Definition
The male-female health-mortality paradox results from the fact that females live longer than males but spend a higher proportion of their total life expectancy in poorer health states. The phenomenon is depicted in schematic Fig. 1, where the gray-shaded area represents the proportion of total life expectancy spent in poor health, for females and males, respectively, on panels a and b. It is clear that the gray-shaded areas, representative of poor life expectancy, are larger for women than for men. The sum of the white area and the gray-shaded area is equal to the total life expectancy. Since health is an important predictor of death, the fact that women live longer in spite of a higher proportion of their lives spent in unhealthy state puzzles researchers. Some other terms used to describe the phenomenon are “gender and health paradox,” “morbidity paradox,” “morbidity-mortality paradox,” or “male-female health-survival paradox.”
References
Beckett LA, Brock DB, Lemke JH et al (1996) Analysis of change in self-reported physical function among older persons in four population studies. Am J Epidemiol 143:766–778
Case A, Paxson C (2005) Sex differences in morbidity and mortality. Demography 42:189–214. https://doi.org/10.2307/4147343
Christensen K, Kristiansen M, Hagen-Larsen H et al (2000) X-linked genetic factors regulate hematopoietic stem-cell kinetics in females. Blood 95:2449–2451
Clutton-Brock T, Isvaran K (2007) Sex differences in ageing in natural populations of vertebrates. Proc R Soc B Biol Sci 274:3097–3104. https://doi.org/10.1098/rspb.2007.1138
Crimmins EM, Kim JK, Hagedorn A (2002) Life with and without disease: women experience more of both. J Women Aging 14:47–59. https://doi.org/10.1300/J074v14n01_04
Deeg DJH, Kriegsman DMW (2003) Concepts of self-rated health: specifying the gender difference in mortality risk. Gerontologist 43:376–386. https://doi.org/10.1093/geront/43.3.376
Galdas PM, Cheater F, Marshall P (2005) Men and health help-seeking behaviour: literature review. J Adv Nurs 49:616–623. https://doi.org/10.1111/j.1365-2648.2004.03331.x
Global Health Observatory, World Health Organization (2018) Life expectancy and healthy life expectancy data by WHO region. Retrieved from http://apps.who.int/gho/data/view.main.SDG2016LEXREGv?lang=en
Green CA, Pope CR (1999) Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Soc Sci Med 48:1363–1372. https://doi.org/10.1016/S0277-9536(98)00440-7
Grundy E (2006) Gender and healthy aging. In: Longer life and healthy aging. Springer, Dordrecht, pp 173–199
Horiuchi S (1997) Postmenopausal acceleration of age-related mortality increase. J Gerontol A Biol Sci Med Sci 52:B78–B92
Idler EL (2003) Discussion: gender differences in self-rated health, in mortality, and in the relationship between the two. Gerontologist 43:372–375. https://doi.org/10.1093/geront/43.3.372
Jenkins CD (1976) Recent evidence supporting psychologic and social risk factors for coronary disease. N Engl J Med 294:1033–1038. https://doi.org/10.1056/NEJM197605062941904
Kalben BB (2002) Why men die younger: causes of mortality differences by sex. Society of Actuaries, Schaumburg
Kalmbach E, Furness RW, Griffiths R (2005) Sex-biased environmental sensitivity: natural and experimental evidence from a bird species with larger females. Behav Ecol 16:442–449. https://doi.org/10.1093/beheco/ari018
Keevil VL, Hayat S, Dalzell N et al (2013) The physical capability of community-based men and women from a British cohort: the European Prospective Investigation into Cancer (EPIC)-Norfolk study. BMC Geriatr 13:93. https://doi.org/10.1186/1471-2318-13-93
Lemaire J (2002) Why do females live longer than males? N Am Actuar J 6:21–37. https://doi.org/10.1080/10920277.2002.10596061
Leong DP, Teo KK, Rangarajan S et al (2015) Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet 386:266–273. https://doi.org/10.1016/S0140-6736(14)62000-6
Leveille SG, Penninx BWJH, Melzer D et al (2000) Sex differences in the prevalence of mobility disability in old age: the dynamics of incidence, recovery, and mortality. J Gerontol B Psychol Sci Soc Sci 55:S41. https://doi.org/10.1093/geronb/55.1.S41
Lorber J, Moore LJ (2002) Gender and the social construction of illness. AltaMira Press, Plymouth
Luy M (2003) Causes of male excess mortality: insights from cloistered populations. Popul Dev Rev 29:647–676. https://doi.org/10.1111/j.1728-4457.2003.00647.x
Luy M, Di Giulio P (2006) The impact of health behaviors and life quality on gender differences in mortality. In: Geppert J, Kühl J (eds) Gender und Lebenserwartung. Kleine, Bielefeld, pp 113–147
Luy M, Gast K (2014) Do women live longer or do men die earlier? Reflections on the causes of sex differences in life expectancy. Gerontology 60:143–153
Luy M, Wegner-Siegmundt C (2015) The impact of smoking on gender differences in life expectancy: more heterogeneous than often stated. Eur J Public Health 25:706–710. https://doi.org/10.1093/eurpub/cku211
Marmot MG, Shipley MJ, Rose G (1984) Inequalities in death – specific explanations of a general pattern? Lancet 1:1003–1006
Moore SL, Wilson K (2002) Parasites as a viability cost of sexual selection in natural populations of mammals. Science (80-) 297:2015–2018. https://doi.org/10.1126/science.1074196
Nathanson CA, Lopez AD (1987) The future of sex mortality differentials in industrialized countries: a structural hypothesis. Popul Res Policy Rev 6:123–136. https://doi.org/10.1007/BF00149204
Oksuzyan A, Juel K, Vaupel JW, Christensen K (2008) Men: good health and high mortality. Sex differences in health and aging. Aging Clin Exp Res 20:91–102
Oksuzyan A, Brønnum-Hansen H, Jeune B (2010) Gender gap in health expectancy. Eur J Ageing 7:213–218. https://doi.org/10.1007/s10433-010-0170-4
Oksuzyan A, Gumà J, Doblhammer G (2018) Sex differences in health and survival. In: A demographic perspective on gender, family and health in Europe. Springer International Publishing, Cham, pp 65–100
Pampel F (2005) Forecasting sex differences in mortality in high income nations. Demogr Res 13:455–484. https://doi.org/10.4054/DemRes.2005.13.18
Pressat R (1973) Surmortalité biologique et surmortalité sociale. Rev Fr Sociol 14:103–110
Preston SH, Wang H (2006) Sex mortality differences in the United States: the role of cohort smoking patterns. Demography 43:631–646
Redondo-Sendino Á, Guallar-Castillón P, Banegas J, Rodríguez-Artalejo F (2006) Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health 6:155. https://doi.org/10.1186/1471-2458-6-155
Rieker PP, Bird CE (2000) Sociological explanations of gender differences in mental and physical health. In: Bird CE, Conrad P, Fremont AM (eds) Handbook of medical sociology. Prentice Hall, Upper Saddle River, pp 98–113
Robine J-M, Jagger C, Romieu I (2001) Disability-free life expectancies in the European Union countries: calculation and comparisons. Genus 57:89–101. https://doi.org/10.2307/29788693
Roe CM, McNamara AM, Motheral BR (2002) Gender- and age-related prescription drug use patterns. Ann Pharmacother 36:30–39. https://doi.org/10.1345/aph.1A113
Simons-Morton BG, Farhat T, ter Bogt TFM et al (2009) Gender specific trends in alcohol use: cross-cultural comparisons from 1998 to 2006 in 24 countries and regions. Int J Public Health 54:199–208. https://doi.org/10.1007/s00038-009-5411-y
Springer KW, Mouzon DM (2011) “Macho men” and preventive health care. J Health Soc Behav 52:212–227. https://doi.org/10.1177/0022146510393972
Staetsky L, Hinde A (2009) Unusually small sex differentials in mortality of Israeli Jews: what does the structure of causes of death tell us? Demogr Res 20:209–252. https://doi.org/10.4054/DemRes.2009.20.11
Théré C, Rohrbasser J-M (2006) Facing death in the early days of life: inequality between the sexes in enlightenment demographic thought. Hist Fam 11:199–210. https://doi.org/10.1016/j.hisfam.2006.12.002
Vaccarino V, Krumholz HM, Mendes de Leon CF et al (1996) Sex differences in survival after myocardial infarction in older adults: a community-based approach. J Am Geriatr Soc 44:1174–1182
Verbrugge LM (1982) Sex differentials in health. Public Health Rep 97:417–437
Verbrugge LM (1985) Gender and health: an update on hypotheses and evidence. J Health Soc Behav 26:156. https://doi.org/10.2307/2136750
Verbrugge LM, Wingard DL (1987) Sex differentials in health and mortality. Women Health 12:103–145. https://doi.org/10.1300/J013v12n02_07
Waldron I (1983) Sex differences in human mortality: the role of genetic factors. Soc Sci Med 17:321–333
Waldron I (1985) What do we know about causes of sex differences in mortality? A review of the literature. Popul Bull UN 18:59–76
Waldron I (1995) Contributions of biological and behavioral factors to changing sex differences in ischaemic heart disease mortality. In: Lopez AD, Valkonen T, Caselli G (eds) Adult mortality in developed countries. Oxford University Press, Oxford, pp 161–178
Wingard DL (1982) The sex differential in morbidity, mortality, and lifestyle. Am J Epidemiol 115:205–216. https://doi.org/10.1146/annurev.pu.05.050184.002245
Wingard DL, Suarez L, Barrett-Connor E (1983) The sex differential in mortality from all causes and ischemic heart disease. Am J Epidemiol 117:165–172
Acknowledgments
This work was supported by the European Research Council, within the European Community’s Seventh Framework Programme (FP7/2007–2013), ERC Grant Agreement No. 262663 (HEMOX) and within the EU Framework Programme for Research and Innovation Horizon 2020, ERC Grant Agreement No. 725187 (LETHE). PI: Marc Luy.
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di Lego, V., Lazarevič, P., Luy, M. (2020). The Male-Female Health-Mortality Paradox. In: Gu, D., Dupre, M. (eds) Encyclopedia of Gerontology and Population Aging. Springer, Cham. https://doi.org/10.1007/978-3-319-69892-2_798-2
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The Male-Female Health-Mortality Paradox- Published:
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DOI: https://doi.org/10.1007/978-3-319-69892-2_798-2
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