Sex Differences In Life Expectancy Research Articles

Do Women Live Longer or Do Men Die Earlier? Reflections on the Causes of Sex Differences in Life Expectancy

Background: Although many different factors have been identified to contribute to excess male mortality, it is still unclear which path of the complex cause-effect chain is the decisive driver of the life expectancy gap between women and men. Objective: The question behind this study is whether these sex differences are caused primarily by factors leading to low female mortality or rather by factors causing high male mortality. We hypothesise that they are to a large extent caused by specific subpopulations of men with particularly high mortality levels that decrease the average life expectancy of men. Methods: To test this hypothesis, we investigate in a meta-analysis the variability in mortality (VM) in women and men - defined as the range of death rates prevailing among subpopulations - in empirical studies analysing specific phenomena of mortality differentials. We used the data of 72 empirical studies, including 146 total effects (TE) and 1,718 single effects (SE) for 21 different risk factors. Results: In 85% of TE and three quarters of SE the VM was higher in men than in women, taking into account men's higher overall mortality. The corresponding figures for the direct differences in the VM between women and men are 92 and 82%, respectively. Cases with higher female VM are rare exceptions and appear in particular in the highest age groups. Conclusions: We find support for our hypothesis that the disproportionate high mortality levels of specific male subpopulations are the central cause of the current extent of sex differences in life expectancy. Thus, public health programmes should be targeted toward these disadvantaged subpopulations among men which seem to be related primarily to socioeconomic characteristics.

Cross-national disparities in sex differences in life expectancy with and without frailty

with continued ageing, levels of frailty are an increasing concern. Women live longer than men, but how life expectancies (LE) with frailty differ between men and women and whether sex differences are the same for all European countries is unknown. to compare sex differences in LE in phenotypic frailty categories and disability at age ≥50 between European countries. the Survey of Health, Ageing and Retirement in Europe (SHARE). a total of 50,351 people aged ≥50 from SHARE wave 4 (included countries: Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Hungary, Italy, the Netherlands, Poland, Portugal, Slovenia, Spain, Sweden). the SHARE Frailty Instrument for Primary Care and the Global Activity Limitation Indicator were combined to define four phenotypic frailty and disability categories: robust, pre-frail, frail and severely limited. LEs with each state by sex and country were calculated using Sullivan's method. at age 70, the LE robust ranged from 4.1 to 10.4 years (men) and 3.0 to 8.9 years (women), LE pre-frail from 0.8-3.1 years (men) and 2.2-5.5 years (women), LE frail from 0.1-1.8 years (men) and 0.4-5.5 years (women) and LE with severe activity limitation from 1.9 to 4.4 years (men) and 2.9 to 7.5 years (women). At all ages and both sexes the fewest years were spent frail. this study is the first to compare differences in LE in frailty categories across European countries. In most European countries, years spent robust (free of frailty or limitation) are significantly less for women than men, perhaps due to socio-economic as well as biological factors.

Exploring the Myth of Unhappiness in Former Communist Countries: The Roles of the Sex Gap in Life Expectancy and the Marital Status Composition

National average happiness and the difference in happiness between women and men are positively correlated in European countries. This study focuses on this cross-country relationship and tests (1) whether, after controlling for socio-economic factors, the correlation is attributed to their direct relationship, or, alternatively, explained by the sex difference in life expectancy, and (2) whether the correlation is not only exogenously explained but also endogenously generated by the sex difference in life expectancy. Performing regression analyses, this study shows that the correlation between happiness and its sex difference is spurious, and that the sex difference in life expectancy generates this correlation and accounts for about one-third of the correlation. A decline in happiness influences men’s mortality more than women’s, and widens the life expectancy gap between women and men. This in turn raises the widowhood ratio among women, lowers women’s average happiness, and reduces the happiness gap between women and men. The results obtained in this study points to the importance of controlling for the demographic composition of the population when we use aggregate happiness measures as national happiness indicators.

Population ageing in Central and Eastern Europe and its demographic and social context.

The article focuses on several demographic and socio-economic idiosyncrasies in Central and Eastern Europe, which impact the process of population ageing and intergenerational relations. These include the adverse mortality trends and especially the excess male mortality in certain countries, which exacerbated sex differences in life expectancy beyond anything ever recorded in peace-time population history, the combination of natural population decrease and net emigration, the disordered cohort flows and the shorter generational length. The rapid demographic change in these countries coincided with political, economic and social transformations. The shock of the fall of communism affected differently younger people, who could relatively easily reorganize their life cycles so as to adapt to the changed circumstances, and older persons for whom such reorganization was more difficult, or even impossible. This created the possibility for the opening of an intergenerational rift, as older generations felt being the losers of the transition. The article explores the implications of these idiosyncrasies and social context for living arrangements, kin networks, individual wellbeing and inter-generational relations, and identifies areas where particular challenges are likely to be faced when it comes to policies and programs aimed at older persons.

Happiness and Sex Difference in Life Expectancy

The aim of this study is to test the explanatory power of happiness on survival at the aggregate level. Based on previous findings that psychological stress adversely affects survival and that its effect on survival is more severe for men, this study uses the sex difference in, rather than the level of, life expectancy as the dependent variable. As long as psychological stress and happiness are negatively correlated, happiness is expected to have a greater impact on men’s life expectancy and negatively influence the life expectancy gap between women and men. However, at the same time, the causality is expected to run in both directions. In the reverse direction from the life expectancy gap to national happiness, the intermediary is the women’s widowhood ratio. Since the widowed are, on average, less happy, an increase in the life expectancy gap, which raises the women’s widowhood ratio, is expected to lower women’s average happiness. For this reason, this study first investigates the reverse causality and demonstrates that the life expectancy gap negatively affects national happiness. Then, taking this reverse causality into account, it shows that happiness is significant in explaining the cross-country differences in the life expectancy gap. As national average happiness decreases, the sex difference in life expectancy increases. This result suggests that happiness has a significant impact on survival even at the aggregate level.

P1-47 An innovative case-spouse control design in practice: an experience in estimating smoking and all cause deaths in Chinese adults

IntroductionWe aimed to show that utilising information from a population-based, retrospective mortality survey for the main determinants of disease is feasible.MethodsDuring 1989–1991, a nationwide retrospective survey of mortality was conducted....

Childhood meat eating and inflammatory markers: The Guangzhou Biobank Cohort Study

BackgroundWe hypothesized that socio-economic development could, via nutritionally driven levels of pubertal sex-steroids, promote a pro-inflammatory state among men but not women in developing countries. We tested this hypothesis, using recalled childhood meat eating as a proxy for childhood nutrition, in southern China.MethodsWe used multivariable linear regression in the Guangzhou Biobank Cohort Study phase 3 (2006-8) to examine the adjusted associations of recalled childhood meat eating, <1/week (n = 5,023), about once per week (n = 3,592) and almost daily (n = 1,252), with white blood cell count and its differentials among older (≥50 years) men (n = 2,498) and women (n = 7,369).ResultsAdjusted for age, childhood socio-economic position, education and smoking, childhood meat eating had sex-specific associations with white blood cell count and lymphocyte count, but not granulocyte count. Men with childhood meat eating almost daily compared to <1/week had higher white blood cell count (0.33 109/L, 95% confidence interval (CI) 0.10 to 0.56) and higher lymphocyte count (0.16 109/L, 95% CI 0.07 to 0.25). Adjustment for obesity slightly attenuated these associations.ConclusionIf confirmed, this hypothesis implies that economic development and the associated improvements in nutrition at puberty may be less beneficial among men than women; consistent with the widening sex differentials in life expectancy with economic development.

SEX DIFFERENCES IN LIFE EXPECTANCY IN CANADA: IMMIGRANT AND NATIVE-BORN POPULATIONS

A growing body of research often indicates that immigrant populations in Western countries enjoy a lower level of mortality in relation to their native-born host populations. In this literature, sex differences in mortality are often reported but substantive analyses of the differences are generally lacking. The present investigation looks at sex differences in life expectancy with specific reference to immigrant and Canadian-born populations in Canada during 1971 and 2001. For these two populations, sex differences in expectation of life at birth are decomposed into cause-of-death components. Immigrants in Canada have a higher life expectancy than their Canadian-born counterparts. In absolute terms, immigrant females enjoy the highest life expectancy. In relative terms, however, immigrant men show a larger longevity advantage, as their expectation of life at birth exceeds that of Canadian-born men by a wider margin than do foreign-born females in relation to Canadian-born females. It is also found that immigrants have a smaller sex differential in life expectancy as compared with the Canadian born. Decomposition analysis shows this is a function of immigrants having smaller sex differences in death rates from heart disease and cancer. Factors thought to underlie these differentials between immigrants and the Canadian born are discussed and suggestions for further research are given.

Life expectancy in Greece 1991–2007: regional variations and spatial clustering

Please click here to download the map associated with this article. In the absence of regional estimates of life-longevity for Greece, we have constructed abridged life tables by sex for the 51 prefectures of the country for 1991, 2001 and 2007, using the Reference to a Standard Table technique. The paper focuses on regional variations and spatial patterns of life expectancy at birth. This is the first time that such demographic information is presented for Greece. Conventional mapping depicts the improvements in mortality achieved for males and females during 1991–2007 as well as the advantage of the islands and of the southern regions of the country over northern Greece. Maps based on local indicators of spatial association (LISA) reveal a cluster of prefectures with low e0 values, covering mainly regions of northern Greece (Macedonia and Thrace) and three clusters with high values, including mainly prefectures of the Peloponnese, the islands of Dodecanese and Crete. Patterns are fairly similar for males and females. The analysis also shows that since 2001 sex differences in life expectancy have been narrowing, indicating that Greece follows the patterns observed in other European and developed countries with a time lag of about two decades.

Spousal Age Differences and Sex Differences in Life Expectancy are Confounders of Matrilateral Biases in Kin Investment

Several evolution-based theories predict discriminative kin investment in humans. Previous research indicates that a matrilateral bias exists, such that maternal relatives invest the most in grandchildren due to the high degree of certainty of biological relatedness. In a sample of 321 Austrian adults, we failed to replicate previous findings using retrospective solicitude ratings and ratings of emotional closeness for grandparent–grandchild and aunt/uncle–niece/nephew relationships. However, exposure time to (i.e., number of years where relative was alive), and residential distance from, the relatives were found to be confounding variables on these commonly used measures of investment.

Smoking-attributable deaths and potential years of life lost from a large, representative study in China

ObjectivesTo provide a more accurate estimate of early smoking-attributable mortality and potential years of life lost using data from a representative study of 103 study areas in China.MethodsTwo datasets were...

Differences in immune response may explain lower survival among older men with pneumonia*

Lower life expectancy in men is generally attributed to higher likelihood of risky behavior and because men develop chronic conditions earlier. If sex-related differences in survival are independent of preinfection chronic health and health behavior, it would suggest that survival differences may occur because of sex differences in quality of care and biological response to infection, and these differences may contribute to sex differences in life expectancy. We assessed if sex-related survival difference following community-acquired pneumonia (CAP) is due to differences in clinical characteristics, quality of care, or immune response. Prospective observational cohort of 2183 subjects with CAP. Mean age was 64.9 years. Men were more likely to smoke and had more comorbidity compared with women. At emergency department presentation, men had different biomarker patterns, as evidenced by higher inflammation (tumor necrosis factor, interleukin [IL]-6, and IL-10) and fibrinolysis (d-dimer), and lower coagulation biomarkers (antithrombin-III and factor IX) (p < 0.05). Small differences in favor of men were seen in care quality, including antibiotic timing and compliance with American Thoracic Society guidelines. Men had lower survival at 30, 90, and 365 days. The higher 1-year mortality was not attenuated when adjusted for differences in demographics, smoking, resuscitation, insurance, and vaccination status, comorbidity, hospital characteristics, and illness severity (unadjusted hazard ratio [HR] = 1.35, p = 0.003; and adjusted HR = 1.29, p = 0.004). HR was no longer statistically significant when additionally adjusted for differences in emergency department concentrations of tumor necrosis factor, IL-6, IL-10, d-dimer, antithrombin-III, and factor IX (adjusted HR = 1.27, p = 0.17). Patterns of biomarkers observed in men were associated with worse survival for 1 year. Lower survival among men following CAP was not explained by differences in chronic diseases, health behaviors, and quality of care. Patterns of inflammatory, coagulation, and fibrinolysis biomarkers among men may explain reduced short-term and long-term survival.

Unusually small sex differentials in mortality of Israeli Jews: What does the structure of causes of death tell us?

Since the establishment of Israel sex differentials in life expectancy at birth exhibited by Israeli Jews have been very low in comparison to other developed countries as a result of relatively high male and relatively low female life expectancy. To ad

Mortality in Catalonia in the context of the third, fourth and future phases of the epidemiological transition theory

Abstract In the period 1960-2000, male and female life expectancy in Spain's Autonomous Region of Catalonia increased by 8.2 and 10.5 years, respectively, thus raising it to among one of the highest in the world. Initially, most gains were due to lower infant mortality, but as cardiovascular diseases declined, this later shifted to advanced ages. Between the mid-1980s and early 1990s life expectancy improvements stagnated as the mortality risk from traffic accidents and HIV/AIDS in young adults increased. Both the age-delay in old age mortality and the simultaneous influence of behavior and lifestyle reflect distinct aspects of the fourth stage of the epidemiological transition. This analysis quantifies the age and cause-of-death contributions to changes and sex-differences in life expectancy in Catalonia. We then compare the most recent life table for women with the Duchene-Wunsch limited life table to estimate the potential gain in life expectancy if all deaths were aging-related and in which ages these improvements would fall. 1. Introduction The decline of mortality constitutes one of the basic, perhaps most fundamental, aspects of demographic change in the 20th century. Its history shows a large heterogeneity between countries, with a variety of traditional models that have been defined in function of its timing, intensity, extent, and underlying causes. Catalonia is one of Spain's Autonomous Regions, but with a larger population than for example Denmark, and is an example of the accelerated transition within the western model, as changes were similar but occurred over a shorter period of time (and later). During the last century, male and female life expectancy increased by 40 and 45 years, respectively, during which time Catalonia consistently enjoyed a higher life expectancy than Spain as a whole. While their current levels are among the highest in the world, the impact of HIV/AIDS and an increased number of motor vehicle accidents caused male life expectancy to actually drop in Catalonia during the second half of the 1980s. This did not occur in Spain as a whole, hence the accelerated mortality transition and the influence of behavior and lifestyle on the mortality trends of young adults merit studying Catalonia on its own. The objective of this article is to describe and analyze mortality trends in Catalonia during the last four decades, starting with the beginning of the 1960s. At that time life expectancy at birth was still slightly lower than the average for the 15 Western European countries of the European Union (former EU15): 68.0 vs. 68.3 years for men and 72.8 vs. 73.8 years for women. Analysis is set within the conceptual framework of the epidemiological transition, whereby the evolution of Catalonian survival and mortality patterns is analyzed based on the features that define the last phases of the transition. Our study therefore links up well with similar studies on the evolution of Canadian mortality during the latter half of the 20th century (e.g. Bah and Rajulton 1991; Lussier et al. 2008). In order to attain our objective, life tables have been reconstructed, making it possible to analyze mortality by age and sex. First, the effects of changes in the age- and sex-specific mortality risk on the change in life expectancy over time are quantified. Subsequently, from 1980, causes of death are introduced. This permits a more detailed study of the characteristics of the current pattern of mortality in Catalonia, and can therefore be seen as an extension of recent research by Gomez- Redondo and Boe (2005) on the contributions of age and sex to changes in life expectancy at birth in Spain. The theory of the epidemiological transition, formulated by Omran (1971, 1983), establishes a general framework to describe and interpret the changes in mortality and health patterns during the broad decline of mortality, as well as its determinants and consequences. Until the second half of the 19th century, mortality was still partly subjected to plagues and famines (first phase). …

Age‐variability in Body Shape Associated With Excess Weight: The UK National Sizing Survey

The health risks of obesity are disproportionately due to central abdominal adiposity; however, the extent to which age is associated with the body shape of obese adults is not known. Three-dimensional (3D) data on body shape from the UK National Sizing Survey were analyzed to investigate age-associated changes in body shape within the BMI bands <20, 20-24.99, 25-29.99 and > or =30 kg/m(2). Measurements of anthropometry (weight and height) and a 3D body scan were obtained in 4,344 men and 5,266 women recruited from eight British cities. The body shape of men showed high consistency within BMI bands between early adulthood and old age. In contrast, the body shape of women altered within each BMI band with increasing age. In obese, overweight, and normal weight women, age was associated with decreased thigh girth, increased waist, and bust girth. Whereas young obese women maintained an hourglass shape, in old age the body shape of obese women converged on that of obese men. The association of age with body shape is markedly different between the sexes, with the impact of obesity on shape strongly age-dependent in women but not in men. The age delay in the association between obesity and high waist girth in women may contribute to the sex-difference in life expectancy. The relationship between body shape change and cardiovascular risk merits longitudinal investigation within individuals.

The Influence of Abnormal Sex Differences in Life Expectancy on National Happiness

Countries with better health, as indexed by life expectancy, score higher on subjective well-being (SWB). It was predicted that deviations from the average sex difference in life expectancy (reflecting reproductive competition among males and discrimination against females) would be inversely related to happiness. Regression analysis of SWB for 178 countries found that deviations from the average sex difference in life expectancy were predictive of unhappiness controlling for life expectancy, national wealth, and income inequality. Countries with a relative scarcity of female children (used as an index of parental bias) were less happy. Societies in which there is an undue burden on the health and survival of either sex are thus unhappy ones due to gender-specific disadvantage and associated gender conflict.

From Divergence to Convergence: The Sex Differential in Life Expectancy in Canada, 1971–2000*

Over the 20th century sex differences in life expectancy in the industrialized countries have widened in favour of women. Recently, a reversal in the long-term pattern of this differential has been noted in some countries. In Canada, between 1981 and 2000, this differential narrowed by almost two years. Greater than expected improvements in male death rates with respect to heart disease, lung cancer, accidents and violence (excluding suicide) explain a large part of this phenomenon. Change in male and female smoking prevalence correlates strongly with change in sex differences in mortality from heart disease and cancer. The reasons underlying men's greater mortality improvements in regard to accidents and violence are less clear and need further investigation.

Narrowing Sex Differential in Life Expectancy in Canada and Austria: Comparative Analysis

Throughout most of the 20 th century the sex gap in life expectancy in the industrialised countries widened in favour of women. By the early 1980s a reversal in the long-term pattern of this differential occurred in some countries, where it reached a maximum and thereafter has followed a declining trend. It is argued in this study that this development represents an emerging feature of the epidemiological profile of post-industrial societies. I look at Canada and Austria as two representative cases of this phenomenon over roughly three decades, between 1970 and 2001. Decomposition analysis shows that reduced sex differences in life expectancy in the 1980s and 1990s obtained mainly from the effects of reduced sex differences in mortality with respect to heart disease, and secondarily accidents and violence and lung cancer. Heart disease has played a larger role in Canada, whereas differential mortality from accidents and violence has been of greater importance in Austria. A further aspect of the investigation links sex differences in smoking prevalence to sex differences in life expectancy. A model is suggested that incorporates female labour force participation and a measure of gender role traditionalism in society as factors in female smoking prevalence. These variables are also postulated to correlate with change in the sex gap in life expectancy by a time lag of twenty years. It is found that sex differences in smoking prevalence in the past are related to sex difference in life expectancy in the present, and that female labour force participation and gender role traditionalism are also associated with the sex gap in expectation of life. The findings are interpreted in reference to epidemiological transition theory and the literature concerning change in the position of women and sex differences in mortality in high-income nations.

Frailty Index as a Measure of Biological Age in a Chinese Population

The concept of a frailty index, developed in Canadian elderly populations as an indicator of biological age as opposed to chronological age, was tested in an elderly Chinese population to determine whether it is applicable in a different ethnic and cultural setting. A data set including 62 physical, psychological, and socioeconomic variables from a cohort of 2,032 persons 70 years and older (999 men, 1,033 women) was used. The distribution of the index was evaluated using the Cramer-von Mises goodness-of-fit test, and multiple linear regression was used to assess its relationship with age and sex. A biological age for each participant was calculated based on an inverse regression of age on mean frailty index and sex. The Cox proportional hazards regression model was used to assess the ability of biological age to predict death. The distribution of the frailty index most closely resembled a Weibull distribution. The frailty index increased with age until the mid-80s, when it leveled off, and was higher in women than men for each age group. The distribution of biological age is wider than that for chronological age, and it strongly predicted death. Women had an estimated 20% lesser chance of dying at a given time than did men of the same chronological age and degree of frailty. The study confirms the robustness of the concept and method of calculating the frailty index developed in elderly Canadian populations. It also suggests that the sex difference in life expectancy may have an underlying genetic basis independent of frailty.

A VARIED PATTERN OF CHANGE OF THE SEX DIFFERENTIAL IN SURVIVAL IN THE G7 COUNTRIES

Over the course of the 20th century the sex differential in life expectancy at birth in the industrialized countries has widened considerably in favour of women. Starting in the early 1970s, the beginning of a reversal in the long-term pattern of this differential has been noted in some high-income countries. This study documents a sustained pattern of narrowing of this measure into the later part of the 1990s for six of the populations that comprise the G7 countries: Canada, France, Germany, Italy, England and Wales (as representative of the United Kingdom) and USA. For Japan, a persistence of widening sex differences in survival is noted. The sex differences in life expectancy are decomposed over roughly three decades (early 1970s to late 1990s) from the point of view of four major cause-of-death categories: circulatory diseases, cancers, accidents/violence/suicide, and 'other' (residual) causes. In the six countries where the sex gap has narrowed, this has resulted primarily from reduced sex differences in circulatory disease mortality, and secondarily from reduced differences in male and female death rates due to accidents, violence and suicide combined. In some of the countries sex differentials in cancer mortality have been converging lately, and this has also contributed to a narrowing of the difference in life expectancy. In Japan, males have been less successful in reducing their survival disadvantage in relation to Japanese women with regard to circulatory disease and cancer; and in the case of accidents/violence/suicide, male death rates increased during the 1990s. These trends explain the divergent pattern of the sex difference in life expectation in Japan as compared with the other G7 nations.