Dynamic gender differences in reporting work limitations: Comparative evidence from the United States and Europe

The gender gap in self-reported work limitations among individuals aged 50 – 70 has persisted over time and across countries. We investigate whether this gap reflects actual differences in work limitations or variations in reporting styles between genders. Using the anchoring vignettes approach and leveraging vignette survey data from the United States and Europe, we examine how men and women assess the severity of identical work limitations related to pain, cardiovascular health, and depression. Our findings show that men tend to classify identical work limitations as more severe than women. This gender difference in reporting styles is consistent across both the U.S. and Europe and throughout the time periods studied. Once we account for these reporting differences, the gender gap in self-reported work limitations narrows or diminishes. These results have broad implications for research on self-reported work disability and highlight the need for caution when using self-reported measures to assess disability patterns and trends.
Angelini, V., Cavapozzi, D., & Paccagnella, O. (2011). Dynamics of reporting work disability in Europe. Journal of the Royal Statistical Society A, 174(3):621-38. https://doi.org/10.1111/j.1467-985X.2011.00705.x
Au, N., & Lorgelly, P. K. (2014). Anchoring vignettes for health comparisons: An analysis of response consistency. Quality of Life Research, 23(6), 1721-31. https://doi.org/10.1007/s11136-013-0615-2
Babik, I., & Gardner, E.S. (2021). Factors affecting the perception of disability: A developmental perspective. Frontier in Psychology, 12:702166. https://doi.org/10.3389/fpsyg.2021.702166
Bago d’Uva, T., O’Donnell, O., & van Doorslaer, E. (2008). Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans. International Journal of Epidemiology, 37(6):1375-1383. https://doi.org/10.1093/ije/dyn146
Baguley, T., Dunham, G., & Steer, O. (2022). Statistical modelling of vignette data in psychology. British Journal of Psychology, 113(4):1143-1163. https://doi.org/10.1111/bjop.12577
Benyamini, Y., Leventhal, E.A., & Leventhal, H. (2000). Gender differences in processing information for making self-assessments of health. Psychosomatic Medicine, 62(3):354-364. https://doi.org/10.1097/00006842-200005000-00009
Biswas, A., Harbin, S., Irvin, E., Johnston, H., Begum, M., Tiong M., et al. (2022). Differences between men and women in their risk of work injury and disability: A systematic review. American Journal of Industrial Medicine, 65(7):576-588. https://doi.org/10.1002/ajim.23364
Börsch-Supan, A., & Jürges, H. (eds.). (2005). The Survey of Health, Ageing and Retirement in Europe - Methodology. Mannheim: MEA.
Campos-Serna, J., Ronda-Pérez, E., Artazcoz, L., Moen, B.E., & Benavides, F.G. (2013). Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: A systematic review. International Journal for Equity in Health, 12(57):57. https://doi.org/10.1186/1475-9276-12-57
Case, A., & Paxson, C. (2005). Sex differences in morbidity and mortality. Demography, 42:189-214. https://doi.org/10.1353/dem.2005.0011
Crimmins, E.M., Kim, J.K., & Sole-Auro, A. (2011). Gender differences in health: Results from SHARE, ELSA and HRS. European Journal of Public Health, 21:81-91. https://doi.org/10.1093/eurpub/ckq022
Dowd, J.B., & Todd, M. (2011). Does self-reported health bias the measurement of health inequalities in U.S. adults? Evidence using anchoring vignettes from the health and retirement study. Journal of Gerontology: Social Sciences, 66(4):478-489. https://doi.org/10.1093/geronb/gbr050
Failla, M.D., Beach P.A., Atalla, S., Dietrich, M.S., Brueh, S., Cowan, R.C., et al. (2024). Gender differences in pain threshold, unpleasantness, and descending pain modulatory activation across the adult life span: A cross sectional study. The Journal of Pain, 25(4):1059-1069. https://doi.org/10.1016/j.jpain.2023.10.027
GBD 2019 Diseases and Injuries Collaborators. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the global burden of disease study 2019. The Lancet, 396(10258):1204-1222. https://doi.org/10.1016/S0140-6736(20)30925-9
Gee, G. C., & Ford, C. L. (2011). Structural racism and health inequities: Old issues, new directions. Du Bois Rev. 8(1):115-132. https://doi.org/10.1017/S1742058X11000130
Harkness, J. (2005). Share translation procedures and translation assessment. In: Börsch-Supan, A. (ed). The Survey of Health, Aging, and Retirement in Europe - Methodology. Mannheim: Munich Center for the Economics of Aging, p.24-27.
Heiland, F., & Yin, N. (2015). Anchoring vignettes in the Health and Retirement Study: How do medical professionals and disability recipients characterize the severity of work limitations? PLoS One, 10(5):e0126218. https://doi.org/10.1371/journal.pone.0126218
Hiebert, J., Kahris, L., & Seefeldt, K. (2024). Making sense of health-related labor-market exits and disability: Evidence from the American voices project. RSF: The Russell Sage Foundation Journal of the Social Sciences, 10(5):66-83. https://doi.org/10.7758/RSF.2024.10.5.03
Hirve, S., Gómez-Olivé, X., Oti, S., Debpuur, C., Juvekar, S., Tollman, S., Ng, N. (2013). Use of anchoring vignettes to evaluate health reporting behavior amongst adults aged 50 years and above in Africa and Asia – testing assumptions. Glob Health Action, 6(1):21064. https://doi.org/10.3402/gha.v6i0.21064
Hooftman, W.E., Van der Beek, A.J., Bongers, P.M., & Van Mechelen, W. (2009). Is there a gender difference in the effect of work-related physical and psychosocial risk factors on musculoskeletal symptoms and related sickness absence? Scandinavian Journal of Work, Environment and Health, 35(2):85-95. https://doi.org/10.5271/sjweh.1316
Hooftman, W.E., Van Poppel, M.N.M., Van der Beek, A.J., Bongers, P.M., & Van Mechelen, W. (2004). Gender differences in the relations between work-related physical and psychosocial risk factors and musculoskeletal complaints. Scandinavian Journal of Work, Environment and Health, 30(4):261-278. https://doi.org/10.5271/sjweh.794
Hosseinpoor, A.R., Stewart Williams, J., Amin, A., Araujo de Carvalho I., Beard J., Boerma, T., et al. (2012). Social determinants of self-reported health in women and men: Understanding the role of gender in population health. PLoS One, 7(4):e34799. https://doi.org/10.1371/journal.pone.0034799
Jetha, A., Gignac, M.A.M., Ibrahim, S., & Martin Ginis, K.A. (2020). Disability and sex/gender intersections in unmet workplace support needs: Findings from a large Canadian survey of workers. American Journal of Industrial Medicine, 64(2):149-161. https://doi.org/10.1002/ajim.23203
Jürges, H. (2007). True health vs. response styles: Exploring cross-country differences in self-reported health. Health Economics, 16(2):163-78. https://doi.org/10.1002/hec.1134
Kaleta, D., Makowiec-Dabrowska, T., & Jegier, A. (2008). Employment status and self-rated health. International Journal of Occupational Medicine and Environmental Health, 21:227-36. https://doi.org/10.2478/v10001-008-0023-y
Kapteyn, A., Smith, J.P., & Van Soest, A. (2007). Vignettes and self-reported work disability in the US and the Netherlands. American Economic Review, 97(1):461-73. https://doi.org/10.1257/aer.97.1.461
Kapteyn, A., Smith, J.P., & Van Soest, A. (2009). Work Disability, Work, and Justification bias in Europe and the U.S., RAND, Labor and Population Working Paper WR-696. Available from: https://www.rand.org/content/dam/rand/pubs/working_papers/2009/rand_wr696.pdf [Last accessed on 2024 Aug 10].
Keogh, E., Boerner, K.E., & Nwasor, E.O. (2024). Overview of Sex and Gender Differences in Human Pain. IASP Global Year. Fact Sheet. Available from: https://www.iasp-pain. org/wp-content/uploads/2024/06/gender-differences-in-pain-fact-sheet_r1.pdf [Last accessed on 2025 Feb 04].
King, G., Murray, C.J.L., Salomon, J., & Tandon, A. (2004). Enhancing the validity and cross-cultural comparability of measurement in survey research. American Political Science Review, 98:184-191. https://doi.org/10.1017/S000305540400108X
Macintyre, S., Ford, G., & Hunt, K. (1999). Do women ‘over-report’ morbidity? Men’s and women’s responses to structured prompting on a standard question on long-standing illness. Social Science & Medicine, 48(1):89-98. https://doi.org/10.1016/S0277-9536(98)00292-5
Mansyur, C.L., Amick, B.C., Franzini, L., & Roberts, R.E. (2009). Culture and the social context of health inequalities. International Journal of Health Services, 39(1):85-106. https://doi.org/10.2190/HS.39.1.d
Martin, C. (2024). Work limitations. In: Maggino, F. (ed.). Encyclopedia of Quality of Life and Well-Being Research. 2nd ed. Switzerland AG, Cham: Springer, p.7790-7791.
Murray, C.J.L., Ozaltin, E., Tandon, A., Salomon, J., Sadana, R., & Chatterji, S. (2003). Empirical evaluation of the anchoring vignettes approach in health surveys. In: Murray, C.J.L., & Evans, D.B. (eds). Health Systems Performance Assessment: Debates, Methods and Empiricism. Geneva: World Health Organization.
Oksuzyan, A., Shkolnikova, M., Vaupel, J. W., Christensen, K., & Shkolnikov, V. M. (2014). Sex differences in health and mortality in Moscow and Denmark. European Journal of Epidemiology, 29(4):243-52. https://doi.org/10.1007/s10654-014-9893-4
Phillips, S.P., O’Connor, M., & Vafaei, A. (2023). Women suffer but men die: Survey data exploring whether this self-reported health paradox is real or an artefact of gender stereotypes. BMC Public Health, 23(1):94. https://doi.org/10.1186/s12889-023-15011-4
Rice, N., Robone, S., & Smith, P. C. (2011). Analysis of the validity of the vignette approach to correct for heterogeneity in reporting health system responsiveness. European Journal of Health Economics, 12(2):141-162. https://doi.org/10.1007/s10198-010-0235-5
Sarrasanti, N., Donkor, F.K., Santos, C., Tsagkari, M., & Wannous, C. (2020). It’s about time we care about an equitable world: Women’s unpaid care work and COVID-19. IEEE Engineering Management Review, 48(4):37-45. https://doi.org/10.1109/emr.2020.3031313
Servais, M. (2010). Overview of HRS Public Data Files for Cross- Sectional and Longitudinal Analysis. Ann Arbor, Michigan: Institute for Social Research, University of Michigan. Available from: https://hrs.isr.umich.edu/publications/biblio/5835 [Last accessed on 2022 Aug 18].
Steiner, P.M., Atzmüller, C., & Su, D. (2017). Designing valid and reliable vignette experiments for survey research: A case study on the fair gender income gap. Journal of Methods and Measurement in the Social Sciences, 7:52-94. https://doi.org/10.2458/v7i2.20321
Sternthal, M. J., Slopen, N., & Williams, D. R. (2011). Racial disparities in health: How much does stress really matter? Du Bois Rev, 8(1):95-113. https://doi.org/10.1017/S1742058X11000087
United Nations. (2015). Transforming our world: The 2030 Agenda for Sustainable Development. United Nations General Assembly. A/RES/70/1. Available from: https://docs. un.org/en/a/res/70/1 [Last accessed on 2024 Dec 28].
Vanajan, A., Bültmann, U., & Henkens, K. (2020). Health-related Work limitations among older workers-the role of flexible work arrangements and organizational climate. The Gerontologist, 60(3):450-459. https://doi.org/10.1093/geront/gnz073
Verbrugge, L.M. (1989). The twain meet: Empirical explanations of sex differences in health and mortality. Journal of Health and Social Behavior, 30:282-304. https://doi.org/10.2307/2136961
Vogel, B., Acevedo, M., Appelman, Y., Bairey Merz, C.N., Chieffo, A., & Figtree, G.A. (2021). The lancet women and cardiovascular disease Commission: Reducing the global burden by 2030. The Lancet, 397(10292):2385-2438. https://doi.org/10.1016/s0140-6736(21)00684-x
Williams, D. R., & Mohammed, S. A. (2013). Racism and health I: Pathways and scientific evidence. American Behavioral Scientist, 57(8):1152-1173. https://doi.org/10.1177/0002764213487340
World Economic Forum. (2023). Global Gender Gap Report 2023. Available from: https:// www.we forum.org / publications/global-gender-gap-report-2023/in-full/ gender-gaps-in-the-workforce [Last accessed on 2024 May 18].
World Health Organization (WHO). (2011). World Report on Disability. WHO: Geneva. Available from: https://www. who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/world-report-on-disability [Last accessed 2025 Jan 09].
Xu, H., & Xie, Y. (2016). Assessing the effectiveness of anchoring vignettes in bias reduction for socioeconomic disparities in self-rated health among Chinese adults. Sociological Methodology, 46(1):84-120. https://doi.org/10.1177/0081175015599808
Yin, N., & Heiland, F. (2017). Disability policies and public views on work disability: A comparative analysis using anchoring vignette data. International Journal of Population Studies, 3(1):42-63. https://doi.org/10.18063/ijps.2017.01.005
Yin, N., & Heiland, F. (2022). Do disability policies shape how people perceive work limitation? An international perspective. Journal of Disability Policy Studies, 33(1):35-45. https://doi.org/10.1177/10442073211010135