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Why Men Die Younger
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This section of the CDC web site includes information of particular interest to men.
The American Psychological Association is the largest scientific and professional organization representing psychology in the United States. APA is the world's largest association of psychologists, with more than 134,000 researchers, educators, clinicians, consultants and students as its members.
Healthfinder has been developed by the U.S. Department of Health and Human Services. The site can lead you to selected online publications, clearinghouses, databases, web sites, and support and self-help groups, as well as the government agencies and not-for-profit organizations that produce reliable information for the public.
This is a page on the Agency for Healthcare Research and Quality, U.S. Department of Health & Human Services web site. The checklist contains suggestions for regular checkups and screenings for every man
This is the site for the magazine, Men's Health. It has information on how to take care of yourself and improve your overall well being. It covers fitness, sex, health, guy wisdom, weight loss, nutrition, and style. In the health section you can find information on illnesses and how to fight them.
MHN is a national non-profit organization. In addition to the information on their web site, you can subscribe to their health issues weekly electronic newsletter, the Healthy E-Male. Also, of particular interest is their 70+ page book, Blueprint for Men's Health, which discusses the main health issues that men face today. Each chapter focuses on a single condition or group of related conditions affecting men including the factors that increase health risks, how to recognize symptoms, and prevention strategies.
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NIA is one of the 27 Institutes and Centers of the National Institute of Health. Their mission is to lead broad scientific efforts to understand the nature of aging and to extend the healthy, active years of life.
See Second Opinion episodes on: Longevity (Episode 311) Obesity (Episode 108) Cardiac Breakthroughs (Episode 407)
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Episode number: 
510

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Biological, social and behavioral issues are just a few factors that play a role in why women live longer.  Experts take an in-depth look into why men die at a younger age than women.

True or false:  Men are the stronger sex. The answer, of course, depends on how you define strong. 

If you define it as size and muscle, then men win hands down.  Men are taller and have stronger bones, tendons and ligaments than women on average.  At age eighteen, men have about 50 percent more muscle mass than women in the upper body and 10 to 15 percent more in the lower.1

Yet, men are physically more vulnerable than women and this fragility starts even before birth.  Boys in the U.S. have a 29 percent higher prenatal death rate2 and are 20 percent more vulnerable to infant mortality up to age one.3   Boys tend to be more at risk than girls of being born with birth defects, perhaps because boys tend to develop at a slower pace, leaving more time for potential problems to arise.4

As of 2005, the average life expectancy in the U.S. is 80.4 for women and 75.2 for men.  That means men, on average, die 5.2 years earlier than women.5.  This phenomenon is world-wide.  Women outlive men almost everywhere in the world.  As Second Opinion participant Thomas Perls, MD, says, "Women are very much the winners of the longevity marathon."

Theories abound about why this is so.  The one thing scientists say they know for sure is that there is no one magic bullet that explains the difference.  They cite a number of genetic-biological and socio-cultural factors that may be at work.

  • Sex hormones.  The female sex hormones, estrogen and progesterone, are believed to play a role in boosting the levels of "good" cholesterol or HDL (high-density lipoprotein) and keeping blood vessel walls relaxed.  That lowers risk for heart disease and stroke.  Male hormones like testosterone are believed to increase levels of "bad" cholesterol or LDL (low-density lipoprotein), raising a man's risk for heart disease and stroke.   Many studies have also shown that testosterone is strongly associated with dangerous behavior.  Men are particularly vulnerable to death from accidents or acts of violence during their late teens and twenties when they go through what scientists call a "testosterone storm," where hormone levels are relatively high and changeable.  

  • Sex chromosomes.  Females are born with two X chromosomes, one from each parent, and males inherit one X chromosome from their mothers and one Y chromosome from their fathers.   More than 1,000 genes reside on the X chromosome.  In contrast, the Y-chromosome carries the instructions for male development and little else – probably fewer than 100 genes in all.6   Scientists theorize that if a mutation occurs in one of the genes of the X chromosome, females have a second X to compensate. 

  • Immune response.  In general, women mount a more vigorous immune response than men to infections.7   Precise reasons remain unclear, but scientists point to both sex hormones and sex chromosomes as likely contributors.  According to the Mayo Clinic, testosterone seems to impede immunity by weakening the response of T-lymphocytes (white blood cells that fight against tumor cells and infection as well as help B-cells make antibodies).  They also found that while T-cell production declined in both sexes as they aged, women still had higher levels of healthy T-cells than men of the same age.8

  • Iron overload.  Males tend to have more iron in their bodies than females because women lose iron through menstruation.  Scientists believe that increased iron raises the risk for heart disease because of the relationship between iron and cell-damaging free radicals. 

  • Natural selection.  Scientists have proposed that evolution has naturally favored the genes of longer-lived women because of their roles in bearing and rearing offspring.  Women's reproductive rate is linear; therefore, the longer they live the more offspring they can produce.  Since women are the primary care-taking parents, the offspring of longer-lived mothers are more likely to survive to adulthood. 9

  • Cultural conditioning.  Differences in what is expected of men and women contribute to variations in mortality. Certain behaviors that are discouraged in women are condoned or even rewarded in men.  Men's higher rates of cigarette smoking, heavy drinking, gun use, and risk taking in recreation and driving are partially responsible for their higher death rate.10   Also,men tend to work in more dangerous settings than women and account for 90 percent of on-the-job fatalities.11   Throughout life,men are conditioned to hide feelings of sadness or pain and not to reach out for help.  They are less likely to seek medical attention, less likely to seek psychological treatment and more likely to commit suicide.  Men take their own lives at nearly four times the rate of females and represent 79.4% of all U.S. suicides.12

  • Social standing:  Humans in lower socio-economic levels tend to have higher mortality rates than their higher-status peers, but the impact of social standing is greater on male mortality than on female mortality.  Scientists surmise thatmen may develop riskier life strategies in an attempt to get ahead.13  

1 A. Glucksman, Sexual Dimorphism in Human and Mammalian Biology and Pathology, (Academic Press, 1981).
2  Number of Fetal Deaths by Sex and Period of Gestation, by Age of Mother: 2004; National Statistics Office, Vital Statistics Division
3 Drevenstedt et al. The rise and fall of excess male infant mortality.  Proceedings National Academy of Sciences April 1, 2008 vol. 105 (13) 5016-5021.
University of Florida (2005, November 21). Multiple-birth Babies, Boys Have Higher Risk of Defects. Science Daily
5 Centers for Disease Control and Prevention, National Center for Health Statistics.
6 Barbara R. Migeon, M.D., The Johns Hopkins University School of Medicine, Baltimore, JAMA media briefing on women's health in New York. Reference: JAMA. March 2006; 295:1428-1433. 
7 National Institutes of Health.
8  Augmentation of T Cell Levels and Responses Induced by Androgen Deprivation, Mayo Clinic, Journal of Immunology, Volume 173 / No. 10 / Nov 15, 2004.
9  T. Perls and R. Fretts, Why women live longer than men. Sci. Am. Pres. 9 (1998).
10  Gender Differences in Mortality. Ingrid Waldron, Ph. D.
11  U.S. Departmentof Labor, Bureau of Labor Statistics.
12 Centers for Disease Control and Prevention (CDC). Injury Statistics Query and Reporting System (WISQARS); 2005.
13 An evolutionary life-history framework for understanding sex differences in human mortality rates;" Daniel Kruger, PhD; Randolph Nesse, MD; Spring 2006, Human Nature.

Quick Facts

  • As of 2005, the average life expectancy in the U.S. is 80.4 for women and 75.2 for men.  That means men, on average, die 5.2 years earlier than women.1  

  • Being male is now the single largest risk factor for early mortality in developed countries.2

  • A number of genetic-biological and socio-cultural factors contribute to the longevity gap between men and women.  They include differences in sex hormones, sex chromosomes, immune response, iron in the blood, natural selection, cultural conditioning and how the sexes deal with their standing in society.  
  • How much of the longevity gap is due to biology and how much to environment or behavior is a matter of debate among scientists but the best data we have today suggests that only about one-third of longevity is due to genes. 

  • Boys in the U.S. have a 29 percent higher prenatal death rate3 and are 20 percent more vulnerable to infant mortality up to age one.4   

  • According to a study done in 2003 by the Institute for Social Research at the University of Michigan, men have higher age-adjusted death rates than women for the 15 leading causes of death in the U.S., with the exception of Alzheimer's disease.5 
     
  • Because men usually develop heart disease 10 to 15 years earlier than women do, they are more likely to die of it in the prime of life. About one-fourth of all heart-disease-related deaths occur in men ages 35 to 65.6

  • More American men than women are stricken with cancer. The age-adjusted invasive cancer incidence rate per 100,000 people in 2004 was 537.6 for men and 402.1 for women.7

  • Men are 30% more likely to suffer a stroke than are women, making it the third-leading cause of death in men.8

  • More than twice as many men die each year because of accidents as do women.9

  • Men have a 30 percent higher risk of death from pneumonia than women.10

  • Men's death rates are at least twice as high as women's for suicide, homicide and cirrhosis of the liver.11 

  • If men attempt suicide, they are more likely to succeed than women.  Suicide was the eighth leading cause of death for males and the sixteenth leading cause of death for females in 2004.12

  • Scientists believe that if everybody adopted a healthy lifestyle and medical advances in prevention, early detection and treatment of disease continue at their present pace, we could achieve an average life expectancy of 85 or 90.

  • As obesity becomes more pervasive in the U.S., some predict that life expectancy may actually decrease.13  

  • Men are more prone to taking risks than women.14  There's also evidence that they are quicker to aggression15 and more likely than females to express their aggression physically.16 

  • Male drivers have a 77 percent higher risk of dying in a car accident than women, based on miles driven.17

  • Men are much more likely to be incarcerated than women18 and are far more likely than women to be victims of violent crime.19 

  • If men attempt suicide, they are more likely to succeed than women.20  

  • About one-quarter of adult men currently smoke at least occasionally compared with one in five women21 which can leadto higher death rates from diseases like arteriosclerotic heart disease, lung cancer and emphysema.

  • Men drink more and indulge in recreational drugs more often than women, both risk factors for long-term health problems and accidental death.

  • A study published in the July 2000 issue of Psychological Review reported that females are more likely to deal with stress by seeking support and men are more likely to bottle it up, become aggressive or self-medicate with alcohol or drugs.

  • Men ages 15 to 44 are half as likely as women to go for preventive care visits.22  Also, compared to working-aged women, working-aged men are less likely to have a regular doctor and health insurance. 23

1 Centers for Disease Control and Prevention, National Center for Health Statistics.
2 Sexual selection and the Male:Female Mortality Ratio; Daniel Kruger, PhD; Randolph Nesse, MD;  Human Nature, 2004. 2: 66-85
Number of Fetal Deaths by Sex and Period of Gestation, by Age of Mother: 2004; National Statistics Office, Vital Statistics Division
4 Drevenstedt et al. The rise and fall of excess male infant mortality.  Proceedings National Academy of Sciences April 1, 2008 vol. 105 (13) 5016-5021.
5 David R. Williams, the Institute for Social Research, American Journal of Public Health, May 2003.
6 American Heart Association.
7 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2004 Incidence and Mortality Web-based Report Version. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute.
8 Department of Health and Human Services (HHS).
9 Centers for Disease Prevention and Control.
10 University of Pittsburg School of the Health Sciences.
11 Institute for Social Research at the University of Michigan.
12 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Injury Statistics Query and Reporting System.
13 S. Jay Olshansky, David S. Ludwig; New England Journal of Medicine, March 17, 2005.
14 Marano, Hara Estroff (2003) The New Sex Scorecard Psychology Today Magazine, Jul/Aug 2003.
15 Zeichner, Amos, Dominic J. Parrott, and F.Charles Frey. 2003. Gender differences in Laboratory aggression under response choice conditions. Aggressive Behavior 29:95-106.
16 Bjorkqvist, K., Osterman, K., and Lagerspetz, K. (1994).  Sex differences in covert aggression among adults.  Aggressive Behavior, 20, 27-33.
17 Traffic STATS, Foundation for Traffic Safety, Carnegie Mellon University and the American Automobile Association.
18 Prevalence of Imprisonment in the U.S. Population; 1974-2001 U.S. Department of Justice Special Report, August 2003, NCJ 197976.
19 Sex Differences in Violent Victimization U.S. Department of Justice Special Report September 1997, NCJ-164508.
20 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System.
21  National Center for Health Statistics, Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2002, Series 10, No. 222, 2004.
22 Physician visits on the rise as Baby Boomers age; Association of Operating Room Nurses, Inc. Nov, 2003
23 U.S. Department of Health and Human Services

 

Ask Your Doctor

  • What are my risk factors for disease?

  • What can I do to lower my risk factors for disease?

  • How often should I come in for routine check-ups?

  • Are there medical screenings I can undergo?

  • What are my numbers (and what should they be) for:
    • Blood pressure
    • Cholesterol
    • Blood sugar
    • Prostate specific antigen (PSA)

  • What vaccines do I need?

  • Should I take vitamins or supplements? 

  • Should I take aspirin to prevent heart disease?

  • How much physical activity is recommended for an adult my age? Is this right for me?

  • Are there exercises I should avoid doing?

  • How can I be sure that I am eating a healthy diet?

  • Are there foods to avoid?

  • If you have any nagging doubts about anything: Is (describe symptom) normal?

Key Point 1

Statistically men in the U.S. die at a younger age than women for several reasons, including genetic and biologic factors.

Being male is now the single largest risk factor for early mortality in developed countries.1  

How much of the longevity gap is due to biology and how much to environment or behavior is a matter of debate among scientists.  Consider melanoma.  Those at increased risk for getting this life-threatening form of skin cancer are people with a fair complexion (a biological factor) and people who over-expose their skin to ultraviolet light from the sun or a sun lamp (environmental and behavioral factors).  Read the introductory page for this topic for an overview of the factors behind our gender longevity gap.    

According to Second Opinion participant Thomas Perls, MD, women have been outliving men for centuries though the gap has changed over time, primarily due to the hazards of childbirth.  As medical science has become more successful in providing better outcomes for women delivering babies, the longevity gap has increased.   In 1900 the differential for Americans was three years (50.9 years for women vs. 47.9 years for men).  By 1950, women outlived men an average of 5.5 years.2

The longevity gap varies by age.  While boys die more frequently than girls in infancy, during childhood, and during each subsequent year of life, male mortality accelerates considerably during certain stages of life.  Between ages 15 and 24 years, when testosterone is at its highest levels in men, they are four to five times more likely to die than women.  The gap then narrows until late middle age when the death rate for men increases mainly due to heart disease, suicide, car accidents and illnesses related to smoking and alcohol use.  Among centenarians worldwide, women outnumber males nine to one.3 

According to a study done in 2003 by the Institute for Social Research at the University of Michigan, men have higher age-adjusted death rates than women for the 15 leading causes of death in the U.S., with the exception of Alzheimer's disease.4   The Centers for Disease Control and Prevention listed those 15 leading causes of death in 2005 as the following:

  • Heart disease
  • Cancer
  • Stroke
  • Chronic lower respiratory diseases
  • Accidents
  • Diabetes
  • Alzheimer's disease
  • Influenza and pneumonia
  • Kidney disease
  • Septicemia
  • Suicide
  • Chronic liver disease and cirrhosis
  • Hypertension
  • Parkinson's disease
  • Homicide

Consider the following:

  • Because men usually develop heart disease 10 to 15 years earlier than women do, they are more likely to die of it in the prime of life. About one-fourth of all heart-disease-related deaths occur in men ages 35 to 65.5 
  • More American men than women are stricken with cancer. The age-adjusted invasive cancer incidence rate per 100,000 people in 2004 was 537.6 for men and 402.1 for women.6
     
  • Men are 30% more likely to suffer a stroke than are women, making it the third-leading cause of death in men.7

  • More than twice as many men die each year because of accidents as do women.8

  • Men have a 30 percent higher risk of death from pneumonia than women.9 

 

  • Men's death rates are at least twice as high as women's for suicide, homicide and cirrhosis of the liver.10  

 

  • If men attempt suicide, they are more likely to succeed than women.  Suicide was the eighth leading cause of death for males and the sixteenth leading cause of death for females in 2004.11

 1 Sexual selection and the Male:Female Mortality Ratio; Daniel Kruger, PhD; Randolph Nesse, MD;  Human Nature, 2004. 2: 66-85 
2 Just Like a Woman: How Gender Science is Redefining What Makes Us Female Dianne Hales, Random House, Inc.      
3 Thomas Perls, MD, Harvard Medical School, New England Centenarian Study (NECS).
4 David R. Williams, the Institute for Social Research, American Journal of Public Health, May 2003.
5 American Heart Association.
6 U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2004 Incidence and Mortality Web-based Report Version. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute.
7 Department of Health and Human Services (HHS).
8 Centers for Disease Prevention and Control.
9 University of Pittsburg School of the Health Sciences.
10 Institute for Social Research at the University of Michigan.
11 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Injury Statistics Query and Reporting System.

Key Point 2

External forces such as social, cultural, environmental and behavioral factors interact with your genetic makeup and have an impact on your lifespan.  You can make a difference in these factors and can take active steps to live longer. 

It is risky being a guy.  American men have made great progress from a life expectancy at birth in 1900 of just 47.9 years to 75.2 years in 2005, but women have outpaced them with a life expectancy that has increased from 50.9 in 1900 to 80.4 in 2005.1-2   The difference:  a longevity gap between men and women that has grown during the 20th century from 3 to 5.2 years. 

No one knows what the upper limit for longevity might be.  What we do know, is most people – of both sexes – are not living to their potential.  Scientists believe that if everybody adopted a healthy lifestyle and medical advances in prevention, early detection and treatment of disease continue at their present pace, we could achieve an average life expectancy of 85 or 90.  See the Second Opinion episode on Longevity for more information.

The best data we have today suggests that only about one-third of longevity is due to genes.  Plus, the importance of genetic inheritance matters less as we age.  By the age of 80, behavioral choices account almost entirely for overall health and longevity.   That leaves us with a big opportunity to make changes that can lead to longer, healthier lives.

Behavioral and environmental factors that influence longevity include:

  • Diet:  An unhealthy diet and obesity contribute to the rise of cancers, heart disease and diabetes. In fact, as obesity becomes more pervasive in the U.S., some predict that life expectancy may actually decrease.3   Doctors recommend a varied diet rich in fruits and vegetables and low in high-fat foods.  Second Opinion participant Thomas Perls, MD, suggests that men reduce their iron intake by eating less red meat to minimize the impact of iron in producing damaging free radicals. A group of European doctors introduced the idea of the "Polymeal" diet in 2004.  They believe the diet, which recipe includes wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds, could increase male life expectancy by 6.6 years and female life expectancy by 4.8 years.4  See the Second Opinionepisodes on:
  • Behaviors:  Men are more prone to taking risks than women.5  There is also evidence that they are quicker to aggression6 and more likely than females to express their aggression physically.

More men than women die in accidents, homicides, and suicides.  They drive more aggressively and are less likely to wear a seatbelt.  Male drivers have a 77 percent higher risk of dying in a car accident than women, based on miles driven.They are much more likely to be incarcerated than women9 and are far more likely than women to be victims of violent crime.10  If men attempt suicide, they are more likely to succeed than women.11  

About one-quarter of adult men currently smoke at least occasionally compared with one in five women12 which can leadto higher death rates from diseases like arteriosclerotic heart disease, lung cancer and emphysema.  They also drink more and indulge in recreational drugs more often than women, both risk factors for long-term health problems and accidental death. 

What can men do?  Cigarette smoking remains the single most preventable cause of death in the United States for both men and women.  By quitting, scientists estimate they can add as many as 7 to 10 years to their lives.  In terms of accidents, the first step to reduce your risk is to face up to your bad behaviors and the fact that you are not invincible.  Make a commitment to:

    • Quit smoking
    • Drink alcohol only in moderation, if at all
    • Drive only when alert and sober; use your seat belt and obey speed limits
    • Avoid places where violence is likely to occur
    • Get counseling if you have problems with anger management, stress or depression

  • Coping skills:  Second Opinion panelist Royda Crose, PhD, says that women's capacity for flexibility, connection, and resilience allows them to sustain and survive life's inevitable disappointments and crises.  Because men are socialized from an early age to be emotionally unexpressive and self-sufficient, they generally have fewer friendships and smaller social networks than women.    

Men and women handle stress differently.  A study published in the July 2000 issue of Psychological Review reported that females are more likely to deal with stress by seeking support and men are more likely to bottle it up, become aggressive or self-medicate with alcohol or drugs.  Stress can depress the immune system, raise blood pressure, raise blood sugar and contribute to cardiovascular problems. 

What strategies help men cope?

    • Making a plan of action to deal with the problem and help men feel more in control
    • Exercising to decrease the production of stress hormones and counteract the body's natural stress response
    • Seeking professional help
    • Becoming more willing to acknowledge their stress and to express emotions to family and friends   

       
  • Access to quality health care.  Men, particularly those under age 40, are much more likely than women to put off routine checkups and ignore symptoms of health problems.  In fact, men ages 15 to 44 are half as likely as women to go for preventive care visits.13 Also, compared to working-aged women, working-aged men are less likely to have a regular doctor and health insurance. 14  Steps to take are simple:
    • Find a primary-care physician. A doctor who knows you can catch problems before they escalate.
    • Learn about your risk factors and find out what you can do to lower them
    • Find out how often you should see your doctor for routine checkups and what screenings, tests, and vaccines you will need.  See the checklist  from the Agency for Healthcare Research and Quality for suggestions.

1 National Center for Health Statistics, 2004
2 Just Like a Woman: How Gender Science is Redefining What Makes Us Female Dianne Hales, Random House, Inc. 
3 S. Jay Olshansky, David S. Ludwig; New England Journal of Medicine, March 17, 2005.
4 Franco OH, Bonneux L, De Laet C, Peeters A, Steyerberg EW, Mackenbach JP. BMJ 2004;329:1447-50.
5 Marano, Hara Estroff (2003) The New Sex Scorecard Psychology Today Magazine, Jul/Aug 2003.
6 Zeichner, Amos, Dominic J. Parrott, and F.Charles Frey. 2003. Gender differences in Laboratory aggression under response choice conditions. Aggressive Behavior 29:95-106.
7 Bjorkqvist, K., Osterman, K., and Lagerspetz, K. (1994).  Sex differences in covert aggression among adults.  Aggressive Behavior, 20, 27-33. 
8 Traffic STATS, Foundation for Traffic Safety, Carnegie Mellon University and the American Automobile Association.
9 Prevalence of Imprisonment in the U.S. Population; 1974-2001 U.S. Department of Justice Special Report, August 2003, NCJ 197976.
10 Sex Differences in Violent Victimization U.S. Department of Justice Special Report September 1997, NCJ-164508.
11 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Injury Statistics Query and Reporting System.
12  National Center for Health Statistics, Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2002, Series 10, No. 222, 2004
13 Physician visits on the rise as Baby Boomers age; Association of Operating Room Nurses, Inc. Nov, 2003
14 U.S. Department of Health and Human Services

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