An examination of gender disparities in functional health limitations

Evidence shows the female disadvantage in functional limitations increases with age. The purpose of this research is to examine gender differentials in trajectories of functional health, which includes activities such as walking, climbing stairs, getting up from a chair, etc., as well as to assess the extent to which gender differences can be explained by various social structural, behavioral, psychosocial, childhood, and other health factors. This research includes an extensive set of covariates, including childhood background factors, which have not been used to examine gender differentials in functional heath. This research also improves upon past research by using latent growth curve analyses to examine gender disparities in functional health among older adults. The data come from seven waves (1992-2004) of the Health and Retirement Study (HRS), which is a U.S. panel study of health, retirement, and aging sponsored by the National Institute on Aging. Because the distribution of functional limitations includes many zeros, two-part modeling for semicontinuous outcomes is performed. There are significant gender differences in the odds of having any functional limitations, as well as in the mean number of functional limitations at baseline. For males and females, self-rated health, obesity, depression, and morbidity are significantly related to the odds of having functional limitations and to the number of limitations at baseline. While the effect of being a current smoker on having limitations and on the number of limitations at baseline is significant for males and females, the effect of being a former smoker is significant for females only. For females, divorce, physical activity, and childhood socioeconomic status are negatively related to having any limitations. Physical activity is negatively related to the number of limitations at baseline for males and females. Being underweight is positively related to the number of limitations at baseline for males, while being overweight is positively related to the number of limitations for females. Education and total household income are significant predictors of having functional limitations and the number of limitations at baseline for males, while net wealth is significant for females. These results show childhood factors are more important for females compared to males. Structural, behavioral, psychosocial, and health factors are important for males and females. However, the significance and strength of these effects vary by indicator suggesting the importance of separating the effects of each set of covariates in order to more thoroughly understand how each impacts gender differences in health.