Gender: gender/sex-related health inequalities

Asthma

In 2012/13 Practice Team Information data showed the national prevalence of asthma was 4.3% for men and 5.7% for women. Prevalence was defined as cases who attended their doctor at least once in the previous year. Further information is available in our Asthma: primary care data page.

Autistic spectrum disorder 

Autism Spectrum Disorder (ASD) occurs considerably more in males than in females at a generally accepted male to female prevalence ratio of approximately 4:1 (Fombonne 1999). This ratio varies across the autistic spectrum (Ehlers & Gillberg 1993, Wing & Gould 1979). There is debate about the extent to which this ratio is a consequence of gender differences in underlying prevalence or gender differences in diagnostic practice (see the National Autistic Society's summary of gender and autism). Using 2011 Census data, the Scottish Learning Disability Observatory estimate that 1.9% of children aged 0-15 years in Scotland have ASD, 3.0% of boys and 0.8% of girls. The corresponding figures for adults aged 16 years and over are 0.3% overall, 0.5% of men and 0.2% of women. See the Public Health Institute of Scotland needs assessment on Autistic Spectrum Disorder (2001) (2Mb) and follow up implementation report (Scottish Government 2006).

Autoimmune disorders

Overall, the incidence of most autoimmune disorders is higher in women than men (Ngo et al 2014). Specific examples include Rheumatoid Arthritis (RA), which is two to four times greater in women than men (NICE 2018), and Multiple Sclerosis, which has an estimated female:male incidence ratio in Scotland of 2.3:1 (incidence ratio estimate comes from the 2016 Scottish Multiple Sclerosis Register report; the register has been recording new confirmed MS diagnoses in Scotland since January 2010 and currently estimates a mean annual incidence rate for 2010-2015 of 8.55 per 100,000 population). For further information, see our Multiple Sclerosis section.

Cancer

One in eight women in Scotland will develop breast cancer during their lifetime (ISD Cancer Statistics). Breast cancer is the most common cancer in women in Scotland accounting for almost 30% of all female cancers diagnosed, excluding non-melanoma skin cancer (2017). In Scotland, 5-year relative survival is 82.8%. Further information is available in our Breast cancer section.

An estimated one in 10 men develop prostate cancer during their lifetime (ISD Cancer Statistics). Excluding non-melanoma skin cancer, prostate cancer accounts for approximately 22% of all cancers diagnosed in men (2017). 5-year relative survival is 84%. Further information is available in our Prostate cancer section.

An estimated one in 12 men, and one in 13 women develop lung cancer during their lifetime (ISD Cancer Statistics). Excluding non-melanoma skin cancer, lung cancer accounts for approximately 16% of all cancers diagnosed in men, and over 17% of all cancers diagnosed in women (2017). Only about 11% of patients are still alive at five years after diagnosis. In the past decade (2007-2017), the European age-standardised incidence rate of lung cancer decreased by an estimated 18% in men, but increased by 3% in women. Further information is available in our Lung cancer section.

An estimated one in 16 men, and one in 21 women develop colorectal cancer during their lifetime (ISD Cancer Statistics). Excluding non-melanoma skin cancer, colorectal cancer accounts for approximately 14% of all cancers diagnosed in men, and 10% of all cancers diagnosed in women (2017). For both men and women, the relative survival at five years increased from approximately 42% for patients diagnosed during 1987-1991 to approximately 60% for those diagnosed during 2007-2011. Further information is available in our Colorectal cancer section.

Chronic liver disease 

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) mortality was almost four fold greater for men compared to women in 1979. Mortality rates from COPD for women and men have converged over the past 30 years as rates have declined in men and increased in women (reflecting more recent rises in female smoking). However, mortality rates remain higher for men; in 2017 the European age-standardised rates were 65.5 per 100,000 for men and 58.9 per 100,000 for women; see our COPD: mortality page for more information.

Incidence rates are more similar between men and women overall, though rates are somewhat higher for men 75 years and over. Our COPD: primary and secondary care data pages have further detail.

Coronary heart disease

Incidence of coronary heart disease (CHD) is strongly related to age, and rates are consistently higher for men than women across all age groups. The prevalence rate in 2017 was higher in men (6%) than in women (4%) (Scottish Health Survey 2017). See our CHD section for further information.

Diabetes

The Scottish Diabetes Survey provides a national prevalence estimate for 2017 of 5.5%, the majority being Type 2 diabetes. Prevalence of diabetes is not available separately for men and women, however the survey notes that a slightly higher proportion of men are diagnosed with diabetes. The 2018 Scottish Health Survey’s self-reported diabetes estimates were also higher in men (8%) than women (6%). For further information see our Diabetes section.

Disability

In 2018, the Scottish Health Survey estimated that 30% of men and 36% of women (aged 16 years and over) in Scotland had a limiting long-term physical or mental health condition or illness, while 8% of both men and women self-rated their health as 'bad' or 'very bad'. See our Disability section for more information.

Epilepsy

The incidence of epilepsy has consistently been higher for men than for women, though the gender gap has decreased over time as the incidence rate has fallen faster in men than in women (see our Epilepsy section). Data from 2012/13 show that GP consultation rates increase with age and fluctuate between men and women, but among those aged 75 and over men have substantially higher rates than women. See ISD’s Practice Team Information website for epilepsy.

Hepatitis C

In 2018, 67% of new cases of Hepatitis C in Scotland were among men with 33% among women (Surveillance of hepatitis C testing, diagnosis and treatment in Scotland, 2019 update). Further information is available in our Hepatitis C section.

Injuries

In 2017/18 rates of emergency hospital admissions as a result of unintentional injury were higher in men than women for those aged under 65 years. For those aged 65-74 years the rates for the two sexes were similar, but were much higher in women than men aged 75 years and over (ISD Unintentional Injuries). For further information see our Injuries section.

Mental health and wellbeing

In 2018, self-reported wellbeing measured using the mean score from the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was similar for men and women (49.3 and 49.6 respectively). Using the GHQ-12 questionnaire as a measure of mental distress or mental ill-health, women show a greater tendency to demonstrate greater mental ill-health than men, although this difference was not significant in 2018 (Scottish Health Survey 2018).  Further information is available in our Mental Health section.

Osteoporosis

Osteoporosis affects both men and women and is a major risk factor for bone fractures. In 2012, women in Scotland had more than twice the rate of fracture than men in the over 50 years age group. Incidence increases with age, and it is particularly common in postmenopausal women. See SIGN Guideline 142 for more information. 

Sexually transmitted infections

More men than women present to sexual health clinics with new acute sexually transmitted infections (STIs). The number of diagnoses of syphilis, gonorrhoea and HIV  is higher in men than women while the number of diagnoses of chlamydia is greater in women (Blood borne viruses and sexually transmitted infections. Scotland, 2017).  See our Sexual health: STI page.

Stroke

Overall the incidence of stroke has declined in Scotland over the last decade but remains consistently higher for men than women across all age groups (ISD Cerebrovascular Disease Incidence). However, death from stroke is more common for women than men (ISD Cerebrovascular Disease Mortality). For further information please see our Stroke section.

Suicide and self-harm

In 2018, Scottish suicide rates were around three times higher for men than women; there is further information on our Suicide section.

If suicide attempts or serious intentional self-harm were taken into account, then the picture would be somewhat different, as self-harm presentations to general hospitals have been found to be higher for women than men (Multicentre Study of self harm in England 2007). Data on self-reported suicide attempts collected since 2008 in Scotland have consistently shown women to report higher rates of attempts than men (7% and 5%, respectively (Scottish Health Survey, 2016/17 combined)).