Do men and women differ in their use of healthcare services following serious health problems?
Women generally live longer than men, but at the same time they more often report poorer self-rated health. This so-called male and female health and survival paradox raises a central question: Why do women live longer but feel less healthy?
Our new research provides insight into a possible explanation for this paradox. When individuals experience sudden and severe health shocks such as heart attacks or strokes, men and women show pronounced differences in their use of healthcare services. Using comprehensive Danish health data and a rigorous research design, we find that men substantially increase their use of healthcare services, particularly consultations with general practitioners and the use of statins, in the five years following such events. Women, on the other hand, increase their use of the healthcare system far less, even though they more frequently report poorer health.
Our study is based on nationwide administrative registers that cover virtually all citizens interactions with the Danish universal healthcare system, including consultations with general practitioners, hospital admissions, and the dispensing of prescription medications. This extensive data foundation makes it possible to follow men and women over many years and compare their use of healthcare services before and after severe health shocks without relying on survey data or self reported behavior.
The results challenge the widespread assumption that women are generally more active users of the healthcare system. On the contrary, our findings point in the opposite direction when it comes to responses to serious health events. After a heart attack or stroke, mens consultations in general practice increase by roughly seventy two percent relative to the level before the event, whereas the increase for women is around thirty five percent. Men are also far more likely to begin or continue treatment with statins, which is a key preventive treatment after cardiovascular events. The use of statins increases by more than one thousand three hundred percent among men compared to roughly one thousand one hundred fifty percent among women. In contrast, the gender difference is smaller for hospital admissions, which are less influenced by personal decisions or clinical judgment. This suggests that the differences primarily arise from variations in health seeking behavior and medical decision making rather than underlying differences in health or access to treatment.
But what might explain this? The answer is complex. Part of the difference reflects mens greater tendency to seek follow up care and collect prescriptions, including statins, but factors on the supply side may also play a role. Women appear to receive these medications less frequently than men even when their medical conditions are comparable. The result is not driven by differences in survival or by the severity of the health shocks, which challenges the assumption that womens longer life expectancy and poorer self reported health automatically lead to more active health seeking behavior. To better understand the gender differences in the use of healthcare services after serious health events, we examine several possible explanations and rule out factors such as differences in survival, household composition, and cohort effects.
It is particularly noteworthy that these differences appear in Denmark, a country with universal healthcare coverage and a high degree of gender equality. This indicates that cultural and behavioral factors play a central role. If such differences exist even in one of the worlds most equal healthcare systems, it is likely that they are even more pronounced in countries where access to treatment depends more heavily on income or insurance.
These findings have important implications for health policy. Targeted strategies that take into account the behavior of men and women after severe health shocks, as well as how healthcare professionals respond to them, can help reduce differences in treatment and improve long term health outcomes for all. More generally, understanding the subtle behavioral and institutional factors behind gender differences in the use of healthcare services is essential for achieving equality in health. Our research urges policymakers, healthcare professionals, and scholars to develop more nuanced and evidence based approaches that address the needs of both men and women.
