By Sola Ogundipe
Who is stronger, a man or a woman? If you say a man is stronger you are correct. If you say a woman is stronger, you are also correct. Both answers are right, depending, of course on the perspective of your reasoning. Being a man symbolises authority, firmness and toughness. The presence of a man evokes an enhanced sense of security and safety. You can’t argue with any of these.
Traditionally, men are tasked with the role of providing security and protecting women and children, not vice versa. Physically, men are averagely bigger, taller, heavier, and are more muscular than women. A man’s bones are stronger and denser and his body is structurally better built to take more physical abuse and trauma than a woman.
Men can jump farther and higher, run faster and further than women. Men can lift and carry heavier weights or throw things farther, and can swim faster over longer distances. Men are more aggressive and better endowed to complete more arduous tasks.
Overall, men are generally bolder and superior in the endurance tasks, but in the medical aspects, it’s a completely different story. Health wise, the more fragile-boned and softer bodied women turn the tables and come out better off than men. It sounds surprising, but the facts are there. Women, even with the comparative disadvantage of their reproductive life cycle, tend to live longer and healthier lives than men.
With changing lifestyles and growing emphasis on healthier diets and regular exercise, life expectancy is also changing, rising slowly but steadily year after year. But one thing that has not changed is the gender gap. Men and women are living longer, but decade after decade; women continue to live longer than men. In fact, the gender gap is wider now than it was a century ago.
When taken together, the longevity gap is quite significant. Everywhere you look; there are more older women than men, more widows than widowers. For instance, in America and to a large extent in Europe, more than half of all women older than 65 are widows and widows outnumber widowers by at least three to one. At age 65, for every 100 American women, there are only 77 men. At age 85, the disparity is even greater, with women outnumbering men by 2.6 to 1. And the longevity gap persists even into very old age, long after hormones have passed their peak; among centenarians, there are four females for every male.
This gender gap is not unique to America. In fact, every country with reliable health statistics reports that women live longer than men. The longevity gap is present both in industrialised societies and in developing countries. It’s a universal observation that suggests a basic difference between the health of men and women.
Not only do men die at a faster rate than women, men die younger. Men are more burdened by lifetime illness than women. On the average, a man falls ill at a younger age and has more chronic illnesses than a woman. The indirect translation of this is that women live longer and healthier lives than men.
For instance, the average overall mortality rate is 41 percent higher for men than for women, and it’s also higher for men for eight of the 10 leading causes of death. In addition, American men are 2.1 times more likely to die from liver disease, 2.7 times more likely to die from HIV/AIDS, 4.1 times more likely to commit suicide, and 3.8 times more likely to be murder victims than women.
Further, men are nearly 10 times more likely to get inguinal hernias than women, and five times more likely to have aortic aneurysms. Men are about as likely to contract HIV and AIDS as women, but are more prone to gout and three times more likely than women to develop kidney stones, to become alcoholics, or to have bladder cancer. Men are about twice as likely to suffer from emphysema or a duodenal ulcer. Although women see the doctor more often, the medical care cost is much higher for men beyond age 65.
The gender gap in health and longevity
A man and a woman each have 22 identical pairs of chromosomes. The 23rd set of chromosomes separates the sexes. This final pair contains the sex chromosomes. In women, the pair are X chromosomes, while in men one is an X and the other a Y. The Y chromosome is smaller and contains fewer genes that may be linked to diseases that contribute to the excess male mortality throughout life. In addition, if a woman has a disease-producing gene on one of her X chromosomes, it may be counterbalanced by a normal gene on the other X, but if a man has the same bad gene on his X chromosome; he lacks the potential protection of a matching gene. Advantage: Women.
This is also key to the health gap between men and women. For instance, the number of new prostate and breast cancers are closely matched, but women are about 45 percent more likely to die from their disease. If malignant and benign diseases of the uterus and the perils of pregnancy and childbirth are factored in, one would expect that women are the more fragile sex. But they are not.
An explanation is the hormonal influence which, however, don’t account for the lion’s share of the gender gap, but they play a role. For instance, oestrogen raises High Density Lipoprotein, HDL or good cholesterol levels, perhaps explaining why heart disease typically begins about 10 years later in women than men. Research shows that in physiologic doses, testosterone may help some men with heart disease. Women who take oestrogen well beyond menopause, when their natural levels plummet, experience an increased risk of heart attacks, strokes, and blood clots.
On the other hand, testosterone may contribute to the risk-taking and aggressive behaviour that causes problems for many young men. And testosterone also fuels diseases of the prostate, both benign and malignant. Even so, the testosterone-prostate connection can’t account for the longevity gap, since there are more deaths from breast cancer than prostate cancer.
Both sex hormones keep bones strong, but here, men have the edge. As men age, testosterone levels decline slowly, about 1 percent a year, but oestrogen levels drop abruptly at menopause, boosting the risk of osteoporosis. Verdict: Draw
Males and females have similar Low Density Lipoproteins, LDL or “bad” cholesterol levels, but women have substantially higher levels of “good” cholesterol (60.3 milligrams per decilitre, or mg/dL, versus 48.5 mg/dL on average). HDL cholesterol protects against heart disease, but triglycerides may increase risk.
Diabetes is a major problem and metabolic risk factor for both sexes and its prevalence is increasing in both. But it affects a somewhat higher percentage in men. Obesity is rapidly increasing. The prevalence of obesity is slightly higher in women than men; although excess weight is more of a problem for males. Women tend to carry excess weight on their hips and thighs (pear shape), while men add the excess weight to their waistlines (apple shape or beer belly). Excess body fat is never a good thing, but abdominal obesity is much riskier than lower body obesity, sharply increasing the risk of heart attack and stroke. Women tend to be shaped well than men. Although obesity is often classified as a metabolic problem, it usually results from unwise health behaviours, another major misfortune for males. Advantage: Women.
Work stress can increase the risk of hypertension, heart attack, and stroke. Stress, hostility, and anger have all been implicated as heart disease risk factors, and these traits tend to have a higher prevalence in men than women. Work-related stress and heart-breaking personality factors may contribute to male vulnerability. But as more women enter the workplace and add financial obligations to their traditional roles at home, they are gradually closing the gender gap by moving in the wrong direction. Advantage: Women.
Social, spiritual networks
Women tend to have much larger and more reliable social networks than men. A study by the New England Research Institute found that 28 percent of women but only 9 percent of men report they can rely on friends for support, and men were 2.5 times more likely than women to lack social support. In general, women are more in touch with their feelings and with other women, and they have a remarkable ability to express their thoughts and emotions. This strong relationships and good communication seem to help explain why women live longer on Earth. Advantage: Women
From boyhood on, males take more risks than females, and they often pay the price in terms of trauma, injury, and death. Simple precautions like seat belts and bike helmets can help, but more complex measures involving education about alcohol, drugs, firearms, and safe sex are also essential. Advantage: Women
Aggression and violence
These are extreme forms of risky behaviour, and they all have many of the same root causes. A man who takes risks places himself in harm’s way, but his unwise choices may not endanger others. Violent behaviour, though, directly threatens the health and well-being of others, both male and female. A man is nearly four times more likely to die from homicide or suicide than a woman, but women are much more likely to be victims of domestic violence. Men need more self-control and anger management if they are to close this portion of the gender gap. Advantage: Women. Smoking
This is the riskiest of all health habits. In the old days, men smoked but women didn’t. Times have changed, now women smoke in large numbers and are catching up with men in heart disease, lung cancer, and emphysema. Both sexes are trying to break the habit, but more men (24 percent) than women (18 percent) are hooked on cigarettes. Tobacco smoking is likely to continue fuelling the gender gap for years to come. Advantage: Women
Alcohol and substance abuse
Like smoking, drinking and drug abuse are self-destructive habits that are traditionally male problems increasingly threatening to women as well. Small to modest amounts of alcohol appear to protect a man’s health, reducing his risk of heart attack and the most common type of stroke. But larger amounts shorten life by increasing the likelihood of hypertension, heart failure, liver disease, various cancers, accidents, and traumatic death. Men are twice as likely as women to be binge drinkers and to become dependent on alcohol. Illicit drugs claim thousands of lives a year and it’s a tragedy for both sexes, but males are 80 percent more likely to abuse drugs than females. Advantage: Women
Meat is bad, veggies are good. It’s an oversimplification, but it may help explain why women are generally healthier than men: in most cases, they eat better. Women are about 50 percent more likely than men to meet the goal of eating at least five servings of fruits and vegetables a day. Advantage: Women
Men and women used to get plenty of exercise from their routine, but as men moved behind desks, women who continued to haul shopping bags, climb stairs, scrub floors, and wash mountains of clothes, continued to get the many health benefits of physical activity. But as modern appliances replace muscles at home and women join men in sedentary jobs, women are falling slightly behind in exercise. But most men still don’t come close to getting the exercise they need for optimal health. Verdict: Draw.
In the developed world, women are likely to think and do more about health. Women are more likely than men to have health insurance and a regular source of health care. But the reverse is the case in developing countries. A major survey by the Commonwealth Fund, shows that three times as many men as women had not seen a doctor in the previous year; more than half of all men had not had a physical exam or cholesterol test in the previous year; among men over 50 years of age, 41 percent had not been screened for prostate cancer, and 60 percent had not been screened for colon cancer in the previous year; and 25 percent of men said they would handle worries about health by waiting as long as possible before seeking help. In general, men who have the most traditional, macho views about masculinity are likely to be the least healthy. Advantage: Women.