Gender Differences in Health and Health Expectancies of Older Adults in Singapore: An Examination of Diseases, Impairments, and Functional Disabilities

Abstract

Using a nationally representative sample of 4,511 Singaporeans aged 55+ from the 2005 National Survey of Senior Citizens (NSSC), this paper examines gender differences in specific diseases, impairments, and disabilities, and computes health expectancies for these health dimensions. Results show that women have higher prevalence for hypertension, bone/joint, eye/vision, and walking problems, while heart diseases and stroke are more common among men, particularly at younger ages. At ages 75+, women have more disabilities related to basic activities of daily living (bathing, dressing, toileting, transferring, and feeding) than men. Health expectancies computations by the Sullivan method reveal that while women live longer than men, they can also expect more years of life both without and with diseases, impairments, and disabilities. At age 65, a larger proportion of women's remaining life is with hypertension, bone/joint problems, vision impairments, walking difficulties, and functional disabilities compared to same-aged men. The findings largely support the gender health-survival paradox found in Western countries--that women have higher morbidity rates despite longer life expectancy. The morbidity differences between men and women, however, vary depending on the particular health dimension and measure examined. Older women in Singapore tend to be advantaged in prevalence of diseases and disease-free life expectancy, but have more impairments and functional disabilities, and a larger proportion of remaining life with these difficulties compared to older men. Health policies and programs in Singapore will need to cater to these gender differences in specific health dimensions and measures.

Older adults' self-rated health and differences by age and gender: A quantitative study

“…A larger proportion of females than males aged 65-79 years reported that they had trouble sleeping due to anxiety, feeling tense, not managing their problems, feeling dejected and depressed, and losing faith in themselves. This is consistent with Yong et al [22], who reported poorer mental health among older females compared with males. The prevalence of mental diseases among older adults is common and increasing rapidly [29].…”

“…This result agrees with several national studies reporting that women rate their health as being poorer than do men [21,22]. Af Sillén et al [10] indicate that males compare their health mainly to that of other males, who they often deem as having poorer health than their own.…”

“…A larger proportion of females than males stated that they had some difficulty with movement. Yong et al [22] showed gender differences in poorer walking and position transitions among females 75 years and older. In the current study, few participants aged 65-79 years needed help with their daily hygiene but the rate increased for both males and females aged 80-84 years.…”

Women's higher health risks in the obesogenic environment: a gender nutrition approach to metabolic dimorphism with predictive, preventive, and personalised medicine

“…A gender health-survival paradox of women's higher morbidity rates despite longer LE—as found in Western countries—is also found in Singapore, where at age 65, women's remaining life yields more disabilities, such as hypertension, bone/joint problems, walking difficulties, and visual and functional impairments compared to same-aged men [10]. The above and further population studies show that women's HLE is compromised beyond their declining longevity, which may necessitate specific preventive strategies.…”

“…This may be especially critical in females, given their innate tendency toward fat accumulation and risks from nutrient-exhausting pregnancy/lactation, and resultant deficiency disorders [4-6]. This new metabolic ‘mismatch’ in women could greatly contribute to the recent decline in the gender gap in life expectancy (LE) and in healthy LE (HLE), associated with a slowed increase in female LE and HLE compared to males [7-10] (Figure 2), that is gradually narrowing the gender gap [11,12] resulting from increases in the environmental burden on women's health and consequently on the healthcare system.…”