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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Man to Man Man to Man
 

Is Being Male Hazardous to Your Health?


January 24, 2013

By Harvey B. Simon M.D.

Harvard Medical School

Ask any man and he's sure to say that the male sex is the stronger one. It's easy to see why: Men are bigger than women, so we can lift more, run faster, and jump higher.

But ask doctors of either gender, and they're likely to say that women are actually stronger, at least where health is concerned.

How much stronger and why? What can men do to become healthier and keep up with women? The answer isn't very complex. Men need to be more like women. That means understanding our bodies, taking better care of ourselves, and getting the medical care we need.

As with so many things, the devil is in the details. That’s why InteliHealth introduced a new monthly column with man-to-man advice. I'll explore various health topics and provide tips to help you lead a longer, healthier, and more vigorous life.

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The Longevity Gap

In the U.S. and around the world, women live longer than men. The average American woman has a life expectancy of 81.3 years while American men lag 5.1 years behind at 76.2 years. At every age, starting at conception, males have a higher death rate than females. The death rate for American men, for example, is 40% greater than for American women according to the National Center for Health Statistics. And when it comes to our five leading causes of death — heart disease, cancer, stroke, chronic lung disease, and accidents — men die at rates 40% to 220% higher than women in the U.S.

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The Health Gap

Men die younger than women, more frequently than women, and have more chronic illnesses than women. We also fall ill at an earlier age. Here is a list of some of the diseases that are much more common in males along with the difference in rates:

Disease or Condition

Male:Female Ratio

Inguinal (groin) hernia
9.5:1
Aortic aneurysm (abnormal swelling of the aortic artery in the abdomen)
5:1
AIDS (in America)
4:1
Gout (a type of arthritis)
4:1
Kidney stones
3.5:1
Alcoholism
3.3:1
Bladder cancer
3:1
Emphysema
2.2:1
Duodenal ulcer
2.2:1
Heart attack
1.9:1

(Source: The Harvard Medical School Guide to Men's Health)

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Why Are Men Less Healthy?

Why do men lead in illness and lag in health? It's the $64,000 question that has no single answer. Instead, the health gap is based on a complex mix of biological, social, and behavioral factors. Here are some possible contributors:

Biological Factors

  • Sex chromosomes — Men have one X chromosome while women have two, which may make men more vulnerable to abnormal mutations on the X chromosome
  • Hormones — Men have much more testosterone than women do, while women have much more estrogen. Testosterone tends to dampen the activity of the immune system while estrogen increases it.
  • Metabolism — Women have higher HDL ("good") cholesterol levels and men more abdominal fat, which lives in and around your organs and is dangerous to your health

Social Factors

  • Work stress — Men suffer more work-related stress than women, putting them at greater risk for stress-related illnesses such as heart disease
  • Social networks and supports — Men have smaller networks of friends and tend to rely on their wives for their social life; social support protects us from mental and physical problems

Behavioral Factors

  • Men are more likely to engage in risky behavior, aggression and violence
  • More men smoke — The gap is narrowing, but 25% of men compared with 20% of women smoke
  • Men are more likely to abuse alcohol and other substances
  • Diet — Men are less diet-conscious than women
  • Exercise — Women are more active than men on the whole
  • Men suffer from "Real-men-don't-see-doctors" syndrome

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The John Wayne Syndrome

When it comes to health, many men put their heads in the sand and deny their symptoms for as long as possible. Whether you call it the John Wayne Syndrome or the Ostrich Mentality, it's an important contributor to the health and longevity gap between the two sexes. When they can no longer pretend nothing's wrong, they grit their teeth and "tough it out" instead of getting prompt medical care.

Women, on the other hand, think about health more than men, and are more diligent about check-ups and preventive care. They are better at listening to their bodies and reporting discordant signals to their doctors.

Even when men do visit their doctors, they tend to minimize symptoms, gloss over concerns, and even disregard medical advice.

Busy work schedules and competing responsibilities and interests may play a role. But it's the macho mentality that appears to be the chief culprit.

Who can blame men for wanting to be John Wayne? What can convince men to take the simple steps to protect themselves from the heart disease and lung cancer that felled the quintessential American he-man? Stay tuned for the answers.

Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

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