Tuesday, April 14, 2009

Why Men Die Early


Why Men die earlier than Women
James Achanyi-Fontem
Coordinator WABA MWG
According to statistics, it is observed that women outlive men in the world today, and scientists have traditionally pointed to riskier behaviour on the part of men as the reason why. Another reason for the earlier demise of men may be that they are more prone to parasitic infections. In a study report, Ian P. F. Owens, from Imperial College London, writes, that "In those species where males die younger than females, the males suffer a disproportionately high rate of parasitism. This is most extreme in those species where male-male competition for mates is most severe. From the above thought, it is believed that male-biased mortality occurs not only as a result of death through risky behaviour, but also because males are more susceptible to parasitic diseases.
Owens believes testosterone may play a key role to make men more prone to infections. The male hormone is well-recognized as an immunosuppressant, and studies have shown men who are castrated (and thus no longer produce testosterone) live about 15 years longer than men who are not castrated. Testosterone may suppress the immune system, he continues, by changing the way men's bodies allocate important resources, such as taking energy away from the immune system and using it for other purposes.
Another explanation for the increased risk for parasitic infections among males, suggested is the simple fact that men are bigger than women and thus provide a larger target for parasites
• As of 2005, the average life expectancy in the U.S. was 80.4 for women and 75.2 for men. That means men, on average, die 5.2 years earlier than women.1
• Statistics show that being male is now the single largest risk factor for early mortality in developed countries.2
• A number of genetic-biological and socio-cultural factors contribute to the longevity gap between men and women. They include differences in sex hormones, sex chromosomes, immune response, iron in the blood, natural selection, cultural conditioning and how the sexes deal with their standing in society.
• How much of the longevity gap is due to biology and how much to environment or behaviour is a matter of debate among scientists but the best data we have today suggests that only about one-third of longevity is due to genes.
• Boys in the U.S are reported to have a 29 percent higher prenatal death rate3 and are 20 percent more vulnerable to infant mortality up to age one.4
• According to a study done in 2003 by the Institute for Social Research at the University of Michigan, men have higher age-adjusted death rates than women for the 15 leading causes of death in the U.S., with the exception of Alzheimer's disease.5
• Because men usually develop heart disease 10 to 15 years earlier than women do, they are more likely to die of it in the prime of life. About one-fourth of all heart-disease-related deaths occur in men aged between 35 to 65.6
• More American men than women are reported stricken with cancer. The age-adjusted invasive cancer incidence rate per 100,000 people in 2004 was 537.6 for men and 402.1 for women.7
• Men are 30% more likely to suffer a stroke than are women, making it the third-leading cause of death in men.8
• More than twice as many men die each year because of accidents as do women.9
• Men have a 30 percent higher risk of death from pneumonia than women.10
• Men's death rates are at least twice as high as women's for suicide, homicide and cirrhosis of the liver.11
• If men attempt suicide, they are more likely to succeed than women. Suicide was the eighth leading cause of death for males and the sixteenth leading cause of death for females in 2004.12
• Scientists believe that if everybody adopted a healthy lifestyle and medical advances in prevention, early detection and treatment of disease continue at their present pace, we could achieve an average life expectancy of 85 or 90.
• As obesity becomes more pervasive in the U.S., some predict that life expectancy may actually decrease.13
• Men are more prone to taking risks than women.14 There's also evidence that they are quicker to aggression15 and more likely than females to express their aggression physically.16
• Male drivers have a 77 percent higher risk of dying in a car accident than women, based on miles driven.17
• Men are much more likely to be incarcerated than women18 and are far more likely than women to be victims of violent crime.19
• If men attempt suicide, they are more likely to succeed than women.20
• About one-quarter of adult men currently smoke at least occasionally compared with one in five women21 which can lead to higher death rates from diseases like arteriosclerotic heart disease, lung cancer and emphysema.
• Men drink more and indulge in recreational drugs more often than women, both risk factors for long-term health problems and accidental death.
A study published in the July 2000 issue of Psychological Review reported that US females are more likely to deal with stress by seeking support than men. Statistically men in Cameroon die at a younger age than women for several reasons, including genetic and biologic factors. This relates to the fact that being male is now the single largest risk factor for early mortality in developing countries on the whole.
How much of the longevity gap is due to biology and how much to environment or behaviour remains a matter of debate among scientists. According to Thomas Perls, MD, women have been outliving men for centuries though the gap has changed over time, primarily due to the hazards of childbirth. Though medical science has become more successful in providing better outcomes for women delivering babies in the developed countries to increase the longevity gap, research needs to be carried in the developing countries to learn about the current real situation estimated at 5 years of outliving men.
The longevity gap varies by age, scientists have revealed. While boys die more frequently than girls in infancy, during childhood, and during each subsequent year of life, male mortality accelerates considerably during certain stages of life. Between ages 15 and 24 years, when testosterone is at its highest levels in men, they are four to five times more likely to die than women. The gap then narrows until late middle age when the death rate for men increases mainly due to heart disease, suicide, car accidents and illnesses related to smoking and alcohol use.
In 2005, the Centres for Disease Control and Prevention listed the 15 leading causes of death as the following:
• Heart disease
• Cancer
• Stroke
• Chronic lower respiratory diseases
• Accidents
• Diabetes
• Alzheimer's disease
• Influenza and pneumonia
• Kidney disease
• Septicaemia
• Suicide
• Chronic liver disease and cirrhosis
• Hypertension
• Parkinson's disease
• Homicide
Consider the following:
• Because men usually develop heart disease 10 to 15 years earlier than women do, they are more likely to die of it in the prime of life. About one-fourth of all heart-disease-related deaths occur in men ages 35 to 65.5
• More men than women are stricken with cancer. The age-adjusted invasive cancer incidence rate per 100,000 people in 2004 was 537.6 for men and 402.1 for women.6
• Men are 30% more likely to suffer a stroke than are women, making it the third-leading cause of death in men.7
• More than twice as many men die each year because of accidents as do women.8
• Men have a 30 percent higher risk of death from pneumonia than women.9
• Men's death rates are at least twice as high as women's for suicide, homicide and cirrhosis of the liver.10
• If men attempt suicide, they are more likely to succeed than women. Suicide was the eighth leading cause of death for males and the sixteenth leading cause of death for females in 2004.11
Sources:
1. Sexual selection and the Male: Female Mortality Ratio; Daniel Kruger, PhD; Randolph Nesse, MD; Human Nature, 2004. 2: 66-85
2. Just Like a Woman: How Gender Science is Redefining What Makes Us Female Dianne Hales, Random House, Inc.
3. Thomas Perls, MD, Harvard Medical School, New England Centenarian Study (NECS).
4. David R. Williams, the Institute for Social Research, American Journal of Public Health, May 2003.
5. American Heart Association.
6. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2004 Incidence and Mortality Web-based Report Version. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute.
7. Department of Health and Human Services (HHS).
8. Centres for Disease Prevention and Control.
9. University of Pittsburgh School of the Health Sciences.
10. Institute for Social Research at the University of Michigan.
11. Centres for Disease Control and Prevention, National Centre for Injury Prevention and Control. Injury Statistics Query and Reporting System.

Monday, April 13, 2009

Men's Health & Gender


Why men die and suffer more than women
By James Achanyi-Fontem,
Coordinator, WABA MWG
Women’s health has always an important part of national priority in most countries of the world, but unfortunately no counselling centres or offices for men’s health exist in most countries. It is within this frame work that one can rightly say that men are silently suffering through what can be described as a serious health crisis. Lifestyle is used to explain the differences in longevity between men and women.
One begins to question whether the mere suggestion that men need their own health counselling centres or health clinics or that men must advocate for their rights like a victimized minority would not rankle women’s health advocates, especially as some politicians are reluctant to take men’s health on as a cause, for fear of alienating women.
Apart from the exception of Alzheimer’s disease, takes the lives of more women than men, men die of just about every one of the leading causes of death at younger ages than women, from lung cancer to influenza and pneumonia, chronic liver disease, diabetes, sickle cell disorder and AIDS. Topping the list for both sexes is heart disease.
Cancer also strikes men disproportionately: one in three women at some point in life; one in two men. In part, that is a result of the fact that more men than women smoke, and possibly of occupational exposures.
On the other hand, men’s vulnerability appears to start quite early. More male foetuses are conceived, but they are at greater risk of stillbirth and miscarriage, scientists find. Even as infants, mortality is higher among newborn boys and premature baby boys.
Behaviour plays a role in some of the extra deaths and illnesses among men: they tend to be more aggressive than women and to take more risks. Men smoke at higher rates than women, drink more alcohol and are less likely to wear seat belts or use sunscreen. Men also suffer more accidental deaths and serious injuries and are more likely to die of injuries and car accidents. They are three times as likely to be victims of murder, four times as likely to commit suicide and, as teenagers, 11 times as likely to drown.
Some experts think that depression contributes to these reckless and self-destructive behaviours, but that just as heart disease was initially defined by men’s experiences and therefore ignored or missed in women, depression may have been framed by women’s experiences and therefore may be missed and go untreated in men.
As a result, even though more baby boys are born, among people in their mid-30s, women outnumber men. Among people age 100, women outnumber men by 8 to one. During a research study carried out by Dr. Legato, he tried asked a number questions, which tried to clarify analysis of male vulnerability like: “Why are there more miscarriages of boy foetuses? What is it about the sexing of the foetus that makes a male more vulnerable? What makes a boy less mature in terms of lung function after he’s born? And what is this propensity for risk-taking?”
One theory is that males are vulnerable because of their chromosomal makeup: where women have two X chromosomes, men have an X chromosome and a Y chromosome. “It is said that even before implantation in the wall of the uterus, the newly fertilized XX entity has a leg up,” Dr. Legato said, “because it can use that extra X to combat mutations in the chromosome that might be lethal or detrimental. And that might be a reason why females have a more sturdy constitution.”
Scientists and advocates who are concerned about men’s health are encouraging men themselves to take the first steps by accepting responsibility for their health status, seeking preventive care and making changes in habits, if necessary. New drugs for erectile dysfunction have helped bring men into doctors’ offices in recent years, experts say, but that is not enough.
Dr. Ken Goldberg, a urologist and the author of “How Men Can Live as Long as Women,” says in his work that “Men need to take as good care of their bodies as they do of their cars and trucks”. Men should stop thinking that they are bulletproof and invincible.
Research based on a 2000 survey by the Commonwealth Fund found that almost a quarter of all men had not seen a doctor during the previous year, compared with only 8 percent of women, and that one in three men had no regular doctor, compared with one in five women. More than half of men had not gone in for a routine check-up or cholesterol test during the previous year. Even if something was bothering them, the survey found, men often expressed reluctance to seek medical help. Nearly 40 percent said they would delay care for a few days, and 17 percent said they would wait at least a week.
Other studies have found that because poor women with children may qualify for Medical aid, poor men are more likely to lack health insurance. Advocates say that research must be directed at how specific diseases develop in men, but that studies should also be done to explore the underlying reasons that men do not take better care of themselves.
Dr. William Pollack, director of the Centre for Men at McLean Hospital in Belmont, Mass., USA affiliated with Harvard Medical School thinks that the problems are rooted in how boys are raised. Very often, “we’ve socialized men from the time they are boys that ‘You have to stand on your own two feet,’ ‘If you have a problem, handle it by yourself,’ ‘Be a man, take one for the team. “All of these mean, men do not have to complain, don’t have to ask for help and they have to solve their problems by themselves.’ ”