Public Health Research Articles

A small sample of population based articles (with links) demonstrating sex and gender differences, and emphasizing the need to include women in public health research and disaggregate data by sex.

BIAS IN PUBLIC HEALTH RESEARCH — Articles about bias in public health research
EPIDEMIOLOGY — Articles showing sex and gender differences in relation to epidemiology
SCREENING, PREVENTION, AND CONTROL — Articles showing sex and gender differences in the domains of screening, prevention, and control
SOCIAL DETERMINANTS OF HEALTH— Articles showing that sex and gender differences should be viewed as a component of the social determinants of health

PubMed Search Tool

PubMed Search Tool For Sex and Gender Content

The Sex and Gender Specific Health website’s resources page contains a PubMed search tool to find articles showing sex and gender differences for health conditions. Basic and advanced PubMed tools are available, as well as instructions for use. Click on Literature Search & Database Resources.

Bias in Public Health Research

Articles about bias in public health research

Research Missing on Women in Sports

March 2017
Sport, exercise and the menstrual cycle: where is the research? AUTHORS: G. Bruinvels, R.J. Burden, et al Despite a decreasing gender gap in exercise participation, there still remains a significant under-representation of women included in sport and exercise medicine research studies.1 A review of 1382 sport and exercise research studies involving over 6 million participants, […]


Articles showing sex and gender differences in relation to epidemiology

Female Disadvantage in U.S. Life Expectancy

October 14, 2016
Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the U.S. Population Authors: Freedman, VA, Wolf, DA, Spillman, BC Abstract: Objectives. To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years).   Methods. We used the 1982 and 2004 National Long […]

Prevalence of Midlife Cardiovascular Diseases Based on Gender

October 26, 2009 
Sex-specific trends in midlife coronary heart disease risk and prevalence. Towfighi, A., Zheng, L., & Ovbiagele, B.  This study aimed to determine sex-specific midlife prevalence of myocardial infarction (MI) and risk of future coronary heart disease. Over the past 2 decades, MI prevalence has increased among midlife women, while declining among similarly aged men. Also, although the risk of future hard cardiovascular events remains higher in midlife men compared with midlife women, the gap has narrowed in recent years. Greater emphasis on vascular risk factor control in midlife women might help mitigate this worrisome trend.

Gender and Chronic Obstructive Pulmonary Disease

August 2, 2007
Gender and chronic obstructive pulmonary disease: why it matters. Han, M. K., Postma, D., Mannino, D. M., Giardino, N. D., Buist, S., Curtis, J. L., & Martinez, F. J. Gender and chronic obstructive pulmonary disease: why it matters The authors present current knowledge regarding how gender influences the epidemiology, diagnosis, and presentation of COPD in addition to physiologic and psychologic impairments and attempt to offer insight into why these differences might exist and how this may influence therapeutic management. Women may actually be at greater risk of smoking-induced lung function impairment, more severe dyspnea, and poorer health status for the same level of tobacco exposure. Nonsmokers with COPD are also more likely to be female. Men and women may be phenotypically different in their response to tobacco smoke, with men being more prone to an emphysematous phenotype and women an airway predominant phenotype.

Sex Differences in Stroke Epidemiology

Sex differences in stroke epidemiology: a systematic review. Appelros, P., Stegmayr, B., & Terént, A.  Worldwide, stroke is more common among men, but women are more severely ill.  Stroke tended to be more severe in women, with a 1-month case fatality of 24.7% compared with 19.7% for men. The mismatch between the sexes is larger than previously described.

Incidence and Prevalence of Rheumatoid Arthritis

February 26, 2010
Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota. Myasoedova, E., Crowson, C. S., Kremers, H. M., Therneau, T. M., & Gabriel, S. E. The incidence of RA in women appears to have increased during the period of time from 1995 to 2007. The reasons for this recent increase are unknown, but environmental factors may play a role. A corresponding increase in the prevalence of RA was also observed.

Psychological Stress and Risk of Dementia

August 1, 2010
Midlife psychological stress and risk of dementia: a 35-year longitudinal population study. Johansson, L., Guo, X., Waern, M., Östling, S., Gustafson, D., Bengtsson, C., & Skoog, I.  Authors found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer’s disease.

Cognitive Impairment Higher in Men

July 31, 2012
Incidence of Mild Cognitive Impairment Differs by subtype and is higher in men.  The Mayo Clinic Study of Aging R.O. Roberts, Y.E. Geda, D.S. Knopman, R.H. Cha, V.S. Pankratz, B.F. Boeve, E.G. Tangalos,  R.J. Ivnik, W.A. Rocca, and R.C. Petersen.   Abstract  Objective: Although incidence […]

Gender Differences with Shingles

January 7, 2004 
Gender difference in the incidence of shingles. Fleming, D. M., Cross, K. W., Cobb, W. A., & Chapman, R. S. Gender-specific age-standardized incidence rates of shingles were calculated for each year and showed a consistent female excess in each of the 8 years (average annual excess 28%).

Melanoma Sex Differences

January 2014
Increasing incidence of melanoma among middle-aged adults: an epidemiologic study in Olmsted County, Minnesota. Lowe, G. C., Saavedra, A., Reed, K. B., Velazquez, A. I., Dronca, R. S., Markovic, S. N., … & Brewer, J. D.  Between 1970 and 2009, age- and sex-adjusted incidence increased significantly over time (P<.001) from 7.9 to 60.0 per 100,000 person-years, with a 24-fold increase in women and a 4.5-fold increase in men. The incidence of cutaneous melanoma among middle-aged adults increased over the past 4 decades, especially in middle-aged women, whereas mortality decreased.

Sex Differences Evident in Cognitive Impairment

January 25, 2012
The incidence of MCI differs by subtype and is higher in men: The Mayo Clinic Study of Aging. Roberts, R. O., Geda, Y. E., Knopman, D. S., Cha, R. H., Pankratz, V. S., Boeve, B. F., … & Petersen, R. C. The incidence rates for mild cognitive impairment (MCI) are substantial. Differences in incidence rates by clinical subtype and by sex, with rates higher in men. This suggests that risk factors for MCI should be investigated separately for aMCI and naMCI, and in men and women.

Glucometabolic Disturbances and Health by Age and Gender

December 28, 2011
The association between glucometabolic disturbances, traditional cardiovascular risk factors and self-rated health by age and gender: A cross-sectional analysis within the Malmö Preventive Project.Leosdottir, M., Willenheimer, R., Persson, M., & Nilsson, P. M. (2011). Author’s observations indicate more pronounced risk factor clustering and worse self-rated health with increased glucometabolic disturbance in older women than in older men.

Screening, Prevention, and Control

Articles showing sex and gender differences in the domains of screening, prevention, and control

Evaluation of the AHA Cardiovascular Disease Prevention Guidelines for Women

February 16, 2010                
Evaluation of the American Heart Association cardiovascular disease prevention guideline for women. Hsia, J., Rodabough, R. J., Manson, J. E., Liu, S., Freiberg, M. S., Graettinger, W., … & Howard, B. V. Risk stratification as proposed in the 2007 AHA guideline is simple, accessible to patients and providers, and identifies cardiovascular risk with accuracy similar to that of the current Framingham algorithm.

Gendered Response to Depression

October 2013                    
The Experience of Symptoms of Depression in Men vs Women Analysis of the National Comorbidity Survey Replication Lisa A. Martin, PhD; Harold W. Neighbors, PhD; Derek M. Griffith,  Abstract Excerpt: Until now, women have been diagnosed with depression twice as often as men. However, men reported higher rates of anger attacks/aggression, substance abuse, and risk taking compared with women. Analyses using the scale that included alternative, male-type symptoms of depression found that a higher proportion of men (26.3%) than women (21.9%) (P=.007) met criteria for depression. Analyses using the scale that included alternative and traditional depression symptoms found that men and women met criteria for depression in equal proportions: 30.6% of men and 33.3% of women (P=.57).

Screening for Osteoporosis

July 20, 2010
Screening for osteoporosis: an update for the US Preventive Services Task Force. Nelson, H. D., Haney, E. M., Dana, T., Bougatsos, C., & Chou, R. Purpose: To determine the effectiveness and harms of osteoporosis screening in reducing fractures for men and postmenopausal women without known previous fractures; the performance of risk-assessment instruments and bone measurement tests in identifying persons with osteoporosis; optimal screening intervals; and the efficacy and harms of medications to reduce primary fractures. Although methods to identify risk for osteoporotic fractures are available and medications to reduce fractures are effective, no trials directly evaluate screening effectiveness, harms, and intervals. For postmenopausal women, bisphosphonates, parathyroid hormone, raloxifene, and estrogen reduce primary vertebral fractures. Trials are lacking for men. Bisphosphonates are not consistently associated with serious adverse events; raloxifene and estrogen increase thromboembolic events; and estrogen causes additional adverse events.

Sex Differences in HIV and Antiretroviral Therapy

August 9, 2010 
Gender-related mortality for HIV-infected patients on highly active antiretroviral therapy (HAART) in rural Uganda.Alibhai, A., Kipp, W., Saunders, L. D., Senthilselvan, A., Kaler, A., Houston, S., … & Rubaale, T. The purpose of this study was to examine gender differences in mortality for human immunodeficiency virus (HIV) patients in rural Western Uganda after six months of highly active antiretroviral therapy (HAART). A higher CD4+ cell count and primary level education were strongly associated with better survival. The association between lower mortality and higher CD4+ levels suggest that males are not accessing treatment early enough and that more concerted efforts need to be made by HAART programs to reach male HIV patients.

Stroke in Women

July 2010
Stroke in women.  Wassertheil-Smoller, S. This article provides an overview of stroke in women and describes modifiable and non-modifiable risk factors. Stroke is the third leading cause of death in women, risk for stroke rises rapidly with age, and the strongest risk factors for stroke are high blood pressure and atrial fibrillation, as well as diabetes and smoking. Death and disability from stroke can be reduced with modification, treatment, and better control of risk factors like hypertension, diabetes and atrial fibrillation.

Quality of Healthcare for Older Women

March, April 2006
What do we know about the Quality of Healthcare Among Seniors? Kosiak B, Sangl J, Correa-de-Araujo R. Agency for Healthcare Research and Quality, Rockville, Maryland, USA. AbstractAs the proportion of the population age 65 and over continues to grow–to a projected 20.5% or 77.2 million by the year 2040–tracking the quality, access, and receipt […]

Social Determinants of Health

Articles showing that sex and gender differences should be viewed as a component of the social determinants of health

Poverty and Gender Bias Lead to Biases in Research

July 1, 2004
The relationship between poverty, gender, and health disparities is multidimensional. Ignoring factors such as socioeconomic class, race and gender leads to biases in both the content and process of research.

Job Status and Hypertension

Gender and sex differences in job status and hypertension  Jane E Clougherty, Ellen A Eisen, Martin D Slade, Ichiro Kawachi, Mark R Cullen.  There are significant risks of hypertension associated with hourly status for women, possibly exacerbated by sociodemographic factors predicting hourly status (eg, single parenthood, low education).

Gender Influences on Worksite Wellness

January 20, 2013
The influence of worksite and employee variables on employee engagement in telephonic health coaching programs: a retrospective multivariate analysis. Grossmeier, J. (2013). This study assessed 11 determinants of health coaching program participation. The study used gender-stratified multivariate logistic regression models. Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

Military Women’s Healthcare

August 26, 2010
A call to action for evidence-based military women’s health care: developing a women’s health research agenda that addresses sex and gender in health and illness.  Trego, L., Wilson, C., & Steele, N. A working group of military women’s health advanced practice nurses (APN) and research experts proposes to address this gap in [sex and gender’ knowledge and practices through sex- and gender-specific research.

Poverty and Gender in Health Research

July 1, 2004
Paying attention to gender and poverty in health research:content and process issues. Piroska Östlin, Gita Sen, & Asha George. Ignoring factors such as socioeconomic class, race and gender leads to biases in both the content and process of research. We use two such factors poverty and gender to illustrate how this occurs. There is a systematic imbalance in medical journals: research into diseases that predominate in the poorest regions of the world is less likely to be published. In addition, the slow recognition of women’s health problems, misdirected and partial approaches to understanding women’s and men’s health, and the dearth of information on how gender interacts with other social determinants continue to limit the content of health research. In the research community these imbalances in content are linked to biases against researchers from poorer regions and women. 

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