Why do women live longer than men?

Hypothesis: Multiple intervening factors from a biopsychosocial perspective are responsible for the male-female life expectancy disparity.

Null hypothesis: The male-female life expectancy disparity can be understood through a single discipline and does not require a biopsychosocial perspective

Women on average have a life expectancy (LE) of 4.6 years longer than men who have higher mortality rates at every age group (WHO, 2015; United Nations Statistics Division, 2012; Holden, 1987; Austad, 2006)

The necessity to investigate psychophysical, biological, economic, political, environment and social causalities requires ‘holistic modelling’ and the use of Engel’s (1989) biopsychosocial model allows for appropriate consideration of intervening factors (Freeman, 2005; Christine, 2008; Weiner & Freedheim, 2003).

Biological and genetics contribute to improved female LE (Ginter & Simko, 2013). Higher immunity (Hirokawa et al., 2013), the additional X chromosome and favourable hormonal balance reduce fatalities (Austad, 2006; Oksuzyan, Juel, Vaupel, Christensen, 2008). Cardiovascular disease (CVD) is a primary cause of male mortality (Beltrán-Sánchez, Finch, & Crimmins, 2015; Weiner & Freedheim, 2003; Ginter & Simko, 2013), biological causality is recognised (Eskes & Haanen, 2007), however behavioural and lifestyle choices additionally contribute. Violence, aggressiveness, homicide, suicide and substance abuse are psychosocial factors increasing male mortality and diseases accounting for one third of the LE disparity (Waldron, 1967; Oksuzyan et al., 2008; Holden, 1987; British Psychological Society, n.d; Batrinos, 2012; Holden, 1987).

The varying LE gap among countries implies social causality (United Nations Statistics Division, 2012). Scandinavia’s LE gap is closing, while others increase (Ginter & Simko, 2013). The ameliorating Scandinavian LE could correlate with their high social gender equality (Borchorst & Siim, 2008; Melby, Ravn & Wetterberg, 2009), supporting the theory that socially expected male behaviours contribute to mortality (Waldron, 1967).

Socioeconomically, gender inequality shows men acquiring greater wealth and status. Low socioeconomic status is linked to mortality (Kavanagh, Shelley & Stevenson, 2017; White, 2005), but despite this, women live longer suggesting psychological factors such as risk-taking may contribute (Oksuzyan et al., 2008). Evidence of risk taking is seen in 97% of job fatalities being male (Waldron, 1967; Health and Safety Executive, 2017).

Despite greater longevity women have more illness, known as the ‘male-female health paradox’ (Oksuzyan et al., 2009). Socially and historically women were more vigilant of family health, meaning women more often; report symptoms, take sick leave and utilise healthcare (Christine, 2008; Oksuzyan et al., 2008; Green, & Pope, 1999). Of reported conditions, men die more frequently indicating understated severity for which cultural disapproval of men appearing ill is possibly causal (Oksuzyan et al., 2008). However, selective bias and non-participation may contribute to data inaccuracy creating the ‘male-female health paradox’ (Oksuzyan et al., 2009).

The significance of social constructs and psychology are additionally seen psychosomatically. Men who are higher in ‘femininity’ and not stereotypically masculine have a lower risk of CVD (Hunt, Lewars, Emslie, Batty, 2007). Additionally, even being male is perceived psychologically as shortening one’s LE (Kobayashi, Beeken, Meisel, 2017).

The complexity of the male LE disparity cannot be understated and many of the numerous intervening factors have their own biopsychosocial causalities. Psychologically men care less for their health, smoke more, have higher obesity rates and poorer diets (Oksuzyan et al., 2008; Costanza, Salamun, Lopez, & Morabia, 2006; Wardle et al., 2004). However social expectations and biological factors are additionally casual. These combined biopsychosocial factors make being male the largest demographic risk factor for premature mortality in developed countries (Kruger & Nesse, 2004). Waldron (1966) suggests changing social expectations is paramount in remedying this phenomenon.



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