Do feminine men have fewer heart attacks?

Context At all ages men have higher rates of coronary heart disease (CHD) than women, although similar proportions of men and women eventually die of CHD. Gender differences in CHD incidenceand mortality are often explained in relation to biological(hormonal) and behavioural risk factors (e.g. smoking), butpsychological factors and broader social constructions of genderare rarely considered.

Objective To examine the relationship between measures of genderrole orientation at baseline in 1988 and mortality from CHDover 17 years (to June 2005).

Design Prospective cohort study linked to national mortality reporting.

Setting Socially varied mainly urban area centred on city of Glasgow in West Central Scotland, UK.

Participants In total, 1551 participants (704 men and 847 women) aged 55 years took part in detailed interviews with nurses trained in survey methods in 1988. These included a wide range of measures of physical development and functioning, self reported health and health behaviour, personal and social circumstances anda measure of gender role orientation (yielding scores for ‘masculinity’and ‘femininity’).

Main outcome measures Mortality from CHD up to June 2005 (88CHD deaths in men; 41 CHD deaths in women).

Results After adjusting for smoking, binge drinking, body mass index, systolic blood pressure, household income and psychologicalwell-being, higher ‘femininity’ scores in men were associated with a lower risk of CHD death (hazards ratio perunit increase in ‘femininity’ score 0.65, 95% CIs0.48–0.87, P = 0.004). No such relationship was observedamongst women. ‘Masculinity’ scores were unrelatedto CHD mortality in either men or women.

Conclusions These results suggest that social constructionsof gender influence the risk of ill health, here death fromCHD. Men who are less able to identify themselves with characteristics identified as ‘feminine’ or expressive (who havea more limited stereotypically masculine self-image) may be at increased risk of coronary disease. Further research on thelink between social constructions of gender and health is needed.

Source: “Decreased risk of death from coronary heart disease amongst men with higher ‘femininity’ scores: a general population cohort study” from International Journal of Epidemiology 2007 36(3):612-620

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