > 150,000) found that girls reported poorer general health than boys at ages 11 (OR = 1.36), 13 (OR = 1.68), and 15 years (OR = 1.97) (Cavallo et al, 2006). Likewise in the Avon Longitudinal Study of Parents and Children (ALSPAC) (n > 13,900), pregnant women in 1991-1992 in Southwestern England were recruited and later asked to report symptoms experienced by their 4-13-year-old children (Sweeting, Whitley, Teyhan, & Hunt, 2017). From 4 years onwards, more girls than boys experienced colds, cold sores, tonsillitis, urinary infections, earaches, headaches, stomachaches, worm infections, head lice or scabies, constipation, and eczema.…”

Staying alive includes adaptations for catalyzing cooperation

“…Employing the Health Behaviour in School-Aged Children (HBSC) scale, a WHO study in 32 countries in Europe and North America plus Israel (n = 1,500 each nation at ages 11, 13, and 15 years, n > 150,000) found that girls reported poorer general health than boys at ages 11 (OR = 1.36), 13 (OR = 1.68), and 15 years (OR = 1.97) (Cavallo et al, 2006). Likewise in the Avon Longitudinal Study of Parents and Children (ALSPAC) (n > 13,900), pregnant women in 1991-1992 in Southwestern England were recruited and later asked to report symptoms experienced by their 4-13-year-old children (Sweeting, Whitley, Teyhan, & Hunt, 2017). From 4 years onwards, more girls than boys experienced colds, cold sores, tonsillitis, urinary infections, earaches, headaches, stomachaches, worm infections, head lice or scabies, constipation, and eczema.…”