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Sex differences in child and adolescent physical morbidity: cohort study
  1. Helen Sweeting1,
  2. Elise Whitley1,
  3. Alison Teyhan2,
  4. Kate Hunt1
  1. 1 MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  2. 2 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to Dr Helen Sweeting; helen.sweeting{at}


Background Evidence on sex differences in physical morbidity in childhood and adolescence is based largely on studies employing single/few physical morbidity measures and different informants. We describe sex differences in a wide range of parent/carer-reported physical morbidity measures between ages 4 and 13 years to determine evidence for a generalised pattern of an emerging/increasing female ‘excess’.

Methods Parents/carers (approximately 90% mothers) of the population-based UK ALSPAC cohort provided data on general health, physical conditions/symptoms and infections in their child approximately annually between ages 4 and 13. Logistic regression analyses determined the odds of each morbidity measure being reported in respect of females (vs males) at each age and the sex-by-age interaction, to investigate any changing sex difference with age.

Results Six measures (general health past year/month, high temperature, rash, eye and ear infections) demonstrated an emerging female ‘excess’, and six (earache, stomach-ache, headache, lice/scabies, cold sores, urinary infections) an increasing female ‘excess’; one (breathlessness) showed a disappearing male ‘excess’. Just two showed either an emerging or increasing male ‘excess’. Most changes were evident during childhood (prepuberty). Six measures showed consistent female ‘excesses’ and four consistent maleexcesses’. Few measures showed no sex differences throughout this period of childhood/early adolescence.

Conclusion Sex differences are evident for a wide range of parent-reported physical morbidity measures in childhood and early adolescence. Far more measures showed an emerging/increasing female ‘excess’ than an emerging/increasing male ‘excess’. Further studies are required to examine whether patterns differ across sociodemographic/cultural groups, and to explain this generalised pattern.

  • adolescent health
  • epidemiology
  • general paediatrics

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  • Contributors HS conceptualised and designed the study with KH, lead the data request and drafted all versions of the manuscript. EW advised on the data request, carried out the analyses, produced the graphical results and commented on all versions of the manuscript. AT advised on the data request, conducted the data extraction and commented on later versions of the manuscript. KH conceptualised and designed the study with HS and commented on all versions of the manuscript. All authors approved the final manuscript as submitted.

  • Funding This work was supported by the UK Medical Research Council, Wellcome Trust and University of Bristol. The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. HS, EW and KH are funded by the UK Medical Research Council MC_UU_12017/12 and MC_UU_12017/13. AT is supported by PEARL (Project to Enhance ALSPAC through Record Linkage), a programme of research funded by the Wellcome Trust (WT086118/Z/08/Z).

  • Competing interests None declared.

  • Ethics approval Ethical approval was obtained from the ALSPAC Law and Ethics Committee and local research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement ALSPAC’s study website includes details of available data via a fully searchable data dictionary ( Our analysis was based on variables which we specifically requested.

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