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→Diseases: adding info about sex differences in heart disease, stroke, and cancer, and their role in the female survival advantage.
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=== Diseases ===
=== Diseases ===
Men suffer from heart disease, cancer, and stroke more than women do. These diseases are the main cause of the gender gap in life expectancy. <ref> Hossin, Muhammad Zakir. "The male disadvantage in life expectancy: can we close the gender gap?" International Health, ihaa106, https://doi.org/10.1093/inthealth/ihaa106 Published: 03 February 2021 </ref>
It has been summarized by many studies that men die more than women, in each age group. Women experience more illnesses than men from [[adolescence]] to adulthood. This can likely be attributed to the fact that women have a higher chance of experiencing chronic conditions than men.


The majority of the female survival advantage is accounted for by differences in mortality rates between men and women ages 50–70 due to differing rates of [[cardiovascular disease]]s.<ref>{{cite journal|last1=Beltrán-Sánchez|first1=Hiram|last2=Finch|first2=Caleb E.|last3=Crimmins|first3=Eileen M.|year=2015|title=Twentieth century surge of excess adult male mortality|journal=Proceedings of the National Academy of Sciences|volume=112|issue=29|pages=8993–8998|bibcode=2015PNAS..112.8993B|doi=10.1073/pnas.1421942112|pmc=4517277|pmid=26150507}}</ref>
The majority of the female survival advantage is accounted for by differences in mortality rates between men and women ages 50–70 due to differing rates of [[cardiovascular disease]]s.<ref>{{cite journal|last1=Beltrán-Sánchez|first1=Hiram|last2=Finch|first2=Caleb E.|last3=Crimmins|first3=Eileen M.|year=2015|title=Twentieth century surge of excess adult male mortality|journal=Proceedings of the National Academy of Sciences|volume=112|issue=29|pages=8993–8998|bibcode=2015PNAS..112.8993B|doi=10.1073/pnas.1421942112|pmc=4517277|pmid=26150507}}</ref>
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Overall, men and women are affected by mental disorders at similar rates, but men and women are diagnosed with different kinds of disorders at different rates. For example, men are more prone to experience [[substance abuse]], whereas women are more prone to be diagnosed with [[major depression|depression]] and [[anxiety disorders]]. <ref>{{cite web |title=Gender differences in Mental Health |url=https://ramh.org/guide/gender-differences-in-mental-health/ |website=Recovery Across Mental Health |publisher=Recovery Across Mental Health |access-date=28 February 2021}}</ref> An additional factor in male mortality is the [[gender differences in suicide]] - men are more likely to die from suicide despite suicide attempt rates being equal between genders. <ref>{{cite journal |last1=Freeman |first1=Aislinné |last2=Mergl |first2=Roland |last3=Kohls |first3=Elisabeth |last4=Székely |first4=András |last5=Gusmao |first5=Ricardo |last6=Arensman |first6=Ella |last7=Koburger |first7=Nicole |last8=Hegerl |first8=Ulrich |last9=Rummel-Kluge |first9=Christine |title=A cross-national study on gender differences in suicide intent |journal=BMC Psychiatry |date=29 June 2017 |volume=17 |issue=234 |url=https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1398-8 |access-date=28 February 2021}}</ref>
Overall, men and women are affected by mental disorders at similar rates, but men and women are diagnosed with different kinds of disorders at different rates. For example, men are more prone to experience [[substance abuse]], whereas women are more prone to be diagnosed with [[major depression|depression]] and [[anxiety disorders]]. <ref>{{cite web |title=Gender differences in Mental Health |url=https://ramh.org/guide/gender-differences-in-mental-health/ |website=Recovery Across Mental Health |publisher=Recovery Across Mental Health |access-date=28 February 2021}}</ref> An additional factor in male mortality is the [[gender differences in suicide]] - men are more likely to die from suicide despite suicide attempt rates being equal between genders. <ref>{{cite journal |last1=Freeman |first1=Aislinné |last2=Mergl |first2=Roland |last3=Kohls |first3=Elisabeth |last4=Székely |first4=András |last5=Gusmao |first5=Ricardo |last6=Arensman |first6=Ella |last7=Koburger |first7=Nicole |last8=Hegerl |first8=Ulrich |last9=Rummel-Kluge |first9=Christine |title=A cross-national study on gender differences in suicide intent |journal=BMC Psychiatry |date=29 June 2017 |volume=17 |issue=234 |url=https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1398-8 |access-date=28 February 2021}}</ref>

=== Social factors ===
=== Social factors ===
It has been concluded that sociological and biological factors both contribute to the paradox.<ref>{{cite journal |doi=10.1093/geronb/60.Special_Issue_2.S40 |title=Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological Perspectives |journal=The Journals of Gerontology: Series B |volume=60 |pages=S40–S47 |year=2005 |last1=Rieker |first1=Patricia P. |last2=Bird |first2=Chloe E. |pmid=16251589 }}</ref>
It has been concluded that sociological and biological factors both contribute to the paradox.<ref>{{cite journal |doi=10.1093/geronb/60.Special_Issue_2.S40 |title=Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological Perspectives |journal=The Journals of Gerontology: Series B |volume=60 |pages=S40–S47 |year=2005 |last1=Rieker |first1=Patricia P. |last2=Bird |first2=Chloe E. |pmid=16251589 }}</ref>

Revision as of 20:16, 3 July 2021

The male-female health-survival paradox, also known as the morbidity-mortality paradox or gender paradox, is the phenomenon in which women experience more medical conditions and disability during their lives, but they unexpectedly live longer than men. It is considered a paradox because of the normal assumption that sicker people will die sooner than people who experience less disease and disability. In this case, however, the population that experiences the most disease and disability is the one that lives longer.

Records of the female survival advantage can be traced back to the 18th century, but gained popularity and caught the eyes of researchers in the 19th century.

Female survival advantage

Women outlive men for all age groups and every year for which reliable records exist.[1] This paradox has not been found in older adults, where women statistically have lower mortality rates than men, but they experience a similar rate of illness, as men. [2]

A female survival advantage is found in some, but not all species. Various explanations for this have been proposed, but none are strongly supported.[3] Most species studied show conditional sex differences in life span, for males or females depending on the species in question. In humans, women outlive men in 176 of 178 countries for which records are available, both at age 5 and at age 50.[4] The female survival advantage holds true among humans, but the same can not be said for baboons.[5][6][7]

Influential factors

Risky behaviors

Despite men having more fatal conditions, women have more non-fatal acute and chronic conditions.[8]

Different rates of alcohol and tobacco usage by men and women contribute to the paradox in developed countries.[9] It has also been stated that men experience smoking-related conditions more than women.[10]

Behavioral factors, like men smoking more than women and engaging in more coronary-prone behavior, as well as biological factors, like female hormones, contribute to the female survival advantage.[11][12]

Diseases

Men suffer from heart disease, cancer, and stroke more than women do. These diseases are the main cause of the gender gap in life expectancy. [13]


The majority of the female survival advantage is accounted for by differences in mortality rates between men and women ages 50–70 due to differing rates of cardiovascular diseases.[14]

This paradox is difficult to detect, especially depending upon the indicators used to identify the phenomenon as well as the phase of the life cycle that each of the participants are in.[15][16] For example, men have higher rates of cardiovascular diseases, after adjusting the data for the gap in life expectancy. When viewing this statistic, it is important to consider that women have higher rates of cardiovascular disease, in general, because of their longer life expectancy.[17] Women also have higher rates of autoimmune disorders than men.

Overall, men and women are affected by mental disorders at similar rates, but men and women are diagnosed with different kinds of disorders at different rates. For example, men are more prone to experience substance abuse, whereas women are more prone to be diagnosed with depression and anxiety disorders. [18] An additional factor in male mortality is the gender differences in suicide - men are more likely to die from suicide despite suicide attempt rates being equal between genders. [19]

Social factors

It has been concluded that sociological and biological factors both contribute to the paradox.[20]

Proposed explanations for the paradox range from genetic, e.g. two X chromosomes protecting against recessive genes; hormonal, e.g. estrogen protecting against cardiovascular diseases; and behavioral, e.g. the expectations around the female sex role making women more willing to seek medical help sooner. There are doubts about the role of hormones due to mixed results in hormone replacement therapy studies on elderly women.

There is also mixed evidence on the role of help-seeking behavior, with some studies reporting that women are more likely to seek medical treatment for all symptoms, and some reporting that women only seek more treatment on malaise-type symptoms.[21]

Genetic and physiological factors

Women's superior ability to store excess calories also contributes to their survival advantage.[22] Women have lower mortality rates in high-mortality conditions like famine and epidemics. In such conditions, most of the advantage comes from differences in infant mortality rates.[23]

A research study conducted on flies indicated that the alleles that contribute to male inclusive fitness also harm female health, and thus contribute to the paradox.[24]

male morbidity advantage

Women tend to report poorer health and more hospital visits than men. Women have more psychological disorders than men. But not more physical disorders. Women spend more years in good health than men. However, women spend more years in poor health than men as a proportion of their life expectancy. This implies that the male morbidity advantage is linked to the female survival advantage. [25]

Potential bias

Data collected from a research study in Denmark indicated that the paradox is likely due, in part, to selection bias.[26] Women have higher preferences for absenteeism. On average, they are absent from work for health reasons more often than men, including when they do not have objectively worse health.[27]

References

  1. ^ Austad, Steven N.; Bartke, Andrzej (2015). "Sex Differences in Longevity and in Responses to Anti-Aging Interventions: A Mini-Review". Gerontology. 62 (1): 40–46. doi:10.1159/000381472. PMID 25968226.
  2. ^ Gordon, Emily H.; Peel, Nancye M.; Hubbard, Ruth E. (2018). "The male-female health-survival paradox in hospitalised older adults". Maturitas. 107: 13–18. doi:10.1016/j.maturitas.2017.09.011. PMID 29169574.
  3. ^ Austad, Steven N. (2006). "Why women live longer than men: Sex differences in longevity". Gender Medicine. 3 (2): 79–92. doi:10.1016/S1550-8579(06)80198-1. PMID 16860268.
  4. ^ Austad, Steven N.; Fischer, Kathleen E. (2016). "Sex Differences in Lifespan". Cell Metabolism. 23 (6): 1022–1033. doi:10.1016/j.cmet.2016.05.019. PMC 4932837. PMID 27304504.
  5. ^ Alberts, Susan C.; Archie, Elizabeth A.; Gesquiere, Laurence R.; Altmann, Jeanne; Vaupel, James W.; Christensen, Kaare (2014). "The Male-Female Health-Survival Paradox: A Comparative Perspective on Sex Differences in Aging and Mortality". In Weinstein, Maxine; Lane, Meredith A. (eds.). Sociality, Hierarchy, Health: Comparative Biodemography: A Collection of Papers. pp. 339–63. ISBN 978-0-309-30661-4.
  6. ^ Austad, Steven N.; Fischer, Kathleen E. (2016). "Sex Differences in Lifespan". Cell Metabolism. 23 (6): 1022–1033. doi:10.1016/j.cmet.2016.05.019. PMC 4932837. PMID 27304504.
  7. ^ Bastos, Tássia Fraga; Canesqui, Ana Maria; Barros, Marilisa Berti de Azevedo (2015). "'Healthy Men' and High Mortality: Contributions from a Population-Based Study for the Gender Paradox Discussion". PLOS ONE. 10 (12): e0144520. Bibcode:2015PLoSO..1044520B. doi:10.1371/journal.pone.0144520. PMC 4671596. PMID 26641245.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  8. ^ Chloe E. Bird, Patricia P. Rieker. "Gender and Health: The Effects of Constrained Choices and Social Policies". page 1.
  9. ^ Van Oyen, Herman; Nusselder, Wilma; Jagger, Carol; Kolip, Petra; Cambois, Emmanuelle; Robine, Jean-Marie (2013). "Gender differences in healthy life years within the EU: An exploration of the "health–survival" paradox". International Journal of Public Health. 58 (1): 143–155. doi:10.1007/s00038-012-0361-1. PMC 3557379. PMID 22618297.
  10. ^ Case, Anne; Paxson, Christina H. (2005). "Sex Differences in Morbidity and Mortality" (PDF). Demography. 42 (2): 189–214. doi:10.1353/dem.2005.0011. JSTOR 4147343. PMID 15986983. S2CID 1112587.
  11. ^ Waldron, Ingrid; Johnston, Susan (1976). "Why do Women Live Longer than Men?". Journal of Human Stress. 2 (2): 19–30. doi:10.1080/0097840X.1976.9936063. PMID 1018115.
  12. ^ Johansson, S. (1989). "Longevity in women". Cardiovascular Clinics. 19 (3): 3–16. PMID 2644037.
  13. ^ Hossin, Muhammad Zakir. "The male disadvantage in life expectancy: can we close the gender gap?" International Health, ihaa106, https://doi.org/10.1093/inthealth/ihaa106 Published: 03 February 2021
  14. ^ Beltrán-Sánchez, Hiram; Finch, Caleb E.; Crimmins, Eileen M. (2015). "Twentieth century surge of excess adult male mortality". Proceedings of the National Academy of Sciences. 112 (29): 8993–8998. Bibcode:2015PNAS..112.8993B. doi:10.1073/pnas.1421942112. PMC 4517277. PMID 26150507.
  15. ^ MacIntyre, Sally; Hunt, Kate; Sweeting, Helen (1996). "Gender differences in health: Are things really as simple as they seem?". Social Science & Medicine. 42 (4): 617–624. doi:10.1016/0277-9536(95)00335-5. PMID 8643986.
  16. ^ Kulminski, Alexander M.; Culminskaya, Irina V.; Ukraintseva, Svetlana V.; Arbeev, Konstantin G.; Land, Kenneth C.; Yashin, Anatoli I. (2008). "Sex-specific health deterioration and mortality: The morbidity–mortality paradox over age and time". Experimental Gerontology. 43 (12): 1052–1057. doi:10.1016/j.exger.2008.09.007. PMC 2703431. PMID 18835429.
  17. ^ Möller-Leimkühler, Anne Maria (2007). "Gender differences in cardiovascular disease and comorbid depression". Dialogues in Clinical Neuroscience. 9 (1): 71–83. doi:10.31887/DCNS.2007.9.1/ammoeller. ISSN 1294-8322. PMC 3181845. PMID 17506227.
  18. ^ "Gender differences in Mental Health". Recovery Across Mental Health. Recovery Across Mental Health. Retrieved 28 February 2021.
  19. ^ Freeman, Aislinné; Mergl, Roland; Kohls, Elisabeth; Székely, András; Gusmao, Ricardo; Arensman, Ella; Koburger, Nicole; Hegerl, Ulrich; Rummel-Kluge, Christine (29 June 2017). "A cross-national study on gender differences in suicide intent". BMC Psychiatry. 17 (234). Retrieved 28 February 2021.
  20. ^ Rieker, Patricia P.; Bird, Chloe E. (2005). "Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological Perspectives". The Journals of Gerontology: Series B. 60: S40–S47. doi:10.1093/geronb/60.Special_Issue_2.S40. PMID 16251589.
  21. ^ Oksuzyan, Anna; Juel, Knud; Vaupel, James W.; Christensen, Kaare (2008). "Men: Good health and high mortality. Sex differences in health and aging". Aging Clinical and Experimental Research. 20 (2): 91–102. doi:10.1007/BF03324754. PMC 3629373. PMID 18431075.
  22. ^ Seely, Stephen (1990). "The gender gap: Why do women live longer than men?". International Journal of Cardiology. 29 (2): 113–119. doi:10.1016/0167-5273(90)90213-O. PMID 2269531.
  23. ^ Zarulli, Virginia; Barthold Jones, Julia A.; Oksuzyan, Anna; Lindahl-Jacobsen, Rune; Christensen, Kaare; Vaupel, James W. (2018). "Women live longer than men even during severe famines and epidemics". Proceedings of the National Academy of Sciences. 115 (4): E832–E840. doi:10.1073/pnas.1701535115. PMC 5789901. PMID 29311321.
  24. ^ Archer, C. Ruth; Recker, Mario; Duffy, Eoin; Hosken, David J. (2018). "Intralocus sexual conflict can resolve the male-female health-survival paradox". Nature Communications. 9 (1): 5048. Bibcode:2018NatCo...9.5048A. doi:10.1038/s41467-018-07541-y. PMC 6261961. PMID 30487539.
  25. ^ Hossin, Muhammad Zakir. "The male disadvantage in life expectancy: can we close the gender gap?" International Health, ihaa106, https://doi.org/10.1093/inthealth/ihaa106 Published: 03 February 2021
  26. ^ Oksuzyan, Anna; Petersen, Inge; Stovring, Henrik; Bingley, Paul; Vaupel, James W.; Christensen, Kaare (2009). "The Male–Female Health–Survival Paradox: A Survey and Register Study of the Impact of Sex-Specific Selection and Information Bias". Annals of Epidemiology. 19 (7): 504–511. doi:10.1016/j.annepidem.2009.03.014. PMC 2696561. PMID 19457685.
  27. ^ Avdic, Daniel; Johansson, Per (2017). "Absenteeism, Gender and the Morbidity-Mortality Paradox". Journal of Applied Econometrics. 32 (2): 440–462. doi:10.1002/jae.2516.
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