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Myles Spar, M.D.

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Why Do Men Die Younger Than Women?

Posted: 02/11/10 08:55 AM ET

We take it for granted that women live longer than men. This is the case in over 98 percent of countries in the world. In the United States, average life expectancy is over five years more for women than for men.

But why is this the case? Why is it that for every major cause of mortality that affects both men and women, men die faster?

Are men genetically programmed to die sooner then women? Is it determined in our genes that men develop cancer and heart disease more often than women? Men have a 60 percent higher chance of developing cancer and a 40 percent higher chance of dying from cancer than women, even when you leave out gender-specific cancers like breast, cervical and prostate cancers.

In fact, men have an increased risk of mortality at all ages. Of the top 10 causes of death in the United States, men are winning in nine of them.

This difference in life span between men and women has been relatively unexamined because it has been assumed to be based on biology. But this does not appear to be the case. For one, the extent of the gender gap in life expectancy changes across time and across countries. In the United States, the gap is narrowing, from 7.8 years in 1979 to just 5.2 years in 2006. This is thought to be due to women increasingly taking on stresses and habits of men such as smoking, drinking alcohol and working outside the home. The gender difference is much larger in African countries where AIDS strikes men at higher rates than women and in countries of the former Soviet Union. Clearly there is more to the gender gap than our genes.

Perhaps masculinity itself is killing us. It seems that doctor-avoidance, risk-taking behavior and stress may be the best explanations for the gender gap. It is true that men just don't go to the doctor. Men are twice as likely as women to say they do not have a usual source of health care, and men attend half as many preventive care visits. This leads to half the opportunities to screen men for high blood pressure, obesity, high cholesterol, high blood sugar, substance abuse, cigarette smoking and depression or anxiety. Lack of identification of such risks leads to fewer chances to intervene in a disease process. Heart attacks, strokes, diabetes and cancer then present more often and in more advanced stages than among those who are diagnosed or treated sooner.

Male gender roles may play a part in making men feel that they should deal with symptoms or illness on their own. Just as men typically don't ask for directions when lost, the male may feel it is not "masculine" to seek help for potentially serious medical symptoms. It remains to be seen whether the metrosexual movement will improve the rate at which men seek care for potentially dangerous conditions. However, to the extent that higher mortality can be explained by avoidance of the health care system, it is incumbent upon creators of health policy and providers of health care to make such services more attractive and accessible to men.

Men's habits and roles also impact their rates of disease incidence, While women are taking on more and more professional roles previously held by men, in the US, 95 percent of workers in the 10 most hazardous occupations are still men. Men die in workplace accidents at much higher rates as women, even excluding combat deaths, which were the leading cause of occupational deaths in the US when last reported in 2005.

Then there are non-occupational risks that men take. Men have an increased risk of heart disease and increased risk of alcoholism, suicide and homicide.

Men drive faster and are more likely to eat an unhealthy diet. Men report higher levels of stress and lower rates of stress-reducing activities like meditation and yoga. Well, then, one might say that men deserve to die younger. However, when disparities are found in risk-taking among ethnic or socioeconomic groups, the usual response is not to blame the group at risk. The socially responsible response is to take a hard look at how the educational and health care systems may have failed that group and what can be done to change that, which promotes risk-taking and avoidance of self-care.

Social policy also impacts the rate at which men access the healthcare system. There are fewer programs that target men as specifically as women. Men are less likely to be insured and are less able to qualify for public insurance, such as Medicaid, than women with children.

It is dangerous to assume that the gap in life expectancy between men and women is biological. Such an assumption stops us from examining social, economic, behavioral, or public health policies that may be contributing to higher mortality among men. In the United States, Men's health is largely neglected when looking at health policy. This is not as much the case in Europe and Australia, where entire departments of Andrology exist at many academic and governmental health institutions. Such departments include anthropologists and sociologists, policy advisors and health service researchers. Women have strongly advocated for their own health, leading to increased research, public policies favorable to women's health concerns and health care delivery approaches that specifically address women's health issues. Men need to do the same, not to take away such programs for women, but to add years to the lives of their fellow men.

 

Follow Myles Spar, M.D. on Twitter: www.twitter.com/drspar

We take it for granted that women live longer than men. This is the case in over 98 percent of countries in the world. In the United States, average life expectancy is over five years more for women t...
We take it for granted that women live longer than men. This is the case in over 98 percent of countries in the world. In the United States, average life expectancy is over five years more for women t...
 
 
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01:13 PM on 03/10/2010
It's simple, women live longer because they take better care of themselves. We watch what we eat. Most women I know are dieting. You can't stuff your face with pizza or fast food and expect to look good. Men don't think that way.

The only thing I can think of is to feed them a heathy diet at home, things they like prepared right. It helps to make up for the junk they devour outside the home.
04:56 PM on 04/03/2010
Actually, men die younger than women because they don't cry, they hold it all in, and never

cleanse their souls which shortens their life span.
06:25 PM on 03/08/2010
Please take a few minutes of your day to access the YouTube.com, then enter: A New Cure for Cancer.
Next go to: A New Cure for Cancer and everything else.
*Understand: The human H2O molecule is surrounded by an "electron" whose orbit is in a 180 degree half-circle to the South. All fluids consumed have first been "forced-through metal piping" which causes their electrons to spin(orbit) to the North, like the insects molecular-rotation. To drink this in-correctly influenced fluid means that you are "NEGATING" your own "7 year cellular rebuild cycle" thus causing your early demise! To begin to "south-spin" ALL FLUIDS means that you are giving your system exactly what it needs to do this cellular replacement correctly. In time you will eat-less, sleep-less, and begin to look much younger. You will also live for up to 1000 years in a healthy and productive physical body.

The New David
01:59 PM on 02/19/2010
Although it's not the focus of this article, breast cancer should not be labled a gender-specific disease. Statistically, a higher percentage of men die from breast cancer than woman. One of the primary causes for higher mortality rates is based on the misconception that breast cancer affects only women.
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03:28 PM on 02/14/2010
One other thought, since it is brought up a lot on this post, how much is the discussion of biology an attempt to maintain the status quo regarding gender roles? Isn't the emphasis, solely on biology, one way to control all of us into maintaining current standards? Also, isn't a way for religion to keep coercing by pointing at men as sinners, women as the fault for us not being in Paradise, etc etc etc. When we divorce discussion of biology from the power of the human brain aren't we conceding we are no more than animals driven by our primitive needs? If that is the case then how have we managed to build so much? Look at technology and, even, the advent of democracy? Human rights, civil rights, etc. The brain has overcome our "baser" natures to build societies that are not based on superstitions, biological imperatives, etc. Our brains!!
04:12 PM on 02/14/2010
Depends on the biology you are talking about.

If you are talking about "men are stronger, thus superior" I agree.

On the other hand, I think we, as humans, tend to give ourselves far too credit thinking we are that much better than animals.

I think our minds allow us to UNDERSTAND the animal nature of man moreso than CONTROL it. We rationalize so many "decisions" that are basically animal instinct.

Look at how often women choose the alpha male in situation after situation, just like in nature. Look at how often men choose the youngest (and most fertile) women, just like in nature.

There was a thread about this the other day, virtually NO animals in nature are monogamous.

It's a concept humans invented to control social behavior.

Should we ignore the special biological bond women have with their children and award child custody strictly 50/50?

Without asking what part biology plays in the debate, we work off man made intellectual standards that might nor reflect reality.
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12:35 AM on 02/15/2010
Interesting. While not completely socially acceptable it is changing and becoming much more prevalent for women to be with younger men and younger men are enjoying this option - it generally precludes having a family which seems to be part of the attraction. I don't think that men always go for younger women necessarily because they are more "fecund" they just, culturally, are considered more attractive. In the past this may have been important but as societies have evolved and we have won over nature, so to speak, it is less and less important. Our culture places a premium on youth and have denigrated aging, mostly in women, not separating a woman's attractiveness from her ability to produce offspring. It is a rather recent phenomena that women who are of a certain age have been sexually attractive. Well, let's say out in the open about their sexual attractiveness. It has long been known that many men are initiated into sex by older women but it wasn't really acceptable for a younger man to be seen in public with this older woman.
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12:36 AM on 02/15/2010
It is interesting that while you fall back on biology to support your views in one instance, as above, you are all about denying biology or genetics having to do with men dying at a younger age. And you also suggest that women break with societal bonds and express/livethemselves whichever way they want, yet you,as noted above, fall back on biology to explain so many things. You can't have it both ways. Women are either biologically monogamous or they aren't. Men are biologically attracted to monogamous women or they aren't.
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02:43 PM on 02/14/2010
I believe, and could be wrong, that one point missing from this article is the fact that the focus on women's health has been a very recent phenomena, when it has become clearer about women's financial power. In that past clinical studies were only done on men because it was assumed, rightly or wrongly, that men controlled the purse strings and, in addition, that physically, women reacted the same way to medications and medical treatments the same way as men. Just look at the recent media awareness of how women's heart attack symptoms are very different from men's. In addition, I wonder what the longetivity rates were for women compared to men were in the past. Wouldn't it be more relevant to discuss this particular issue in the context of societal changes rather to look at a current point in time and make such grandiose statements about the differences between men and women?
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12:15 PM on 02/14/2010
The answer is: Because they want to.
05:32 AM on 02/13/2010
In my whole life, I have known, at most, 2 or 3 men who WANTED to get married.

I know plenty of guys who meet girls they don't want to lose, so they give in and get married.

Humans act out of self interest.

The claim has been made here again and again that marriage is VERY beneficial to men.

So...how do you explain this disconnect?

What does those men who don't want to get married EVEN though it's TOTALLY in the their self interest (big grain of salt) know that the women (and Rand Corp.) telling them it's good for them not know?

Or what do those women (and Rand Corp.) know that these men don't?

Why is it so hard to convince men to do something that is great for them?

Flip side, why are women so eager for something that is not?
10:40 PM on 02/12/2010
to escape?
09:39 PM on 02/12/2010
Women are prone to serial monogamy. Look it up.
05:43 AM on 02/13/2010
Women have used biological differences to explain away the life span differences in many posts here.

"Women live longer, it's just biology, no big deal, just move along...." or "men are just here to spread the seeds, so biological, it's important for women to live longer to raise the offspring"

This last line sounded to me a lot like what men say when they explain why monogamy is unrealistic.

NONE of the women here who expect us to shrug our shoulders and say "well, I guess, it's biology, oh well...I won't look into why I die ten years sooner anymore" will buy into the notion that biology rather than man-made social concepts to prevent pregnancy before birth control, should determine our attitude towards monogamy.

If it's good for the gander, it had better be good for the goose.

If it's good for the goose, forget the gander.

As you point out, monogamy is NOT a burden to most women, it is their preference. So, they have no interest in re-examining the science or biology of that concept.
08:54 PM on 02/12/2010
Hardly, my dad has out lived two wives and is in his eighties.

Both died of cancer. One breast and the other skin.
07:46 AM on 02/12/2010
And let's stop pretending that masculine independence is the reason for men's avoidance of medical treatment and that, conversely, feminine weakness and dependence are the reasons women see a doctor more often than men do. Women consult doctors because of menstruation, contraception, and pregnancy--which men don't have to deal with. Also because of those changes in their reproductive cycle, women are more in tune with their own body--from puberty to menopause. They know when they need to go to a doctor, and they go.

Biology is the reason men die younger. Let's admit it and stop making excuses for them.
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10:05 AM on 02/12/2010
Amen, Boomerang. Men's lives are no more stressful than women's, and men are not any stronger emotionally (just witness when a man gets sick or loses his wife and compare their handling of those things with the way most women handle those things). This article and many of the comments here reveal a deep hostility toward women and a "man-as-victim" mentality.
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Neophile
01:03 PM on 02/12/2010
Sure, there's only inequity when it adversely effects a woman. Sorry, life is more complicated than that. "Men's issues" are just as real as "women's issues."
07:43 AM on 02/12/2010
Here we go again. Until about 20 years ago, the popular wisdom was that men die younger because they "work harder" and are therefore more subject to "stress." Now Dr. Spar is trying to make that old false claim.

As a physician, he should know that males are more susceptible to disease than females are even before they're born, and at every stage of the lifespan thereafter. Males are certainly not subject to more stress than females while they're still in the womb or, after that, in the cradle, because they're "working harder" or because of "gender roles"!

He should also know that, regarding heart disease, the female cardiovascular system is stronger than that of the male because it's designed to withstand the physical rigors of pregnancy and childbirth. In the first trimester of pregnancy and then again during labor and delivery, cardiac output is increased by 30% to 50%. Women don't have less stress than men...they're simply built to endure it better than men are.
08:09 AM on 02/12/2010
Wrong on so many levels. Cardiac input cannot increase by 30% to 50% or the heart would collapse in on itself. Normal cardiac output is 60%. An output of even 75% would mean the atriums have collapsed trying to provide enough blood to the ventricles. An output of 110%... well that's just something fox news would say and it would result if your entire heart collapsing into a solid rock.
10:21 AM on 02/12/2010
No, not from Fox News. The information is from the medical textbook "Management of Cerebral Aneurysms," authors Le Roux, Newell, and Winn, publisher Elsevier Health Science, copyright 2003, ISBN 0721687547, chapter 23: Pregnancy and Aneurysms.

But all you have to do is Google "cardiac output" and "pregnancy" to confirm the percentage of increase.

PS--I did not use the words "cardiac input" --you did.
07:32 AM on 02/12/2010
I love the women who come here and try to paint married life as such a GREAT DEAL for men and such an AWFUL CHORE for women.

That's why NOT ONE man in my life has EVER asked me, "So, when you are getting married?"

That's why (almost) every woman in my life has...
07:12 PM on 02/12/2010
Every generation is different when it comes to marriage. Older generations generally value marriage more than younger generations. The right age to get married keeps getting older and older so it depends on the generation really. Majority of 20 something year old's now cannot even imagine themselves getting married that young.

It also does not help that it is ingrained in women from birth that they have to get married. Or it should be their goal in life. Just about everything fed to little girls deals with prince charming, marriage, and children. It's hard to become unconditioned to things you have been fed since birth. While men and women both receive pressure to get married, women are told by the media more often that they are failures if they do not get married.

Men are more likely to be applauded for not getting married while women are shunned and told to think about their biological clocks. So it's no surprise women ask other women and men when they are getting married. Marriage is still a goal for a lot of people.
05:48 AM on 02/13/2010
"It's hard to become unconditioned to things you have been fed since birth."

Just curious...

Do you not think men are "conditioned" to do things their entire lives?

Men are immune to social pressures?

They are not.

Men are, however, FAR more likely to IGNORE that social pressure, because it is just that. Ultimately, people have to make their own decisions and OWN them. Rather than just go along...

How, and in what context, are men "applauded" for not getting married? How are women shunned?
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MegaSAHD is where its @
07:15 AM on 02/12/2010
My first thought was how much stress being in relationships causes. I'm not kidding. Men are not as prone to monogamy, so the stress of maintaining marriage and family coupled with the stress of being the primary provider kills us dead. (I know the primary provider thing is changing but your stats probably go back a ways.)
07:27 AM on 02/12/2010
I doubt this is much of a factor but it's worth looking into...

You mention momogamy. Most women are naturally inclined towards it, while men are the exact opposite.

I wonder if the fact that society has NO interest in understanding ONLY comdemning men for not being naturally monogamous in a society with great social and financial penalties for failing to do so...adds to the stress that kills them?
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02:31 PM on 02/14/2010
Actually, I am not sure that it is a natural prediliction for women to be monagamous as one that is made of necessity. If a woman is promiscuous and becomes pregnant why would any man claim paternity and raise the child? If a woman can't identify the father, why would any man protect her? If a woman can't identify the father, what claims does she have to his estate? If a man can accuse a woman of infidelity doesn't he have control over her? He can cast her out at any time saying that is not his child. Historically, the laws supported men's accusations and women had no redress. Now with DNA testing we do have ways to combat this and the laws, regarding divorce, have tended to catch up with the times - women have far more rights than they have had in the past.

Monogamy, I believe, is a cultural phenomenom that is also driven by biology but only in that women can get pregnant. It really is her and her child's best interest to be monogamous so that she can, with reliability, point a finger at the father so she can have protection for herself and her child.
05:38 AM on 02/12/2010
In my family, the men live fairly long lives. However, the last few years are characterized by significant grouchiness as there is little to do but bemoan lost opportunity. Unfortunately, the brain stays sharp enough to dwell incessantly on the predicament of will over ability. We aren't too pleasant to be around. I suspect the women end up killing us just to shut us up. I'll let you know when I get there.

I remember my father in his seventies saying to me, "I wish I could just go to Acapulco and lie on the beach for a few days." This from a WWII vet, you understand. I said, "I'll buy you a ticket and make the hotel reservations." He said, "Oh, your mother wouldn't want to go."