7 Reasons Men Die First

Popular culture may paint men as the stronger sex, but from the moment a boy is born, his life is more likely than his sister's to be cut short. Across national and cultural boundaries, men die an average of seven years earlier than women; the disparity in the United States is approximately five years. In a new book, Why Men Die First, Dr. Marianne Legato, a specialist in gender-specific medicine at Columbia University, explains why men are so vulnerable.

Dr. Legato previewed some of the conclusions she found in her book with U.S. News Magazine editor Adam Voiland and described seven reasons why males die prematurely and seven actions men can take to live long and well.

While every cell in a woman's body has two large X chromosomes, men have one X and one smaller Y chromosome; the Y is half the size. The "spare" X chromosomes allow women's bodies to compensate when faced with damage in ways that men's cells cannot. In addition, mutations are three to six times more likely in a Y chromosome than an X chromosome. This genetic deficit could be part of the reason why miscarriages, infections, birth defects, cancers, and many other health problems strike males especially hard.

Baby boys are one-and-a-half to two times more likely to die at birth than girls. A weaker immune system, a tendency for immature lung development, inadequate blood flow to male fetuses, and high vulnerability to maternal stresses seem to be the culprits. Brain hemorrhages, congenital malformations, pneumonia, and urinary tract infections are all more common among male newborns.

An article published in the British Medical Journal notes that a variety of disorders—including reading delays, deafness, autism, ADHD, blindness, seizure disorders, hyperactivity, clumsiness, stammering, and Tourette's syndrome are three to four times more common in boys than girls. There are 10 males for every female with Asperger's syndrome, a mild form of autism.

Slower development of the area of the brain that governs judgment makes males—especially adolescents—more likely than girls to die in accidents. According to a National Safety Council statistics, males were involved in 82 percent of accidental deaths associated with firearms, 87 percent of bicycle-related fatalities, nearly double the number of poisoning deaths, and almost four times as many homicides in 2004. Likewise, in 2006 they were in 81 percent of fatal crashes involving drunken driving.

Although women are more likely to make suicide attempts, the ratio of men to women who actually kill themselves is nearly 4 to 1. For men ages 20 to 24, fully 15 percent of all deaths are suicides.

[I would also note that the recent research that I conducted on gender and depression shows that male depression tends to be under-diagnosed and under-reported. Further men tend to "act out" their depression through irritability and anger, and so don’t appear depressed. As a result millions of men kill themselves each year who could be saved if we recognized that their irritability and anger were marks of depression not just "typical grumpy old male" syndrome.]

The bulk of sailors, firefighters, police officers, construction workers, and farmers are men. Of the 5,734 fatalities that occurred on the job in 2005, men were the victims in the vast majority—5,328. And men still do the vast majority of the fighting during military conflicts.

Estrogen seems to protect women from heart disease until they are well into midlife, but it is common for symptoms to begin in men by the age of 35. Making matters worse, men have naturally low levels of protective HDL cholesterol. The result: Between 70 percent and 89 percent of all sudden cardiac events occur in men, and men die three times more frequently of coronary artery disease than women.

1. Know your blood pressure no matter what your age; exercise vigorously every day to increase your naturally low HDL levels; and start getting screened for coronary artery disease in your twenties.

2. Go to the doctor and tell him or her if you're having a health problem of any kind. Our culture may reward stoic behavior from men; disease does not. This is especially true for men who feel sad or depressed for extended periods. It is extremely common for men to internalize and ignore their problems. Seek help.

3. Monitor your behavior and minimize tendencies to act in a boneheaded way. You know better than to drive recklessly, ignore safety protocols at work, or operate machinery while intoxicated.

4. Keep off excess weight to avoid a phalanx of chronic diseases that will impair your quality of life well before they actually kill you. Coronary artery disease, diabetes, and prostate cancer are a few extremely common risks associated with being overweight that typically take a toll on your well-being—including the ability to have an erection—long before life is actually cut short. In some cases, it's the disease itself that causes the sexual problems; in others it's the medications or surgeries used to treat the disease that take the toll.

5. Don't smoke. According to the American Cancer Society, smokers who quit at age 35 can expect to live up to eight and a half years longer than continuing smokers. Risk begins to fall within months and falls to the levels of nonsmokers in three to five years.

6. Don't fear digital rectal exams. PSA screening for prostate cancer is controversial because it might pick up tiny cancers that aren't clinically important, but there's little doubt that digital exams reveal dangerous cancers that have to be treated. Same goes for colonoscopies. They're uncomfortable, yes, but far less so than malignant colon cancer and chemotherapy.

7. Protect your head, and tell your doctor if you get dinged especially hard. A CT scan may be needed. Concussions may seem harmless, but they can cause long-term brain bleeding that lead to memory problems, disrupted sleep, and personality changes that last a lifetime.

What has your experience been with the relationship between whether you’re male or female and whether you live long and well? As we celebrate Father’s Day, chances are your father will die before your mother? We can change those patterns so all of us can enjoy the benefits of a long and healthy live.

To read Adam Voiland's article in US News, visit: http://www.usnews.com:80/blogs/on-men/2008/06/13/7-reasons-men-die-first...

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