Gender Differences in Hazard Rate Affecting Death in the Elderly Population in Taiwan

Abstract

As the age-specific mortality of women is lower than that of men, feminization of later life is becoming common in all societies. Although elderly women enjoy lower mortality, the health status of women is not necessarily better than that of men. In this study, the mortality change, characteristics of the elderly population, and the trend of feminization in later life in Taiwan was reviewed. Various measures which are used to analyze the gender differences of health status among Taiwan's elderly, and estimation of the effects of factors influencing health were discussed using data from The Survey of Health and Living Status of the Elderly in Taiwan, published by The Department of Health in the Bureau of Health Promotion. The patterns of diseases, functional status, self-rated health and causal relationships among them were also investigated. The hazard rate model was employed to compare the dynamics of health and the functional status for men and women. The probability of being institutionalized and/or death for women is lower than for men for all functional status. However, the health status of women is not significantly better than men. Elderly women are less affected by fatal diseases but have more benign diseases restricting motion and function, which unexpectedly extends the effects of being more cautious, and, therefore, women live longer. The influence of self-rated health and functional status to hazard rate of death for both genders was equivalent and coincides with what was previously anticipated.

Healthy Behaviors and Onset of Functional Disability in Older Adults: Results of a National Longitudinal Study

“…A longer life expectancy for women (79.3 years) than for men (73.4 years) in 2006 1 indicates more years of functional disability for women than for men. Cumulative disadvantages in socioeconomic status 7 and a greater likelihood of having benign diseases that restrict motion 42 may partly explain the greater female functional disability in later life. The study design did not allow whether multiple healthy behaviors affect the number of years with functional disability to be tested.…”

Event History Analysis of Factors Affecting Survival of Older Adults in Taiwan

“…These studies found that the risk of stroke was higher in people who were active smokers, and people who chewed betel nut in the past had a higher mortality rate due to cardiovascular diseases [ 18 , 19 , 20 ]. Ho [ 21 ] and Wang [ 22 ] examined the relationship between gender, medical behavior, and survival rate, pointing out that the risk of death was lower in women than that in men and that subjects with a longer length of hospitalization and more outpatient visits had a lower survival rate. Moreover, the presence of a spouse could reduce the risk of death in older adults [ 22 , 23 ].…”

“…Ho [ 21 ] and Wang [ 22 ] examined the relationship between gender, medical behavior, and survival rate, pointing out that the risk of death was lower in women than that in men and that subjects with a longer length of hospitalization and more outpatient visits had a lower survival rate. Moreover, the presence of a spouse could reduce the risk of death in older adults [ 22 , 23 ]. Hsu [ 24 ] and Lan et al [ 25 ] examined the relationships between death risk, social participation, and sleep.…”

“…It has been shown that the disease status of older adults is associated with health status and survival rate and this could be used as one of the main measurement methods of health status in older adults [ 22 ]. Anderson et al [ 26 ] emphasized that the probability of death did not increase with more comorbidities in older adults, and that mobility is a predictor of increased survival in older adults.…”

The Determinants of Income for the Elderly in Taiwan

“…Since the 1980s, the public has looked forward to the establishment of a national pension program. In the 1990s, the public required more resources from the government to set up a social security program for the elderly (Wang, 2006).…”