Sex differences in reports of illness and disability: a further test of the fixed role hypothesis.

Data from a longitudinal study of adult health behavior (N = 1088) were used to test the 'fixed role' hypothesis as an explanation for sex differences in reports of illness and disability. According to this hypothesis, the traditional female excess in reported morbidity is due to females having more flexible role obligations than men--thus making it easier for women to adopt the sick role. In this analysis, regression techniques were used to examine sex differentials in reports of both 'symptom episodes' and bed days, while controlling statistically for fixed roles such as employment status, head of household and % contribution to the total family income. Our findings showed that the three fixed role measures did not explain sex differences in reports of symptom episodes or total bed days (N = 1088). However, among people reporting at least one bed day (N = 503), such obligations did explain the female excess in reported bed days. These findings suggest that fixed role obligations may play a larger role in determining when to relinquish the sick role as opposed to its adoption. These analyses also suggest that role obligations associated with employment status have the major influence on such sick role behavior.