Advantage In Life Expectancy Research Articles

XX > XY?: The changing female advantage in life expectancy

Females live a lot longer than males in most parts of the world today. But that was not always the case. We ask when and why the female advantage emerged. We show that reductions in maternal mortality and fertility are only partial reasons. Rather, the sharp reduction in infectious disease in the early twentieth century played a role. Those who survive most infectious diseases carry a health burden that affects organs and impacts general well-being. We use newly collected data from Massachusetts containing information on cause of death since 1887 to show that females between the ages of 5 and 25 were disproportionately affected by infectious diseases. Both males and females lived longer as the burden of infectious disease fell, but women were more greatly impacted. Our explanation does not tell us precisely why women live longer than men, but it does help understand the timing of their relative increase.

Would the elimination of obesity and smoking reduce U.S. racial/ethnic/nativity disparities in total and healthy life expectancy?

Obesity and smoking are the two leading causes of preventable death and disability in the United States. Both of these health risks are socially patterned in ways that likely produce racial/ethnic/nativity disparities in total and healthy life expectancy. The current study simulates the extent to which the hypothetical elimination of smoking and obesity would change disparities in longevity and disability by analyzing data from 19,574 U.S.-born white, black, Hispanic and foreign-born Hispanic men and women in the 1999–2000 through 2009–2010 National Health and Nutrition Examination Survey and linked mortality files. Results suggest that the elimination of both obesity and smoking would significantly narrow disparities in total and healthy life expectancy between black and white adults and remaining differences are statistically non-significant. The longstanding life expectancy advantage of Hispanic immigrants over whites is reduced, but remains large. The life expectancy advantage of U.S.-born Hispanics is reduced as well, though to a smaller extent than what is observed for Hispanic immigrants. There were no significant observed healthy life expectancy differences between white and U.S.-born Hispanic adults. Overall study results suggest that the elimination of obesity and smoking would change the shape of racial/ethnic/nativity disparities in ways that would result in greater health equity.

Trajectories of allostatic load among older Americans and Britons: longitudinal cohort studies

BackgroundDifference in life expectancy between males and females has been suggested to rest on sex difference in physiological dysregulation. But allostatic load, a physiological index, has not been carefully examined for an extended period beyond middle age. We aim to draw longitudinal trajectories of allostatic load in a national sample of older Americans and Britons; also to examine sex-based trajectories and factors behind their differences.MethodsWe studied men and women aged ≥50 years participating in the Health and Retirement Study Waves 8–11, 2006–2012 (N = 15,583 person-years) and the English Longitudinal Study of Ageing Waves 2, 4 and 6, 2004–2012 (N = 14,765 person-years). Because of the difference in provenance, we included different number of biomarkers to calculate allostatic load in HRS and ELSA. In HRS we used 8 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, cystatin C, and C-reactive protein), while ELSA allostatic load was constructed from 10 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, BMI, triglyceride, fibrinogen and C-reactive protein). A growth curve model was fitted to repeated observations of allostatic load, demographic characteristics, socioeconomic position, comorbidities and health behaviours (smoking, drinking, and physical exercise). To account for attrition, a joint model was applied.ResultsThe analysis showed that allostatic load increases linearly with age in the U.S. However, there are different levels for males and females. In England allostatic load follows such different paths that their trajectories cross in later life.ConclusionsSex-based trajectories of allostatic load showed distinct female advantage and are mostly consistent with female advantage in life expectancy.

Age of Migration Differentials in Life Expectancy With Cognitive Impairment: 20-Year Findings From the Hispanic-EPESE.

To examine differences in life expectancy with cognitive impairment among older Mexican adults according to nativity (U.S.-born/foreign-born) and among immigrants, age of migration to the United States. This study employs 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent cognitively healthy and cognitively impaired prior to death among older Mexican adults residing in the southwestern United States. We combine age-specific mortality rates with age-specific prevalence of cognitive impairment, defined as a Mini-Mental Status Exam score of less than 21 points to calculate Sullivan-based life table models with and without cognitive impairment in later life. Foreign-born Mexican immigrants have longer total life expectancy and comparable cognitive healthy life expectancy regardless of gender compared to U.S.-born Mexican-Americans. However, the foreign-born spend a greater number of years after age 65 with cognitive impairment relative to their U.S.-born counterparts. Furthermore, we document an advantage in life expectancy with cognitive impairment and proportion of years after age 65 cognitively healthy among mid-life immigrant men and women relative to early- and late-life migrants. The relationship between nativity, age of migration, and life expectancy with cognitive impairment means that the foreign-born are in more need of support and time-intensive care in late life. This issue merits special attention to develop appropriate and targeted screening efforts that reduce cognitive decline for diverse subgroups of older Mexican-origin adults as they age.

Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble

SummaryBackgroundProjections of future mortality and life expectancy are needed to plan for health and social services and pensions. Our aim was to forecast national age-specific mortality and life expectancy using an approach that takes into account the uncertainty related to the choice of forecasting model.MethodsWe developed an ensemble of 21 forecasting models, all of which probabilistically contributed towards the final projections. We applied this approach to project age-specific mortality to 2030 in 35 industrialised countries with high-quality vital statistics data. We used age-specific death rates to calculate life expectancy at birth and at age 65 years, and probability of dying before age 70 years, with life table methods.FindingsLife expectancy is projected to increase in all 35 countries with a probability of at least 65% for women and 85% for men. There is a 90% probability that life expectancy at birth among South Korean women in 2030 will be higher than 86·7 years, the same as the highest worldwide life expectancy in 2012, and a 57% probability that it will be higher than 90 years. Projected female life expectancy in South Korea is followed by those in France, Spain, and Japan. There is a greater than 95% probability that life expectancy at birth among men in South Korea, Australia, and Switzerland will surpass 80 years in 2030, and a greater than 27% probability that it will surpass 85 years. Of the countries studied, the USA, Japan, Sweden, Greece, Macedonia, and Serbia have some of the lowest projected life expectancy gains for both men and women. The female life expectancy advantage over men is likely to shrink by 2030 in every country except Mexico, where female life expectancy is predicted to increase more than male life expectancy, and in Chile, France, and Greece where the two sexes will see similar gains. More than half of the projected gains in life expectancy at birth in women will be due to enhanced longevity above age 65 years.InterpretationThere is more than a 50% probability that by 2030, national female life expectancy will break the 90 year barrier, a level that was deemed unattainable by some at the turn of the 21st century. Our projections show continued increases in longevity, and the need for careful planning for health and social services and pensions.FundingUK Medical Research Council and US Environmental Protection Agency.

Decision analysis to define the optimal management of athletes with anomalous aortic origin of a coronary artery

ObjectivesThe goal of this study was to use decision analysis to evaluate the impact of varying uncertainties on the outcomes of patients with anomalous aortic origin of a coronary artery. MethodsTwo separate decision analysis models were created: one for anomalous left coronary artery (ALCA) and one for anomalous right coronary artery (ARCA). Three strategies were compared: observation, exercise restriction, and surgery. Probabilities and health utilities were estimated on the basis of existing literature. Deterministic and probabilistic sensitivity analyses were performed. ResultsSurgery was the optimal management strategy for patients <30 years of age with ALCA. As age increased, observation became an equivalent strategy and eventually surpassed surgery as the treatment of choice. The advantage on life expectancy for surgery over observation ranged from 2.6 ± 1.7 years for a 10-year-old patient to −0.03 ± 0.1 for a 65-year old patient. In patients with ARCA, observation was the optimal strategy for most patients with a life expectancy advantage over surgery of 0.1 ± 0.1 years to 0.2 ± 0.4 years, depending on age. Surgery was the preferred strategy only for patients <25 years of age when the perceived risk of sudden cardiac death was high and the perioperative mortality was low. Exercise restriction was a suboptimal strategy for both ALCA and ARCA in all scenarios. ConclusionsThe optimal management in anomalous aortic origin of a coronary artery depends on multiple factors, including individual patient characteristics. Decision analysis provides a tool to understand how these characteristics affect the outcomes with each management strategy and thus may aid in the decision making process for a particular patient.

Life Expectancy Among U.S.-born and Foreign-born Older Adults in the United States: Estimates From Linked Social Security and Medicare Data.

In recent decades, the geographic origins of America's foreign-born population have become increasingly diverse. The sending countries of the U.S. foreign-born vary substantially in levels of health and economic development, and immigrants have arrived with distinct distributions of socioeconomic status, visa type, year of immigration, and age at immigration. We use high-quality linked Social Security and Medicare records to estimate life tables for the older U.S. population over the full range of birth regions. In 2000-2009, the foreign-born had a 2.4-year advantage in life expectancy at age 65 relative to the U.S.-born, with Asian-born subgroups displaying exceptionally high longevity. Foreign-born individuals who migrated more recently had lower mortality compared with those who migrated earlier. Nonetheless, we also find remarkable similarities in life expectancy among many foreign-born subgroups that were born in very different geographic and socioeconomic contexts (e.g., Central America, western/eastern Europe, and Africa).

Gender roles and traits in stress and health.

Women have a life-expectancy advantage over men, but a marked disadvantage with regards to morbidity. This is known as the female–male health-survival paradox in disciplines such as medicine, medical sociology, and epidemiology. Individual differences in physical and mental health are further notably explained by the degree of stress individuals endure, with women being more affected by stressors than men. Here, we briefly examine the literature on women’s disadvantage in health and stress. Beyond biological considerations, we follow with socio-cognitive explanations of gender differences in health and stress. We show that gender roles and traits (masculinity in particular) explain part of the gender differences in stress, notably cognitive appraisal and coping. Stress in turn degrades health. Implications are discussed. In conclusion, traditional socialization is advantageous for men in terms of health.

Widening Life Expectancy Advantage of Hispanics in the United States: 1990-2010.

We examine trends in the Hispanic longevity advantage between 1990 and 2010, focusing on the contribution of cigarette smoking. We calculate life expectancy at age 50 for Hispanics and non-Hispanic whites between 1990 and 2010. We use an indirect method to calculate the contribution of smoking to changes over time in life expectancy. Among women, the Hispanic advantage in life expectancy grows from 2.14years in 1990 (95% CI 1.99-2.30years) to 3.53years in 2010 (3.42-3.64years). More than 40% of this increase reflects widening differences in smoking-attributable mortality. The advantage for Hispanic men increases from 2.27years (2.14-2.41years) to 2.91years (2.81-3.01years), although smoking makes only a small contribution. Despite persistent disadvantage, US Hispanics have increased their longevity advantage over non-Hispanic whites since 1990, much of which reflects the continuing importance of cigarette smoking to the Hispanic advantage.

Mortality by marital status in a rapidly changing society: Evidence from the Czech Republic

AbstractBACKGROUNDMarried people tend to live longer than their unmarried counterparts, and the advantage in life expectancy enjoyed by married people relative to other groups has been increasing over time. The question of whether the benefits of marriage result from selection or protection continues to be debated. But even as this advantage has been increasing, the share of married people in the population has been declining.OBJECTIVEWe explore the dynamics of marital status mortality differentials in the Czech Republic since 1961. We are interested in the selection environment before and after the abrupt political shift in 1989, which led to a great deal of social change.METHODSUnlinked all-cause death counts were combined with the census population by marital status. Changes in overall life expectancy at age 30 were decomposed into those associated with mortality change within marital statuses, and those attributable to changes in the marital status composition of the population.RESULTSMortality differences by marital status increased mainly between 1961 and 1991, and were largely due to the failure of unmarried adults to catch up with the (modest) mortality improvements seen among married adults. Since 1991, the differentials have risen only slightly. Never-married people have lagged the most, with a life expectancy in 2010 that was 9.6 years lower among men and 7.7 years among women than among their married counterparts. The decrease in marriage prevalence reduced the improvement in overall male life expectancy by 0.9 years.CONCLUSIONSWhile there has been an absolute improvement in mortality among unmarried men since 1991, the life expectancy gap between married and unmarried men has increased. A plausible explanation for this gap is that the benefits of marriage are now available to a more (positively) selected population. Further research is needed to confirm these findings.1. IntroductionThere is extensive evidence that married people live longer than people who are unmarried (Ben-Shlomo et al. 1993; Burgoa et al. 1998; Hu and Goldman 1990; Lillard and Panis 1996; Martikainen et al. 2005; Vallin, Mesle, and Valkonen 2001; van Poppel and Joung 2001), and that mortality differentials by marital status tend to increase with time (Hu and Goldman 1990; Murphy, Grundy, and Kalogirou 2007; Valkonen, Martikainen, and Blomgren 2004). The majority of the previous research has focused on Western Europe and North America. At present, however, the European countries in which the relationship between mortality and marital status is changing most rapidly are those of the former Eastern Bloc. Studies of differential mortality in some former Soviet Republics have found extreme variability by marital status (Jasilionis et al. 2007; Kalediene, Petrauskiene, and Starkuviene 2007), and have demonstrated that the abandonment of marriage is an important obstacle to health improvement (Jasilionis et al. 2012).Our paper focuses on marital status mortality differentials in the Czech Republic between 1961 and 2010. These five decades cover three types of marital regimes: 1) pre-war, which was characterized by quasi-universal marriage and persists in older cohorts; 2) socialist, which was typified by high marriage and high divorce rates following the liberalization of divorce legislation in the 1960s; and 3) modern, which has been part of the on-going second demographic transition, and has been in place since the 1990s (Sobotka et al. 2008). In the modern regime, marriage is postponed and is no longer universal, cohabitation is prevalent, and divorce rates are still high. During the period studied, adult mortality stagnated for long stretches, but was improving rapidly by the end of the 1980s, mainly due to advances in health care (Rychta?ikova 2004). Despite these social and demographic changes in marriage patterns, little attention has been paid to mortality differentials by marital status in the Czech Republic. …

The rise and fall of women’s advantage: a comparison of national trends in life expectancy at age 65 years

The female advantage in life expectancy (LE) is found worldwide, despite differences in living conditions, the status of women and other factors. However, this advantage has decreased in recent years in low-mortality countries. Few researchers have looked at the gender gap in LE in old age (age 65) in a longer historical perspective. Have women always had an advantage in LE at old age and do different countries share the same trends? Life expectancy data for 17 countries were assessed from Human Mortality Database from 1751 to 2007. Since most of the changes in LE taking place today are driven by reductions of old age mortality the gender difference in LE was calculated at age 65. Most low-mortality countries show the same historical trend, a rise and fall of women’s advantage in LE at age 65. Three phases that all but two countries passed through were discerned. After a long phase with a female advantage in LE at 65 of <1 year, the gender gap increased significantly during the twentieth century. The increase occurred in all countries but at different time points. Some countries such as England and France had an early rise in female advantage (1900–1919), while it occurred 50 years later in Sweden, Norway and in the Netherlands. The rise was followed by a more simultaneous fall in female advantage in the studied countries towards the end of the century, with exceptions of Japan and Spain. The different timing regarding the increase of women’s advantage indicates that country-specific factors may have driven the rise in female advantage, while factors shared by all countries may underlie the simultaneous fall. More comprehensive, multi-disciplinary study of the evolution of the gender gap in old age could provide new hypotheses concerning the determinants of gendered differences in mortality.

Revisiting the Hispanic mortality advantage in the United States: The role of smoking

More than three decades of health disparities research in the United States has consistently found lower adult mortality risks among Hispanics than their non-Hispanic white counterparts, despite lower socioeconomic status among Hispanics. Explanations for the “Hispanic Paradox” include selective migration and cultural factors, though neither has received convincing support. This paper uses a large nationally representative survey of health and smoking behavior to examine whether smoking can explain life expectancy advantage of Hispanics over US-born non-Hispanics whites, with special attention to individuals of Mexican origin. It tests the selective migration hypothesis using data on smoking among Mexico-to-US migrants in Mexico and the United States. Both US-born and foreign-born Mexican-Americans exhibit a life expectancy advantage vis-à-vis whites. All other Hispanics only show a longevity advantage among the foreign-born, while those born in the United States are disadvantaged relative to whites. Smoking-attributable mortality explains the majority of the advantage for Mexican-Americans, with more than 60% of the gap deriving from lower rates of smoking among Mexican-Americans. There is no evidence of selective migration with respect to smoking; Mexicans who migrate to the US smoke at similar rates to Mexicans who remain in Mexico, with both groups smoking substantially less than non-Hispanic whites in the US. The results suggest that more research is needed to effectively explain the low burden of smoking among Mexican-Americans in the United States.

Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis.

BackgroundNigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country’s NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care.MethodsThe World Bank and other sources were used to provide comparative health and economic data. Pubmed, Embase and EconLit were searched to locate studies providing descriptions of each NHIS and empirical evidence regarding equity in financing and access to health care. A diagrammatical representation of revenue-raising, pooling, purchasing and provision was produced in order to analyse the two countries’ systems.ResultsOver the period 2000–2010, Ghana maintained a marked advantage in life expectancy, infant mortality, under-5 year mortality, and has a lower burden of major diseases. Health care expenditure is about 5% of GDP in both countries but public expenditure in 2010 was 38% of total expenditure in Nigeria and 60% in Ghana. Financing and access are less equitable in Nigeria as, inter alia, private out-of-pocket expenditure has fallen from 80% to 66% of total spending in Ghana since the introduction of its NHIS but has remained at over 90% in Nigeria; NHIS membership in Nigeria and Ghana is approximately 3.5% and 65%, respectively; Nigeria offers a variable benefits package depending on membership category while Ghana has uniform benefits across all beneficiaries. Both countries exhibit improvements in equity but there is a pro-rich and pro-urban bias in membership.ConclusionsMajor health indicators are more favourable in Ghana and overall equity in financing and access are weaker in Nigeria. Nigeria is taking steps to expand NHIS membership and has potential to expand its public spending to achieve greater equity. However, heavy burdens of poverty, disease and remote settings make this a substantial challenge. Ghana’s relative success has to be tempered by the high number of exemptions through taxation and the threat of moral hazard. The results and methods are anticipated to be informative for policy makers and researchers in both countries and other developing countries more widely.

Years of Life Gained Due to Leisure-Time Physical Activity in the U.S.

Physical inactivity is an important modifiable risk factor for noncommunicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity in the U.S. Data from the National Health and Nutrition Examination Survey (2007-2010); National Health Interview Study mortality linkage (1990-2006); and U.S. Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate to vigorous physical activity); somewhat-active (some moderate to vigorous activity but <500 MET minutes/week); and active (≥ 500 MET minutes/week of moderate to vigorous activity) adults. Analyses were conducted in 2012. Somewhat-active and active non-Hispanic white men had a life expectancy at age 20 years that was ~2.4 years longer than that for the inactive men; this life expectancy advantage was 1.2 years at age 80 years. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 years and 1.6 years at age 80 years. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat-active and active non-Hispanic black men; however, among Hispanics the years-of-life-gained estimates were not significantly different from 0 years gained. Leisure-time physical activity is associated with increases in longevity.

An Evaluation of Major Determinants of Health Care Facilities for Women in India

The women in India belong to various socio-economic backgrounds and are sometimes marginalized or neglected on the gender discrimination when it comes to basic healthcare The fact that the typical female advantage in life expectancy is not seen in India suggests that there are systematic problems with women's health. Indian women have high mortality rates, particularly during childhood and in their productive years. Most women who did not receive health care during pregnancy said they thought it was unnecessary. Another reason for the low levels of prenatal care is lack of adequate health care centers. It was estimated that 16 percent of the population in rural areas lives more than 10 kilometers away from any medical facility. Keeping these issues in mind this paper focuses on various determinants of health care facilities such as: Residence, Media Exposure, Females & Partner's Education and Females & their Partner's Employment, Religion of Household Head and Female's Economic Status. Using Household data from Demographic Health Survey and by using ordered Logistic Regression Analysis, this paper seeks to examine the above mentioned socio economic factors which are responsible for poor health status of women in India on the basis of parameters like Delivery at Health Facility, Antenatal care, Level of anemia, Family planning, Knowledge of STD and Prenatal care.

An analysis of gender-based reversal in life expectancy in southern Africa

This paper uses a geographic perspective in discussing the social inequalities in health between men and women in southern Africa. Keeping in mind the reality of data scarcity that show male and female differences in mortality, this paper uses life expectancy data to illustrate the widening gender inequalities in access to health. The analysis in the paper addresses two main objectives. First, the paper reviews the literature on the underlying factors behind the presence of drastic differences between male and female life expectancies. Secondly, the paper examines in greater detail the trends and geographical patterns in life expectancy in southern African countries, particularly the reversal of life expectancy in favor of men during the past 30 years or so. The results of the analysis show a worrisome trend in life expectancies with regard to gender. The advantage in life expectancy that females had over men before 1980 has all but disappeared during the past 25 years. To make matters worse, life expectancy declined dramatically for both males and females, and in some cases the declines were more than 10 years. Women experienced greater declines in life expectancy lowering them to below those of men, a condition contrary to what existed before the 1980s. The upsurge in HIV infections and the attendant high female mortality rates as well as other factors have combined to result in the unequal gender realities in as far as life expectancies are concerned in the countries of southern Africa.

Widening health inequalities among U.S. military retirees since 1974

I explore trends in mortality among U.S. military retirees using a new dataset of payroll records that include pay grade. Trends in mortality by pay grade reveal that health inequalities steadily widened between 1974 and 2004. Additive differentials in mortality rates remained stable, but since mortality declined exponentially, by a factor of about one third, proportional differentials in mortality and thus additive differentials in life expectancy have widened. The advantage in life expectancy enjoyed by retired officers grew roughly from 3 to 4 years. The sources of these trends remain unclear and are beyond the ability of the data to inform, but the results bear implications for trends in inequality and for policy.

Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in the International Subarachnoid Aneurysm Trial?

The present purpose is to define the sensitivity of the superiority of coil embolization observed in the International Subarachnoid Aneurysm Trial (ISAT) according to the rate of late rebleeding over a reasonable range, and to find the range of rebleeding rates for which it may be overturned. In the ISAT, coil embolization appears to be safer than clip ligation at 1 year, and clip occlusion has better long-term efficacy at preventing rebleeding. This leaves open the question of which is better in the longer term. The authors calculate the life expectancy of patients following a subarachnoid hemorrhage (SAH) and compare the life expectancy of those who underwent coil embolization with those who underwent clip ligation in the ISAT cohort. The 1-year poor outcome rate following treatment climbs rapidly with advancing age. A consequence is that the absolute difference between the poor outcome rates after coil embolization and clip occlusion is lower in those < 50 years of age (3.3%) than it is for those > 50 years of age (10.1%). This difference may be enough to give clip application the advantage in the < 40-year-old group despite the small size of the difference in 1-year rebleeding rates thus far observed (0.152%). When treating ruptured cerebral aneurysms, the advantage of coil embolization over clip ligation cannot be assumed for patients < 40 years old. In this age range the difference in the safety of the 2 procedures is small, and the better long-term protection from SAH afforded by clip placement may give this treatment an advantage in life expectancy for patients < 40 years of age.

родолжительность жизни – чем больше знаем, тем дольше живем?

В данной статье анализируется взаимосвязь продолжительности жизни и уровня образования населения. В статье отмечается, что, к сожалению, данные о смертности населения России в зависимости от уровня образования фрагментарны, и ее динамику невозможно проследить на протяжении достаточно длительного периода. В своем исследовании авторы рассматривают наиболее образованную часть населения России, рассматривая динамику смертности, научной элиты.

A “fair innings” between the sexes: are men being treated inequitably?

In most modern developed communities, women are known to live longer than men. A less known fact is that in many statistics reporting differences in life expectancy between socio-economic classes, on average women in the worst-off social class live as long as men in the best-off social class, if not longer. It is true that women tend to have higher morbidity, or lower health-related quality of life, especially at advanced age, but this female disadvantage does not offset the life expectancy advantage sufficiently to lead to the conclusion that men and women enjoy comparable lifetime health prospects in these communities. Although there is much public and policy discussion about the inequity of health inequalities between the social classes, there is relatively little discussion about such inequalities between the sexes. The paper first discusses the applicability of the fair innings argument to the issue of inequality in health between the sexes. It critically examines six arguments concerning why inequality in health between the sexes may or may not be an inequity. Next, special attention is given to the argument that it is wrong to judge the fairness or unfairness of health inequalities in isolation, but that this judgement should be made only after considering other inequalities relevant to overall human well-being, many of which are believed to work to the disadvantage of women. An analytical framework based on the Gender-related Development Index (a supplementary index to the Human Development Index) is taken as a starting point, to address the issue of health and overall well-being. But this is found wanting, and suggestions are made as to how its conceptual and empirical properties could be improved. Meanwhile we conclude that a prima facie case has been made that the current distribution of health in most countries does not give men a “fair innings”, but the broader question about general well-being remains unresolved.