Sex Differences in Mortality at the Local Level: An Analysis of Belgian Municipalities

Abstract

Explanations for the consistentfemale mortality advantage have ranged from thebiological, through the behavioural to thesocial, but we are still far from asatisfactory explanation. The current mortalityadvantage, which women enjoy in almost allsocieties and age groups, is not a historicaluniversal. Indeed, it may even be a uniquedevelopment of the 20th century. Even ifthis is the case, however, this does not makeit a necessary corollary of low mortality.Human mortality reflects the pattern of socialrelationships, standards of living, livingarrangements, and patterns of power andinequality in the society, and althoughmortality levels are similar for men and forwomen, they nonetheless display importantdifferences. These differences, in their turn,reflect the pattern of relationships betweenmen and women in the society. The presentanalysis looks at mortality levels anddifferences between men and women in Belgium.We focus on aggregate effects at themunicipality level (the smallest level oflocal government), and show that mortality isnegatively associated with high standards ofliving; familial solidarity; immigrantconcentration and a stable, locally born,population. It is positively associated with ahigh tendency to cohabitation. Male mortalityis more sensitive to social conditions than isfemale mortality so that as conditions improvethe female mortality advantage declines. Wealso show that net of these conditions thereremains a mortality disadvantage inWallonia, and this can only partly be explainedin terms of social differences between the twomajor regions of the country.