If Men Are Favored in Society, Why Do They Die Younger?

Women experience higher stress, more chronic disease, more depression, more anxiety and are more likely to be victims of violence. Women earn less than men, and in many countries they don’t have the same human rights as men. Despite the social inequality women experience, they live longer than men. This is the case without a single exception, in all countries. For instance, in the U.S. in 2015 female full-time workers made only 80 cents for every dollar earned by men, indicating a 20 percent gender wage gap. Yet, life expectancy for women in the U.S. is 81.2 years compared to 76.4 for males. Even in countries with larger wage gaps or extreme gender inequalities, women live longer than men. As a researcher who studies cross-country and gender differences in health, I am always fascinated by how the intersection of these factors influences health. So why do women live longer, despite their lower social rank and worse health? Is it basic biology? Gender refers to social aspects of being a woman or a man such as social stress, opportunity and social expectations. Sex, on the other hand, refers to biology. Biology can contribute to this difference in life expectancy. Women have biological advantages that let them live longer. For instance, estrogen benefits women because it lowers low-density lipoprotein cholesterol (or LDL, what you may know as "bad" cholesterol) and increases high-density lipoprotein cholesterol (or HDL, the "good" cholesterol), which reduces cardiovascular risk. Testosterone, on the other hand, increases blood levels of the bad cholesterol and decreases levels of good cholesterol. This puts men at greater risk of hypertension, heart disease and stroke. When it comes to chronic diseases, women tend to have more of them. But there is a caveat here. Men and women have different types of chronic disease. Women have more nonfatal, chronic conditions, while men have more fatal conditions. For example, women have more arthritis, which does not kill, even if disabling. In contrast, men are at higher risk of chronic diseases that are leading killers. Heart disease starts 10 years earlier in men than women. So, biological differences play a role in this life expectancy gap, but gender, I argue, plays a bigger role. Women are more health aware Studies have shown that, in general, women are more health conscious, and they have higher awareness of their physical and mental symptoms. These all result in healthier lifestyles and better health care use. Women also communicate better about their problems, which helps the process of diagnosis. Being a man means delayed initiation of treatment of any kind. Men are less adherent to treatment. These issues collectively cause males to be vulnerable to therapeutic failure. Masculinity is a socially learned construct, and it can have unhealthy effects. Many men define unhealthy and risky behaviors as masculine, while they see health care use and health-promoting behaviors as feminine. Risky behavior and sensation-seeking Testosterone puts men at risk biologically, but it also puts men at risk behaviorally. It increases aggressiveness, and, in a cascading effect, results in higher death rate from accidents and homicide. My colleague and I followed more than 250 youth and found that baseline testestrone predicts future violent behaviors. Women systematically overestimate risk of any type, while men consistently underestimate it. This pattern has been observed regardless of the context. These include examples ranging from crossing a road to perception of risk of volcano, smoking or a terrorist attack. Among pedestrians, males violate more rules than females. Among drivers, men more commonly break the rules. Accidents, like motor vehicle crashes, are far more common among men than women. This is due in part to men’s greater risk-taking, underestimation of risk, sensation-seeking, and tendency to be more impulsive. This difference extends to almost any task in real lives.