Why women live longer than men - and what men can do about it

Ebony, Feb, 1991 by Alex Poinsett

"I can't make it without you," whispered Celestine Williams to her husband, Lorenzo, as he lay hooked up to life-saving equipment in a Gary, Ind., hospital. "Yes you can," he assured her.

For more than 10 years, the 47-year-old businessman had lived with hypertension, diabetes and failing kidneys--all prominent killers of Black men. But three days after comforting his wife, Lorenzo died of a heart attack. Since that sad day in 1981--after 23 years of happy marriage--Williams has managed her late husband's liquor store, taught grade school and reared four daughters. Only 53 today and not planning marriage, she might survive Lorenzo another 20 years, predicts Dr. Toni Miles, an epidemiologist at the University of Illinois at Chicago.

The plight of Celestine Williams is becoming increasingly common in Black America and has raised once again the question of why--in virtually every culture--women outlive men. Are the answers to the longevity gap embedded in genes, hormones, environment or all of the above? And can it ever be eliminated?

White females--the longest survivors--life from five to eight years longer than White males, and eight years longer than Black men, explains Dr. David Satcher, president of Meharry Medical College and an epidemiologist. White men--the second logest survivors--live about five years more than Black men. At the bottom of the longevity scale, Black men are outsurvived about eight years by Black women.

The gap between Black men and women is greater at younger ages and less at older ages, says Dr. Miles. "A 65-year-old Black woman today can expect to live an additional 17 years. But her Black male counterpart will live only 14 more years."

While medical scientists are uncertain about the exact causes of women outliving men, they cite telltale clues that the main reasons are 1) biological (mainly genes and hormones), 2) cultural (stress-related illnesses, homicides, etc.), 3) a subtle interaction of these factors.

Genetically, everyone has chromosomes in his/her cells that blueprint bodily development. Men have X and Y chromosomes while females have pairs of X chromosomes. During pregnancy, ALL male fetuses are at risk because of their apparent fragility. Therefore, male fetuses are much more likely than female fetuses to abort spontaneously, Dr. Miles explains, adding:

"Part of that is related to the Y chromosome. From the time that egg and sperm unite, the natural tendency is for females to develop. You get males because a protein on the Y chromosome directs male development. In other words, femaleness is the natural order and maleness is a very special side trip. It's a chancy proposition from Day One that you're going to get out a functioning male."

The epidemiologist's explanation debunks the chest-beating macho dogma which suggests that maleness is the warf and woof of the universe. Yes, males are generally heavier and larger at birth. But also they are less well-developed neurologically than females, reports Emory University's Dr. Margaret Beale Spencer, who has been a student of Black child development for more than 20 years. Indeed, if Black males survive infant mortality rates that are nearly double those for White infants, they are still more likely than females to succumb to infectious and non-infectious diseases in the first year of their lives. That fundamental vulnerability, that basic susceptibility to stress remains a physical and mental health hazard for the remainder of their lives. In short, adult males are more likely than females to have chronic illnesses and higher rates of psychological or behavioral problems. From conception to birth, and throughout life they are more at risk than females.

Part of that at-risk-ness stems from hormones, even though Dr. Satcher questions whether hormonal differences between males and females really account for the death-rate gap between them. He notes that once women pass menopause and lose the shielding against heart attacks and strokes that the female hormone, estrogen, provides, their death rate from hypertension, for example, becomes more like that for men. Indeed, hormonal differences clearly do not explain why males are more likely than females to die in the first year of life when hormones are absent.

Medical scientists define the longevity gap between men and women culturally as well as biologically. "Men and women don't have equal opportunity exposure to the toxins that kill men," suggests Dr. Cheryl Woodson, an assistant professor of medicine at the University of Chicago. "However, since the women's movement brought more women into the workforce, stress-related illnesses among them have also gone up. Lung cancer has now outstripped breast cancer as their number one cancer cause of death because they're smoking more. Those who are getting involved in white-collar executive jobs are exposed to the same kind of coronary disease factors that kill men."

Women live longer, but are not necessarily healthier. The very nature of their bodies obliges them to see physicians more frequently and to take more medications. Men, culturally conditioned early on to ignore their aches and pains, do not visit doctors as often.