Bertrand Desjardins, a researcher in the demography department of the University of Montreal, explains.

Men dying sooner than women makes sense biologically: because 105 males are born for every 100 females, it would assure that there are about the same number of men and women at reproductive ages. But even though women showed a longer life expectancy in almost every human society in the last decade of the 20th century, the size of the advantage varied greatly. For example, in the U.S. male life expectancy was 73.4 years for males and 80.1 years for females, a difference of 6.7 years, whereas in France it was 7.8 years and in the U.K., 5.3 years. The discrepancy was much greater in some countries, with the difference in Russia reaching more than 12 years, but in others, such as India (0.6 year) or Bangladesh (0.1 year), it was much less.

The diversity in worldwide longevity alone indicates that the difference in mortality between the sexes is not purely biological and that there are intervening social factors. The current range of situations actually reflects different stages of a three-part historical evolution. Women most probably have a biological advantage that allows them to live longer, but in the past–and in several places, still today–the status and life conditions of women nullified this benefit. Today, given the general progress in female life conditions, women have not only regained their biological advantage, but have gone much beyond it, both because they tend to engage in fewer behaviors that are bad for health than men do and because they better profit from current advances in health care and living conditions.

The biological advantage that women have is taken as a certainty, because the mortality of males is higher than that of females from the very outset of life: during the first year of life, in the absence of any outside influence which could differentiate mortality between the sexes, male mortality is 25 to 30 percent greater than is female mortality. The genetic advantage of females is evident. When a mutation of one of the genes of the X chromosome occurs, females have a second X to compensate, whereas all genes of the unique X chromosome of males express themselves, even if they are deleterious. More generally, the genetic difference between the sexes is associated with a better resistance to biological aging. Furthermore, female hormones and the role of women in reproduction have been linked to greater longevity. Estrogen, for example, facilitates the elimination of bad cholesterol and thus may offer some protection against heart disease; testosterone, on the other hand, has been linked to violence and risk taking. Finally, the female body has to make reserves to accommodate the needs of pregnancy and breast feeding; this ability has been associated with a greater ability to cope with overeating and eliminating excess food.

Even though many biological and genetic factors have been identified, their overall effect is impossible to measure, especially given the influence of social factors on mortality. The extraordinary economic and social progress that has occurred since the 18th century has been accompanied by a dramatic reduction of the social differences between men and women and of the burden of motherhood, which had previously negated women’s biological advantage. But the recent mortality trends have gone much farther than the mere recovery of an original advantage, creating instead a new advantage of greater magnitude for women. Observations indicate that the growing excess male mortality in industrial countries could be explained by the rise of so-called “man-made diseases,” which are more typically male. These include exposure to the hazards of the workplace in an industrial context, alcoholism, smoking and road accidents, which have indeed increased considerably throughout the 20th century.

But if these diseases are the only explanation for longer female life expectancy, why has the gap continued to grow even though male and female behavior and life conditions have been converging in recent years? Part of the paradox can certainly be explained by the fact that this convergence is not absolute: male smokers tend to smoke more cigarettes than female smokers do, and men drive more recklessly than females drivers, for instance.

French demographer Jacques Vallin has long been monitoring longevity in general and sex differences in mortality in particular. He adds to the above an interesting explanation of women’s current mortality advantage that could explain the more recent trends: the dramatic increase in excess male mortality emerged as an equally dramatic progress in the general health conditions of our societies was taking place. He thus argues that beyond the negative behavioral or environmental factors that affect men more than they do women, there could be very well be a more fundamental difference in lifestyles that allows women to better benefit from the general progress in health. For example, although women now participate massively in the work force, their roles remain different and their professional activities are, on average, less prejudicial to their health. In addition, women often relate to their bodies, their health and their lives in general in a much different way than men do. To caricature, women seek beauty, men seek strength and power; thus, a woman’s body must remain young and healthy as long as possible, whereas a man’s body must be submitted to risks and challenges from an early age. The result is that women, much more than men, are attentive to their bodies and their needs and often carry on deeper dialogs more easily with their doctors. Hence, women, being more inclined to take care of their bodies and to prolong their lives, may be better able to glean greater profit from modern medical and social advances by practicing activities that are healthier and better protect their bodies. In this context, women’s biological advantage now appears relatively minor in the total mortality differences between the sexes.

Why Life Expectancy Is Longer for Women Worldwide

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Today, women are outliving men in every country in the world. That’s right: According to the latest U.S. report, life expectancy for the ladies is 81.2 years compared to 76.4 years for males (sorry, guys!). But even though the fact that women outliving men has become widely accepted as the norm, a new study led by University of California, Los Angeles and University of Southern California researchers shows that this difference in survival rate is actually a relatively recent phenomenon, beginning just in the 20th century. (What affects your mortality risk? These 11 Things You’re Doing Could Shorten Your Life.)

Focusing on mortality in adults over the age of 40, the team analyzed historical data from more than 1,700 individuals born between 1800 and 1935 in 13 developed countries. The researchers found that while mortality rates decreased for both sexes throughout the 19th and 20th centuries, female death rates began decreasing a whopping 70 percent faster than those of males after 1880.

“As infectious disease prevention, improved diets, and other positive health behaviors were adopted by people born during the 1800s and early 1900s, death rates plummeted, but women began reaping the longevity benefits at a much faster rate,” the press release explained.

The biggest culprit for this surge of death rates for men? Heart disease, the study concludes. Even after accounting for deaths due to smoking, cardiovascular disease appears to still be the leading cause of most preventable deaths in men over 40.

“I was very surprised when I looked at the divergence as we got closer to the 1900s. The common belief was that this pattern would be there even in the 1800s, but it wasn’t,” explained lead study author Hiram Beltrán-Sánchez. “Since our biology hasn’t changed over the last one hundred years, we realized there must be some other reason that men are dying at higher rates.”

That other reason? Lifestyle. The increasing rates of cardiovascular disease in men is attributed to health-related behaviors, in particular smoking and a diet high in both calories and saturated fats, says Beltrán-Sánchez. While there is little evidence of biology’s role in this mortality gap between the sexes, there is still a possibility that men may experience an inherent, biological vulnerability to cardiovascular disease, he adds.

It’s not that men are subject to dangers that women are immune to, though, says Clyde Yancy, M.D., chief of cardiology at Northwestern Memorial Hospital. After all, across their lifetime, women and men bare the same risk of heart disease, he explains.

Of course, you can never fully account for genetics, so it all comes down to avoiding three basic dangers that we can control: avoid tobacco, diets high in saturated fat, and inactivity. And that’s advice for the ladies: “Today’s woman is at risk of replicating the history of yesterday’s man by being exposed to these negative influences,” Yancy adds. (Check out the American Heart Association’s “Life’s Simple 7” to get your own health score, and find outWhy the Diseases That Are the Biggest Killers Get the Least Attention.)

The bottom line? Don’t let the stats go to your head. Behavior matters, regardless of your gender.

  • By Kylie Gilbert @KylieMGilbert

Women live longer than men even during severe famines and epidemics

Discussion

The conditions experienced by the people in the analyzed populations were horrific. Even though the crises reduced the female survival advantage in life expectancy, women still survived better than men. In all populations men had equal or higher mortality than women across almost all ages. A substantial part of the overall female advantage in life expectancy was due to survival differences among infants. Further support for the hypothesis of an overall ability of women to withstand high-mortality crises better than men comes from a different mortality measure: For all populations, the extreme age (the age to which 5% of the population survived) was higher for females than for males.

A female survival advantage has also been documented in more recent and less extreme famines. During the Dutch Hunger Winter (33), the famines of Madras and Bombay (34), five south Asian famines, the Bengal famine, and the famine in the Matlab region (35), the overall effect of the crisis was greater for men than for women, even in regions where women usually had higher mortality than men. The Matlab famine did not significantly affect neonatal mortality, which increased only slightly (35). However, data on infants, especially during crises, must be considered with caution: Infants’ deaths could be underreported when mortality increases (during a crisis) because more children die at very young ages, which increases the probability of the death not being reported (36).

In all populations under study, with the partial exception of the Trinidad slaves (in the case of the lower-bound scenario), females lived longer than males. These results indicate an important distinction: In populations that are exposed to harsh famines and epidemics the female survival advantage holds at all ages, whereas in slave populations in which stressors are or have been under some human control, males can have higher life expectancy and lower mortality than females, at least across some ages.

The slaves of Trinidad differ from the other populations in that their age-structure and mortality are heavily influenced by the decisions of the slave owners. Among the Trinidad slaves, young adult men had lower mortality than young women, perhaps because a premium was placed on their survival. Several studies show that male slaves employed in the plantations during the 19th century had a higher monetary value than female slaves (for both creole and African-born slaves) in the United States, Cuba, the British West Indies, and Brazil; only occasionally did female prices exceed those of males, namely, in urban areas, where women were valued for domestic work (37⇓–39). The higher male mortality after age 15 y or age 25 y, depending on whether the upper- or lower-bound scenario is considered, could reflect their harder working conditions. A series of frequent revolts between 1638 and 1838 in the British Caribbean testifies to very tough working conditions (40⇓–42). For example, as late as 1823 the planters of Barbados refused a proposal to give the slaves 1 d off per week, and those of Trinidad and British Guiana rejected a document by the British governor which proposed, among other things, a day off to permit religious instruction and the abolition of the whip; the planters argued that the whip was necessary to maintain discipline, and time for religious duties would merely encourage idleness among the slaves (43). Moreover, to keep sugar mills and boilers operating 24 h a day, slaves could work shifts up to 30 h long (25) while having minimal and inadequate nutrition, affected by periodic severe dietary deprivation and occasional near starvation, as showed by physical anthropological evidence (44). The skeletal and dental analyses suggest an average life expectancy at birth of 29 y for a population of slaves in a sugar plantation of Barbados between 1660 and 1820 (44). However, the authors point out, this estimate was severely biased by the highly inaccurate skeletal estimate of infant survival (95% infant survival against slightly more than 50% obtained from more accurate historical records for the same population) (44), implying that the real life expectancy value was much lower. Finally, the low life expectancy of the slave population of Trinidad could also be the consequence of Trinidad’s being one of the three Caribbean colonies with the most rapidly expanding export sector in the 19th century. The demand for newly arrived slaves was larger in these colonies than in other colonies. Slaves just arrived in the Americas had lower life expectancy than those born there or who had been there already for some time, because of the adaptation period (called “seasoning”) that lasted about 1 y after the arrival (45).

A similar explanation is not available for Liberia, where males had lower mortality than females between ages 35 y and 49 y. Several explanations can be hypothesized. The impossibility of determining the gender for 4% of the records, as mentioned above, might have caused some bias in the sex-specific death rates. A second explanation could be related to the need to establish a stable colony in an initially very hostile environment, which might have favored the individuals considered more important for this purpose, namely, adult men in the most productive ages. Overall males in Liberia still had a lower life expectancy than females because adult ages contributed little to life expectancy, as shown by the age decomposition analysis.

A specific distribution of causes of death could partly explain these patterns, but this appears not to have been the case among the Liberian former slaves. This population is the only one for which we have a detailed list of causes of death. The registration shows that the distribution of causes of death is similar for males and females, except for deaths due to childbirth and gynecological diseases, which obviously affected only women, and deaths due to accident and violence, which were higher among men. This suggests another important point of discussion: that in times of crises, the well-known propensity of men more than women to die from accidents or violence could partly be the cause for their higher mortality. However, this is hard to assess with certainty because of the lack of data on causes of death in all the other cases (and for crisis populations in general). Secondly, if men die more from these causes, women still die from childbirth and gynecological diseases that affect women exclusively, even in a context of reduced fertility such as that characterized by critical mortality conditions.

At the onset of famines and epidemics, the age structures of the populations at risk were shaped by previous mortality, fertility, and migration patterns. The risk of death then suddenly rose to extreme levels for everyone. Under these conditions, the youngest ages contributed the most to sex differences in life expectancy. The importance of infant and early childhood mortality was particularly striking in the two Icelandic epidemics. This was expected, as measles is mostly a childhood disease. Moreover, Iceland is the only case in which mortality increased relatively more for women than for men. This is consistent with the pattern of sex difference in measles survival: Excess female measles mortality is found worldwide (46), even with equal vaccination rates for both sexes, lower incidence of measles for girls than for boys, and higher and longer-persisting antibody titers on vaccination among girls than among boys (47, 48). It was hypothesized that this difference could be due to different treatments by sex or to higher intensity of exposure for females, but studies from rural Senegal and Guinea Bissau showed no sign of sex bias in health maintenance, nutritional status, or breastfeeding patterns (49⇓⇓–52). Moreover, for the age group 5–14 y (in which most measles cases are contracted in school), conditions were similar for boys and girls, and among those infected at home boys and girls had the same mean intensity of exposure (49). Further investigations have led to the discovery that the administration of the high-titer measles vaccine at age 4–5 mo and the resulting shift of diphtheria, pertussis, and tetanus (DTP) and inactivated polio vaccine (IPV) administration after measles vaccination were associated with an increased female:male mortality ratio compared with the administration of the medium-titer measles vaccine at 9 mo, which usually comes after the DTP and IPV vaccines. These findings highlight a differential effect of vaccines depending on sex and sequence of vaccinations (53, 54). The relative increase of mortality in the two Icelandic epidemics was indeed bigger for women than for men, especially at young ages; this is the only case where this happens among the seven populations considered in this study. However, women still showed a marked overall survival advantage, and the survival advantage of girls contributed the most to the entire gender difference in life expectancy.

Infant age affects life expectancy the most when infant mortality is high, even in noncrisis years. However, it is striking that during epidemics and famines as harsh as those analyzed here newborn girls still survived better than newborn boys. Even in Liberia, the population with the lowest life expectancy, newborn girls were hardier than newborn boys. That females survived more than males even at the infant ages, when behavioral differences are minimal, lends support to a biological underpinning of the female survival advantage. However, even if behavioral differences among infants are small, parents can have different attitudes toward children, depending on their sex. Studies show that in preindustrial Europe, the addition of a child increased the parents’ mortality risk when resources were scarce and had to be shared. If the child was a boy, the mortality increase was the same for both mother and father, but if the child was a girl, the father’s risk did not increase because he was not willing to share resources with an additional girl, while the mother’s risk increased even more (55). Other studies found that the number of sons or daughters born or raised to adulthood had no effect on paternal longevity but did affect maternal postreproductive longevity (56) and that, irrespective of access to resources, having many sons reduced the survival of mothers but not of fathers (57).

Except for the slave population of Trinidad, in all the other cases starvation dysentery and diarrhea are likely to have been major causes of death. These causes are strongly associated with nutritional status, and therefore, the allocation of food might have played a key role in shaping the survival patterns. Evidence suggests that sudden changes in availability of food may not influence infant mortality during crises characterized by nutritionally related diseases: When the mother breastfeeds, the infant is protected because breast milk appears to be sufficient until the mother is nearly starved (58). For other age groups, studies on practices of resource allocation from various areas of preindustrial Europe show a penalty for women, especially at young ages. From 1775 to 1850 the preexisting female excess mortality between the ages of 1 and 14 y increased sharply, mostly due to discrimination in the resource allocation within the household (55, 59).

Widespread social practices could be disrupted by famines or epidemics. Famines were often accompanied by prostitution, child abandonment or infanticide, aberrant food practices, and massive migration flows (60). Some of these factors could act in favor of women; others could be detrimental to them. While increased prostitution rates and migration could partly contribute to the higher survival chances of women (through prostitution women are able to get extra resources; migration reduces the pressure on the scarce resources, thus offering some relief from hunger to those who stay, composed mostly of women, children, and the elderly), child abandonment and infanticide, at least in some cases, could favor boys at the expenses of girls (60). Various stories from different crises testify to maternal resilience and tell of mothers taking extreme actions that led to the survival of both mother and infant (61⇓–63).

A growing body of research on sex differences in mortality and immunoresponse among humans and other mammals supports the fundamentally biological foundations of sex differences in human mortality. Biological factors include hormonal and chromosomal genetic differences. Sex hormones seem to play a key role (64, 65): estrogens have antiinflammatory, vasoprotective effects (66⇓–68), whereas testosterone seems to increase the mortality risk for certain diseases (69, 70), although the evidence on this point is mixed (71, 72). Moreover, while estrogens enhance immune defenses, testosterone and progesterone may have immunosuppressive effects (73⇓–75). The presence of two X-chromosomes may pose a further advantage with respect to specific X-linked diseases (e.g., hemophilia A) due to an amelioration of harmful gene mutations through nonmutated alleles on the other X-chromosome. The possibility of having two different alleles on the two X-chromosomes further contributes to the physiological diversity that can be advantageous when encountering new immune challenges (76⇓⇓–79).

Females live longer than males in humans and in the large majority of monkeys and apes for which data are available, in both captive and wild populations (80). Mammalian females generally outlive males in species in which males compete with each other for opportunities to mate (81, 82). This occurs in polygynous species and is commonly accompanied by sexual dimorphism in body size, which helps males compete for females. The sexual dimorphism in human body size indicates that our evolutionary history contained a long period of polygynous reproduction (83). Furthermore, the ratio of testes to body size is larger in polygynously mating species than in monogamous species (84). The relative testes size of humans in comparison with other species is further evidence that humans mated polygynously during their evolutionary history (84). Therefore, from an evolutionary perspective, the observed sex differences in human mortality are not exceptional; instead, humans fall well within the range of sex differences observed in other mammal species (81, 82, 85). Furthermore, among vertebrates males are more likely to be infected with parasites and to carry a greater intensity of infection than female conspecifics (86). It has been argued that this is due to an immunosuppressive effect of testosterone (86), but evidence is mixed (87). An alternative explanation comes from one experimental study that points toward a role of testosterone in altering social behavior so as to increase exposure to infection rather than the hormone acting as an immunosuppressant (88). It has further been argued that increases in Darwinian fitness accompanying a higher investment in the immune system in females, but not in males, may be sufficient to explain the observed sex differences in immune response (87, 89). Female mammals not only seem to be better at dealing with infection but also survive better than male mammals under harsh environmental conditions—an observation confirmed by a large comparative study on 26 ungulate populations (90), among others.

Research has also provided evidence for an apparent female advantage in immune protection among humans: The incidence of many bacterial, viral, parasitic, and fungal infectious diseases (e.g., leptospirosis, chistosomiasis, brucellosis, rabies, leishmaniasis, pulmonary tuberculosis, hepatitis A, meningococcal and pneumococcal infections, and seasonal influenza) is substantially higher in men than in premenopausal women. This suggests that progesterone and testosterone have mainly immunosuppressive effects, whereas estrogens enhance immune defenses (73⇓–75) and act as antioxidant (91). Moreover, autoimmune diseases are more prevalent in women than in men, as is a stronger immune response to vaccinations (74, 92). These findings led researchers to conclude that low male immunocompetence contributes to sex differences in mortality (93), but the mechanisms through which sex hormones affect immune responses in humans have not been fully elucidated.

Additionally, behavioral factors have been identified as important determinants of the male–female survival difference in contemporary populations (94, 95). The high preponderance of risk-taking behaviors among men contributes substantially to the sex gap in life expectancy. Men consume tobacco, alcohol, and psychoactive substances in greater quantities, drive less safely, and eat less salubriously than women do; this results in elevated risks of cardiovascular diseases, lung cancer, liver cirrhosis, and accident fatalities (96, 97). In high-income countries cigarette smoking has been identified as the largest factor contributing to the mortality differential (98, 99). However, although behaviors are important factors, they cannot fully explain the sex difference in survival, as suggested by the fact that some female advantage is found among nonsmokers (6, 7), devout Mormons (8), and Catholic nuns vs. monks (9).

In almost all human populations women live longer than men. In this study we found that the female survival advantage extends to seven documented populations experiencing high-mortality crises. Our results add another piece to the puzzle of gender differences in survival. They suggest that the female advantage stems from fundamental biological roots and is influenced by socially and environmentally determined risks, opportunities, and resources.

Life expectancy in USA hits record high

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Good news, America: We’re living longer!

Life expectancy in the USA rose in 2012 to 78.8 years – a record high.

That was an increase of 0.1 year from 2011 when it was 78.7 years, according to a new report on mortality in the USA from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The news is a little better for women, a little worse for men. Life expectancy for females is 81.2 years; for males, it’s 76.4 years. That difference of 4.8 years is the same as in 2011.

Those life expectancy estimates are for people born in 2012 and represent “the average number of years that a group of infants would live if the group was to experience throughout life the age-specific death rates present in the year of birth,” the report says.

The average life expectancy for a person who was 65 years old in 2012 is 19.3 years – 20.5 years for women and 17.9 years for men. The difference in life expectancy at 65 years between males and females increased 0.1 year from 2.5 years in 2011 to 2.6 years in 2012.

It’s not that a person born in 2012 is expected to have a shorter life span than a person who was 65 in 2012, says Jiaquan Xu, a medical doctor and lead author of the report. But the averages for people born in 2012 includes those who will be subject to infant mortality and teen mortality, which are higher than for a group of older people.

As far as the life expectancy difference between the sexes, Xu says it’s not clear whether genetics plays a role, but behavior probably does. “Men usually take more risks, and they participate in risky outdoor activities like climbing and scuba diving,” he says. “Also, teenage boys do more high-risk activities, and they get in more car wrecks, than girls.”

Among other findings of the 2012 mortality report:

•The age-adjusted death rate for the USA decreased 1.1% from 2011 to 2012 to a record low of 732.8 per 100,000 population. The report attributes much of the recent improvement in both death rates and life expectancy to reductions in deaths from such major illnesses as heart disease, cancer and stroke.

“I think the health of the U.S. population is improving,” Xu says. “The death rates for heart disease and cancer, the two leading causes of death that account for 46.5% of all deaths, have been falling since 1999.”

•The 10 leading causes of death in 2012 were the same as in 2011: heart disease, cancer, chronic lower respiratory diseases, stroke, unintentional injuries, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide. Those 10 causes accounted for 73.8% of all deaths in the USA.

However, from 2011 to 2012, age-adjusted death rates declined significantly for 8 of the 10 leading causes of death. The rate for suicide rose and the rate for unintentional injuries was unchanged.

•The infant mortality rate decreased 1.5% from 2011 to 2012 to a historic low of 597.8 infant deaths per 100,000 live births. The 10 leading causes of infant death, which accounted for 69.8% of all infant deaths, remained unchanged. They are: congenital malformations, low birth weight, sudden infant death syndrome (SIDS), maternal complications, unintentional injuries, cord and placental complications, bacterial sepsis of newborn, respiratory distress of newborn, diseases of the circulatory system and neonatal hemorrhage.

The infant mortality rate for SIDS decreased 12% from 48.3 infant deaths per 100,000 live births in 2011 to 42.5 in 2012; mortality rates for the other leading causes of death showed no significant change.

•Black males have the highest death rates, and black females have higher death rates than white females. Xu says African Americans have higher rates of heart disease than other races and have double the rate of hypertension as non-Hispanic whites; the rate of homicide, considered an unintentional injury, for blacks is 5.2 per 100,000 population, compared to 2.5 for non-Hispanic whites, he says.

  • Life expectancy for U.S. men slipped for a third straight year, according to new data from the National Center for Health Statistics.
  • The average male lifespan stood at 76.1 years in 2017, a four-month decline since 2014.
  • Drug overdose rates for men are almost twice as high as a decade ago.

Life expectancy for American men dropped for a third consecutive year, with the National Center for Health Statistics citing an increase in so-called “deaths of despair,” such as the rise in drug overdose deaths.

The average lifespan of men in the U.S. dipped to 76.1 years in 2017 (the latest data available), amounting to a four-month decline in life expectancy since 2014. The findings shed additional light on economic research into the sharp increase in recent years in deaths from overdoses and suicides among white men with less education.

In 2017, the life expectancy at birth for males was 76.1 years. Life expectancy at birth for males has decreased each year since 2014. For more data on life expectancy #HealthUS #lifeexpectancy https://t.co/lKhXRC5GvK pic.twitter.com/W4bpfoED1B

— NCHS (@NCHStats) October 30, 2019

Princeton economists Anne Case and Nobel laureate Angus Deaton first highlighted the issue in 2015 with their research on how white, less-educated Americans had veered off track. In 1999, the mortality rate for this demographic was about 30% lower than those of African-Americans. But by 2015, their mortality rate had eclipsed that of blacks by 30%, the economists found. The reason? A spike in death rates due to alcohol and drug poisoning, suicide, and alcoholic liver disease and cirrhosis.

The new data from the National Center for Health Statistics underline the scale of the problem. Drug overdose deaths for males over age 15 has almost doubled over the last decade, the agency found, rising to 29.1 deaths per 100,000 men in 2017, from 14.9 deaths per 100,000 in 2007.

“The recent increases were especially pronounced among men aged 25–34 and 35–44,” the NCHS report noted. “From 2013 to 2017, the drug overdose death rate increased by an average of 18.5% per year among men aged 25–34 and by an average of 18.8% per year among men aged 35–44.”

America is an outlier

Unlike other industrialized countries, the U.S. is seeing a plateau or decline in life expectancy, making it an outlier since higher health expenditures are typically tied with longer lives. One theory attributes that to different health outcomes for rich and poor households, an issue that has been exacerbated by rising income inequality in the U.S.

Wealthier Americans are more likely to live into their 70s and 80s than people in the middle class and the poor, according to a September report from the U.S. Government Accountability Office. In other words, being poor can be hazardous to your health.

And that can lead to significantly different life expectancies, according to a recent Harvard analysis of 15 years’ worth of IRS data. Men who are among the richest 1% of Americans live almost 15 years longer than those who are in the poorest 1%, the Harvard analysis found. The gap was about 10 years for the richest versus poorest women.

Billionaires now pay lower tax rates than the working class

Poor Americans are more likely to skip or delay health care treatment because of cost, the NCHS study said. It’s an issue that impacts about 1 in 6 Americans who live at or below the poverty line, the study found.

Young women are also experiencing a sharp uptick in drug overdoses, although the rate remains lower than that seen among men, the NCHS noted. The drug overdose death rate for women over age 15 jumped 64% from 2007 to 2017, hitting 14.4 deaths per 100,000 women, it added.

Life expectancy for women, black and Latino residents has held steady since 2014, the agency said.

Life expectancy

Situation

Life expectancy at birth reflects the overall mortality level of a population. It summarizes the mortality pattern that prevails across all age groups in a given year – children and adolescents, adults and the elderly. Global life expectancy at birth in 2016 was 72.0 years (74.2 years for females and 69.8 years for males), ranging from 61.2 years in the WHO African Region to 77.5 years in the WHO European Region, giving a ratio of 1.3 between the two regions. Women live longer than men all around the world. The gap in life expectancy between the sexes was 4.3 years in 2000and had remained almost the same by 2016 (4.4).

Global average life expectancy increased by 5.5 years between 2000 and 2016, the fastest increase since the 1960s. Those gains reverse declines during the 1990s, when life expectancy fell in Africa because of the AIDS epidemic, and in Eastern Europe following the collapse of the Soviet Union. The 2000-2016 increase was greatest in the WHO African Region, where life expectancy increased by 10.3 years to 61.2 years, driven mainly by improvements in child survival, and expanded access to antiretrovirals for treatment of HIV.

Female life expectancy

  • Situation and trends

Women generally live longer than males – on average by six to eight years. This difference is partly due to an inherent biological advantage for the female, but it also reflects behavioural differences between men and women. However, in some settings, notably in parts of Asia, these advantages are overridden by gender-based discrimination so that female life expectancy at birth is lower than or equal to that of males. Life expectancy for women also varies across regions and income levels of countries. For instance, life expectancy for women is more than 80 years in at least 35 countries. In the WHO African Region it was estimated at only 54 years and in some countries, particularly in East and Southern Africa, the lack of improvement in life expectancy is mainly due to HIV/AIDS and maternal mortality.

Newborn girls are more likely to survive to their first birthday than newborn boys are. This advantage continues through­out life: women tend to have lower rates of mortality at all age. Women’s longevity advantage becomes most apparent in old age. This may be the result of lower lifetime risk behaviours such as smoking and alcohol use. Alternatively, it may be the effect of harder-to-identify biological advantages that result in relatively lower rates of cardiovascular disease and cancer in women. The gap in life expectancy between women and men is narrowing to some extent in some developed coun­tries. This may be due to increased smoking among women and falling rates of cardio­vascular disease among men. It is also important to note that the extra years of life for women are not always lived in good health.

Life expectancy for men and women

A male child born in the United States today will be 76.1 years old on average. This puts the male citizens of the US in 43rd place in this ranking. On average, US women are even 5.0 years older, reaching an age of 81.1. The world average instead, is a few years lower at 70.2 years for men and 74.7 years for women. Within the European Union, these are 78.4 and respectively 83.8 years.
Birth rate and death rate are given in births/deaths per 1000 inhabitants within 1 year. The table shows the official data from the year 2017. In some minor cases, no data of this year are known, so that the previously published data were used.

Development of life expectancy worldwide

In the years 1960 to 2017, life expectancy has increased perceptibly worldwide. Starting at 50.7 years, it increased for men by 19.5 years to 70.2 years. For women, life expectancy increased since 1960 by 20.1 years from 54.6 up to an average of 74.7 years.

Differentiation by region

Life expectancy in Africa Male Female
Western Africa 56.39 years 58.38 years
Northern Africa 69.81 years 73.47 years
Eastern Africa 61.98 years 66.21 years
Central Africa 57.57 years 61.00 years
Southern Africa 59.92 years 66.75 years
Life expectancy in America Male Female
North America 76.53 years 81.43 years
Caribbean 70.46 years 75.36 years
South America 72.34 years 79.03 years
Central America 71.97 years 77.88 years
Life expectancy in Asia Male Female
East Asia 74.95 years 79.69 years
Southeast Asia 69.26 years 75.28 years
South Asia 68.27 years 70.79 years
Central Asia 68.46 years 74.30 years
Western Asia 71.84 years 76.70 years
Life expectancy in Australia Male Female
Australia/New Zealand 80.33 years 84.49 years
Life expectancy in Europe Male Female
Western Europe 79.22 years 84.38 years
British Isles 79.45 years 83.05 years
Eastern Europe 69.09 years 78.42 years
Northern Europe 78.23 years 83.29 years
Southern Europe 79.48 years 84.64 years
Life expectancy in Oceania Male Female
Polynesia 72.63 years 76.83 years
Melanesia 64.00 years 66.74 years
Micronesia 68.71 years 74.73 years

What is life expectancy?

The life expectancy indicates the expected age that is estimated for a human at the time of birth. This number of years is determined mainly from the current mortality rates. However, since these data only take into account the past, additional estimates are included to determine the future age due to external influences. These can be environmental factors as well as developments in health care. The average life expectancy is therefore not a measured value, but a prognosis for the future.
Above all, life expectancy is a result of the living conditions of a person or a population group. Essential factors are e.g. medical care, a constant and balanced nutrition and drinking water supply. These factors are significantly influenced by political factors, which is why life expectancy often derives from a country’s standard of living.

The difference between men and women

In the vast majority of countries, women are 4-8 years older than men. According to many scientists, this is not a purely biological difference. Instead it is also attributed to the different behaviors. According to this view, men are less careful about their bodies than women. In fact, smokers and alcohol consumers are more common among men. Also physical stress with simultaneous aversions against medical treatments and health precaution are responsible for this. Indeed, there is also an additional genetic reason for women’s longer lives.

Influence of the mortality rate of children

A significant impact on life expectancy is the mortality rate of children. Both in the Middle Ages, as well as in the developing countries today, the death rate of children at birth or in the first few years of life is disproportionately high. These factors are already included in the average life expectancy. If one subtracts the proportion of children already deceased after the first years of living, the “average” is maintained, but the life expectancy of the rest increases distinctively.

In developed countries, the gender gap has long favoured women by one measure at least: life expectancy.

Throughout the past 100 years women have significantly outlived men, on whom war, heavy industry and cigarettes – among other things – have taken a heavier toll.

But this gender gap is closing – and a new statistical analysis of life expectancy in England and Wales since 1950 suggests that, by the year 2032, men can expect to live as long as women, with both sexes sharing an average life expectancy of 87.5 years.

The study, led by Les Mayhew, professor of statistics at Cass Business School, calculated how long a sample of 100,000 people aged 30 would live if they experienced the average mortality rates for each ensuing year, projecting forward until the male and female life expectancy curves intersected.

There are a number of factors that explain the narrowing gap, according to Mayhew. “A general fall in tobacco and alcohol consumption has disproportionately benefited men, who tended to smoke and drink more than women.

“We’ve also made great strides in tackling heart disease, which is more prevalent in men,” Mayhew said. “And men are far more likely to engage in ‘high-risk’ behaviours, and far more likely to die in road accidents, which have fallen too.”

The life expectancy gender gap appears to be closing faster than was previously thought: research published in 2015 by Imperial College had indicated it would narrow to 1.9 years by 2030. The UK as a whole has slightly lower lifespan averages, as life expectancy tends to be higher in England than the other constituent nations.

Life expectancy

In the years immediately after 1950, women’s life expectancy increased faster than men’s in England and Wales, with the gender gap peaking in 1969, when women lived on average 5.68 years longer.

Majid Ezzati, professor of global environmental health at Imperial College, said the gap can be attributed largely to social rather than biological factors: “It’s actually the existence of the gap that is unusual, rather than the narrowing. It’s a recent phenomenon which began in the 20th century.”

In addition to the heavy male death tolls caused by two world wars, men started to smoke in large numbers before women did and women’s consumption never outpaced men’s. Male cigarette consumption peaked in the 1940s when tobacco industry figures revealed that more than two-thirds of men smoked. Female consumption peaked later, in the 1960s.

As well as changing attitudes to cigarettes and alcohol, the loss of heavy industry jobs – statistically more dangerous in both the short- and long-term – also disproportionately affected men.

“As the gap narrows, our understanding of what it means to be a man and a woman changes,” said Danny Dorling, professor of geography at the University of Oxford.

“The difference between the genders also narrows because of the introduction of contraception and female entry into the labour market. But the really interesting thing is it’s actually a kind of reverse inequality: women have lived longer than men who are paid more throughout their lives and are structurally advantaged in any number of ways. We haven’t entirely worked out why that might be.”

Postcodes and poverty

While life expectancy is projected to improve for everybody in the coming decades, the rate of improvement varies significantly depending on where you live.

The Cass analysis projects that by 2030, men in the most deprived areas of England and Wales will on average die 8.8 years earlier than those in the least deprived. For women, the gap between rich and poor will be 7.3 years – with both these lifespan inequalities worsening from their current levels.

Rate of deaths

The research made use of mortality rates after age 30 in order to exclude instances of early death, which are becoming increasingly unusual. But dying young is also much more likely if you’re from a poor background.

“Early death will certainly become a rarer event, but higher mortality rates for younger ages will still be the norm in the most deprived decile in England and Wales, unless something radically changes,” Mayhew warned.

Even in wealthy areas, however, the rate of improvement in life expectancy appears to be slowing. In May, consultants at PricewaterhouseCoopers (PwC) predicted that pension funds – which consider mortality rates when estimating future payouts – might be able to wipe £300bn off their deficits.

“In the first decade of this century, there was a clear trend for improvements in life expectancy,” Raj Mody, global head of pensions with PwC, told the Financial Times. “Pension funds have typically been assuming this trend will continue when forecasting deficits. But over the last five years, that trend has changed and there is a growing view that it is not just a blip.”

As life expectancy increases, the number of deaths per year tends to fall. Since 1980 the number of deaths has fallen for both men and women, but the decrease has been greater for men.

However, in 2012 the number of deaths per year started to rise again, peaking at 529,655 in 2015 – an unprecedented increase of more than 28,000 deaths on the previous year. This was the biggest jump in percentage terms in almost half a century. The number of deaths in 2016 was down by 0.9% year-on-year, but still represented a significant increase from 2014.

The Office of National Statistics believes the upturn in deaths might be because of an ageing population. “As people are tending to live longer, leading to the population increasing in both size and age over time, we may also expect the number of deaths to increase,” a 2016 report said.

But a number of academics have attributed the slowdown in improvement to government spending cuts, particularly those affecting social care and the NHS.

“There is no biological reason why life expectancy in Britain should level out rather than keep on improving. The UK is still some way behind Japan, for example,” said Mayhew.

“But improvement in life expectancy is becoming increasingly difficult to sustain in an economic downturn with an ageing population,” Mayhew added. “Austerity in recent years has affected the supply of social care, for example, and this may have caused mortality to rise in some instances.”

Mars vs. Venus: The gender gap in health

Updated: August 26, 2019Published: January, 2010

Ask any guy, and he’ll tell you that men are the stronger sex. His reasoning is obvious: in general, men are bigger and more muscular than women. They can run faster, lift more, and throw things farther. Men rule on the playing field, but in medical terms, it’s a very different story. When it comes to health, men are the weaker sex.

The longevity gap

Much has changed in the United States over the past 100 years. Medicine has evolved as much as any field, with dramatic advances in diagnosis and treatment. Changing, too, is the American lifestyle, with its new emphasis on healthier diets and regular exercise and its declining dependence on tobacco. As a result of these developments, life expectancy is also changing, rising slowly but steadily year after year (see Table 1). One thing, though, has not changed — the gender gap. People of both sexes are living longer, but decade after decade, women continue to outpace men. In fact, the gap is wider now than it was a century ago.

Table 1: Life expectancy in America

Year

Females

Males

Gender gap

2 years

5.5 years

5.4 years

5 years

Source: National Center for Health Statistics

The longevity gap is responsible for the striking demographic characteristics of older Americans. More than half of all women older than 65 are widows, and widows outnumber widowers by at least three to one. At age 65, for every 100 American women, there are only 77 men. At age 85, the disparity is even greater, with women outnumbering men by 2.6 to 1. And the longevity gap persists even into very old age, long after hormones have passed their peak; among centenarians, there are four females for every male.

The gender gap is not unique to America. In fact, every country with reliable health statistics reports that women live longer than men. The longevity gap is present both in industrialized societies and in developing countries. It’s a universal observation that suggests a basic difference between the health of men and women.

The health gap

Men die younger than women, and they are more burdened by illness during life. They fall ill at a younger age and have more chronic illnesses than women. For example, men are nearly 10 times more likely to get inguinal hernias than women, and five times more likely to have aortic aneurysms. American men are about four times more likely to be hit by gout; they are more than three times more likely than women to develop kidney stones, to become alcoholics, or to have bladder cancer. And they are about twice as likely to suffer from emphysema or a duodenal ulcer. Although women see doctors more often than men, men cost our society much more for medical care beyond age 65.

A lifelong gap

When it comes to health, males are the weaker sex throughout life. But why? It’s the $64,000 question, but there is no single answer. Instead, the gap depends on a complex mix of biological, social, and behavioral factors (see Table 2).

Table 2: Why do men lag?

Biological factors

  • Sex chromosomes
  • Hormones
  • Reproductive anatomy (?)
  • Metabolism

Social factors

  • Work stress
  • Lack of social networks and supports

Behavioral factors

  • Risky behavior
  • Aggression and violence
  • Smoking
  • Alcohol and substance abuse
  • Diet
  • Lack of exercise
  • Lack of routine medical care

Biological factors

Genes and chromosomes. Males and females are different from the very moment of conception. Each has 23 pairs of chromosomes, which carry the body’s 20,000 to 25,000 genes. Twenty-two of these pairs are present in both males and females, but the 23rd separates the sexes. This final pair contains the sex chromosomes. In women, both members of the pair are X chromosomes, but in men one is an X and the other a Y.

The Y chromosome is only about a third as large as the X and contains far fewer genes than the female sex chromosome. Some of these genes may be linked to diseases that contribute to the excess male mortality throughout life. In addition, if a woman has a disease-producing gene on one of her X chromosomes, it may be counterbalanced by a normal gene on the other X, but if a man has the same bad gene on his X chromosome, he lacks the potential protection of a matching gene.

Hormones. It used to be so simple: testosterone got the blame for premature heart disease in men, while estrogen got the credit for protecting women. The theory was based on the observation that athletes who abuse androgens — male hormones — develop unfavorable cholesterol profiles and suffer an increased risk of cardiovascular disease. But research shows that in physiologic doses, testosterone neither impairs cholesterol levels nor damages the heart. In fact, small studies suggest that testosterone treatment may even help some men with heart disease. Moreover, women who take estrogen well beyond menopause, when their natural levels plummet, experience an increased risk of heart attacks, strokes, and blood clots.

Even if hormones don’t account for the lion’s share of the gender gap, they do play a role. Estrogen appears to have some protective effect against heart disease, perhaps explaining why heart disease typically begins about 10 years later in women than men. On the other hand, testosterone may contribute to the risk-taking and aggressive behavior that causes problems for many young men. And testosterone also fuels diseases of the prostate, both benign and malignant. Even so, the testosterone-prostate connection can’t account for the longevity gap, since there are more deaths from breast cancer than prostate cancer.

Both sex hormones keep bones strong, but here, men actually have the edge. As men age, testosterone levels decline slowly, about 1% a year, but estrogen levels drop abruptly at menopause, boosting the risk of osteoporosis.

Reproductive anatomy. Many men view the prostate gland as a vulnerability. That may be, but reproductive factors actually hold down the health gap between men and women. The number of new prostate and breast cancers are closely matched, but women are about 45% more likely to die from their disease. Add malignant and benign diseases of the uterus and the perils of pregnancy and childbirth, and you’d suppose that women are the more fragile sex. Since they’re not, males must have important problems in other areas.

Metabolism. Cholesterol may account for some of the health gap. Males and females have similar LDL (“bad”) cholesterol levels, but women have substantially higher levels of HDL (“good”) cholesterol (60.3 milligrams per deciliter, or mg/dL, versus 48.5 mg/dL on average). Higher HDL cholesterol is associated with a lower risk of heart disease.

Diabetes is a major problem for both sexes, and its prevalence is increasing in both.

Like diabetes, obesity is rapidly increasing in the United States. More than two-thirds of American adults are overweight or obese. The prevalence of obesity is slightly higher in American women than men; still, excess weight is more of a problem for males. That’s because women tend to carry excess weight on their hips and thighs (the “pear shape”), while men add it to their waistlines (the “apple shape,” or “beer belly”). Excess body fat is never a good thing, but abdominal obesity is much riskier than lower body obesity, sharply increasing the risk of heart attack and stroke. Aesthetics aside, women are shaped better.

Although obesity is often classified as a metabolic problem, it usually results from unwise health behaviors, another major misfortune for males. In fact, although metabolic, genetic, and hormonal factors may explain part of the health gap, particularly very early in life, social and behavioral factors play a larger role in adults.

Social factors

Work stress and hostility. It’s a common explanation for excess male mortality, and there may be something to it. Indeed, the stereotype of the harried, hard-driving, overworked male executive has a basis in fact, and work stress can increase the risk of hypertension, heart attack, and stroke. In fact, karoshi, “death from overwork,” is a recognized diagnosis in Japan, and it triggers compensatory payments to survivors. Type A behavior, stress, hostility, and anger have all been implicated as heart disease risk factors, and these traits tend to have a higher prevalence in men than women.

Work-related stress and heart-breaking personality factors may contribute to male vulnerability. But as more women enter the workplace and add financial obligations to their traditional roles at home, they may have the dubious honor of closing the gender gap by moving in the wrong direction.

Social networks and supports. It’s true: people are good medicine. Strong interpersonal relationships and support networks reduce the risk of many problems, ranging from the common cold and depression to heart attacks and strokes. In contrast, social isolation has been identified as a heart disease risk factor.

Women have much larger and more reliable social networks than men. There is more than a germ of truth in the quip that two men can’t take a walk together unless one is carrying a ball. In general, women are in touch with their feelings and with other women, and they have a remarkable ability to express their thoughts and emotions. Women may not really be from Venus any more than men are from Mars, but strong relationships and good communication seem to help explain why women live longer on Earth.

Behavioral factors

Biological factors account for part of the gender gap, social factors for another portion. But from adolescence onward, male behavior is the main reason that men fall ill sooner and die off faster than women.

Risky behavior. Is it nature or nurture, the Y chromosome and testosterone, or daredevil role models and cultural norms? Nobody knows, but the answer is not likely to be either/or but all of the above. Whatever the cause, from boyhood on, males take more risks than females, and they often pay the price in terms of trauma, injury, and death. Simple precautions like seat belts and bike helmets can help, but more complex measures involving education about alcohol, drugs, firearms, and safe sex are also essential. More than ever before, young males need role models who demonstrate that common sense and prudence are manly traits.

Aggression and violence. These are extreme forms of risky behavior, and they all have many of the same root causes. But there is a difference between risk taking and aggressive or violent behavior. A man who takes risks places himself in harm’s way, but his unwise choices may not endanger others. Violent behavior, though, directly threatens the health and well-being of others, both male and female. A man is nearly four times more likely to die from homicide or suicide than a woman, but women are much more likely to be victims of domestic violence. Men need to learn self-control and anger management if they are to close this portion of the gender gap. Understanding that real men have feelings and that strong emotions are best expressed with words, not acts, is also important.

Smoking. It’s the riskiest of all health habits, and since secondhand smoke is dangerous to others, it’s also a form of undercover hostility.

In the old days, men smoked but women didn’t. Those were good old days for women, but not for men. Times changed; when women began to smoke in large numbers, they started to catch up to men in heart disease, lung cancer, and emphysema.

Alcohol and substance abuse. Like smoking, drinking and drug abuse are traditionally male problems that are increasingly threatening to women as well. Still, males dominate in these self-destructive habits.

Diet. In most cases, women eat a healthier diet than men. In a Massachusetts survey, for example, women were about 50% more likely than men to meet the goal of eating at least five servings of fruits and vegetables a day. The masculine ideal of meat and potatoes should give way to vegetables, fruits, grains, and fish.

Exercise. When human survival depended on physical work, both men and women got plenty of exercise. As men moved behind desks, women who continued to haul groceries, climb stairs, scrub, and wash continued to get the many health benefits of physical activity. But as modern appliances replace muscles at home and women join men in sedentary jobs, American women have fallen slightly behind in exercise. It’s small comfort to men, though, since most men don’t come close to getting the exercise they need for health.

Medical care. Women think about health, and they do more about it. Women are more likely than men to have health insurance and a regular source of health care. According to a major survey conducted by the Commonwealth Fund, three times as many men as women had not seen a doctor in the previous year; more than half of all men had not had a physical exam or cholesterol test in the previous year. In general, men who have the most traditional, macho views about masculinity are the least likely to get routine check-ups and necessary medical care.

Call it the ostrich mentality or the John Wayne Syndrome; by any name, men who skip tests and treatments, minimize symptoms, and disregard medical advice are asking for trouble. Men who look under the hood every time the engine coughs should be as quick to get help when they cough.

It is hard to know why men make such poor patients; busy work schedules and competing responsibilities and interests may play a role, but the macho mentality appears to be the chief culprit. Who can blame men for wanting to be John Wayne? But by following the example of that quintessential American he-man, men fail to take the simple steps that can protect them from heart disease and lung cancer — the very same illnesses that plagued John Wayne before his death at age 72.

Closing the gap

Men can’t change their chromosomes and genes, and very few would change their hormones. Still, men can catch up to women in some other areas. That doesn’t mean “going girly,” though it does mean following some simple rules. But will men change their behavior?

An incident reported in The Wall Street Journal may help you decide about making changes. In the 1960s, when Muhammad Ali was a brash and fearless boxing sensation still known as Cassius Clay, he boarded a plane to fly to a big fight. While preparing for takeoff, a flight attendant noticed that the boxer had not fastened his seat belt. She asked him to buckle up, but he ignored her. When she asked again, he replied, “Superman don’t need no seat belt.” Her retort: “Superman don’t need no airplane. Buckle up.” And he did.

Men who think they are too tough to get sick are risking a medical crash-landing. To stay healthy, we all need to follow the rules (including the one about seat belts). Here are 10 tips to help you wing your way to a long and healthy life.

1. Avoid tobacco in all its forms.

2. Eat well. That means eating more healthful foods and fewer harmful foods.

  • Eat more: whole grains, fruits, vegetables and legumes, fish, low- or non-fat dairy products, and nuts and seeds.
  • Eat less: red meat, whole-milk dairy products, poultry skin, high-sodium (salty) processed foods, sweets, sugary drinks and refined carbohydrates, and if you need to lose weight, calories.

3. Exercise regularly, including:

  • At least 30 minutes of moderate exercise nearly every day.
  • Exercises for strength two to three times a week.
  • Exercises for flexibility and balance according to need.

4. Stay lean. It’s equally hard for men and women, but even partial success will help.

5. If you choose to drink, limit yourself to one to two drinks a day, counting 5 ounces of wine, 12 ounces of beer, and 1.5 ounces of liquor as one drink.

6. Reduce stress. Get enough sleep. Build social ties and community support.

7. Avoid risky behavior, including drug abuse, unsafe sex, dangerous driving, unsafe firearm use, and living in hazardous household conditions.

8. Reduce exposure to toxins and radiation, including sunlight and medical x-rays.

9. Get regular medical check-ups, screening tests, and immunizations. Listen to your body and report sounds of discord to your doctor.

10. Seek joy and share it with others. Laughter is good medicine. Fun and optimism improve health as well as happiness. And if you make changes 1 to 9 slowly, steadily, and reasonably, you will actually come to enjoy your healthful lifestyle.

As things now stand, men are from Mars, women from Venus. But gents who get their planets aligned correctly can enjoy the best of both worlds — and good health right here on Earth.

Photo: Thinkstock

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