Gender differences in health and medical care: Thailand.

Abstract

This dissertation examines the determinants of the gender difference in reported morbidity and the use of medical care in Thailand to examine why women are more likely to report illness than men but live longer. Health status was measured by self reports of illness in the past month for persons aged 15 and older using the 1985 Mortality and Morbidity Survey. Use of medical care was measured by self reports of using non-traditional practitioners. A gender difference of about two percentage points was found. Several explanations for the higher rates of illness among women were examined. An indirect measure of whether the respondent answered the illness questions him or herself versus having a proxy report had the strongest influence on the gender difference in reported morbidity, causing gender to loose its predictive power. Educational and occupational status partially explained the gender difference, although it appears that with respect to occupational status, the main mechanism influencing the gender difference in reported morbidity is the selection of ill men out of the labor force. Holding constant marital status and being a woman of reproductive age did not influence the gender difference in reported morbidity. There were no important gender differences in the reporting of life-threatening versus non-life-threatening illnesses. The severity of the condition does not help to explain why women are more likely to report illness but live longer than men. Among those who were identified as ill in the past month, women reported more use of medical care than men. Thus, women might be more inclined to get their health conditions treated and therefore, may be less likely to experience mortality. Several recommendations are made to reduce the influence of reporting behavior and selection effects in future studies of gender differences in health. In particular, assuring that studies ask men and women directly about their health status is critical. Accurate measures of the mechanisms that are thought to influence health differently for men and women are also important to collect. Finally, it is important to collect information that will facilitate making conclusions about causality.