Gender differences in trajectories of health limitations and subsequent mortality. A study based on the German Socioeconomic Panel 1995-2001 with a mortality follow-up 2002-2005.

OBJECTIVES: Although research on health limitations has investigated gender differences in health and mortality, gender differentials in individual-level trajectories have been studied less frequently. Moreover, there are no studies on the relationship between course types and subsequent mortality. We investigate course types, explore confounding by socioeconomic and demographic correlates, and pose the question of whether the gender gap in morbidity results from differences in the onset of, and/or survival with, health limitations.
METHODS: Using the German Socioeconomic Panel, we identify individual trajectories of health limitations and use multinomial logistic regressions to explore confounding and the relationship with mortality.
RESULTS: The frequency of stable trajectories without limitations is lower among women because they tend to experience courses that involve extended periods of limitations and deteriorating health. Women also experience more frequently improvement after deterioration. The female mortality advantage is particularly large after health deterioration. DISCUSSION: Health limitations do not make men and women more equal in the face of death. Our results are consistent with earlier studies showing that mortality selection and differences in chronic conditions may explain the gender gap in health and mortality. We extend previous research showing that the female health disadvantage is largely the result of their mortality advantage.