Sex Differences in Health: Evidence and Explanations 359with a health care system that is not sensi-
tive to homosexuality. Over the last decade,
lesbians have become more likely to disclose
their sexual orientation to health care provid-
ers (Roberts et al., 2004). However, the health
care of older sexual minorities is an issue be-
cause older people are less likely to disclose
their sexual orientation (Addis et al., 2009).
What are the implications of heterosex-
ual women’s greater use of medical services for
prevention compared to men? Theoretically,
if women visit the doctor more frequently
than men do, women’s illnesses should be di-
agnosed at an earlier stage than men’s. Early
intervention may keep minor illnesses from
developing into fatal ones. Routine office vis-
its provide physicians with an opportunity to
detect disease and provide patients with an
opportunity to disclose problems. Although
this is a compelling explanation for sex dif-
ferences in mortality, there is no evidence to
show that women’s greater use of health ser-
vices leads to earlier detection of disease. In
fact, heart disease is detected later in women
than men, and women delay longer in seeking
treatment for symptoms of heart disease.Smoking
Smoking has been referred to as the single
most preventable cause of death (American
Cancer Society, 2009). Tobacco accounts for
almost one in five deaths in the United States
and 30% of cancer-related deaths. Smok-
ing is a major cause of heart disease, stroke,
and emphysema. It is also a contributor to at
least 15 different kinds of cancer, including
lung, lip, oral, esophagus, pancreas, kidney,
and stomach. Among men, smoking is as-
sociated with slightly less than a one in two
chance of developing cancer at some point in
life; among women, the rate is slightly more
than one in three. There also are some other
chronic conditions associated with smokingplace because of reproductive issues. Thus,
when it comes to getting a flu shot, getting a
regular physical, and seeking medical atten-
tion in response to a complaint, women are
more likely to have a resource available and
to be familiar with turning to that resource.
Conduct Do Gender 10.2 to find out if your
female and male peers have a physician and
examine their reasons.
One group of women do not receive
greater health care compared to men: lesbians.
Both lesbians and gay men are underserved by
the health care system, in part due to a lack
of health insurance (Johnson, Miamiaga, &
Bradford, 2008). Lesbians are less likely than
heterosexual women to have health insurance
from a spouse’s employment, and lesbian
households have lower income. Although
rates of screening have increased in recent
years for lesbians, screening rates are still
lower than rates for heterosexual women
(Roberts et al., 2004). Both lesbians and gay
men report feeling uncomfortable dealingDO GENDER 10.2
Do You Have a Doctor?Interview 10 female and 10 male college
students to find out if they have a regular
doctor. You might ask, “If you become
sick, is there a specific doctor you would
call?” To really be certain that people have
a physician, you might even ask for the
physician’s name. If a person does not
have a physician, ask why.
Then, interview 20 older adults (10
female, 10 male) and ask the same ques-
tion. You might interview the same stu-
dents’ parents, university staff, or faculty.
Are there sex differences in having a
physician? Does it depend on age? What are
the reasons for not having a physician? Do
men and women provide different reasons?M10_HELG0185_04_SE_C10.indd 359 6/21/11 8:54 AM