When you hear someone talking about gender equality, they almost never talk about the risks men face just for the fact of being men. These risks are real, not a made-up illusion, as some people are inclined to think.

In fact, men live fewer years than women. That is the reality. The question is: why?

According to the World Health Organization, there is a combination of biological and social reasons that explain why women live 5 years more on average than men.

Stroke, lung cancer, traffic accidents, suicides, cirrhosis, tuberculosis, HIV, homicides… The list is long.

Of the 40 leading causes of death in the world, 33 reduce more the lives of men than women. The result is that a girl born today will live 74.2 years on average, 4.4 more than a boy.

You can bet that people who call for gender equality will never agree to this kind of equality.

These are data that the World Health Organization (WHO) has just published in its Summary of World Health Statistics 2019, which analyzes the sociodemographic and gender differences in life expectancy.

The big conclusions are not new: in poor countries, life expectancy is lower -18.1 years less than in the richest nations- and women live longer.

But behind these thick strokes, there are details that help us understand the numbers and keys to improve them.

“The breakdown of the data is vital to understanding who is lagging behind and why,” says WHO director general, Tedros Adhanom Ghebreyesus.

The reasons why low-income countries have less life expectancy are predictable: worse health systems, poor nutrition, infectious diseases, complications in childbirth, problems with water and sanitation.

But why do women live longer than men? The reasons are varied and there are both natural and social.

“Biologically, women have a stronger immune system, which means that, especially in low-income countries, boys up to five years old die more than girls,” said Richard Cibulskis, lead author of the report.

This explains, from the evolutionary point of view, that more males are born: of the 141 million babies that will come to the world this year, 73 million will be boys and 68 million girls.

A difference of 105 or 110 boys per 100 girls is expected due to natural causes. But, as explained by the WHO specialist, there are countries in which this ratio can increase to 120 per 100, which is probably explained by selective abortion of girls in cultures where they are less valued.

Although in the first years of life there is a small survival advantage in girls, the big differences come after puberty.

“Certain hormones make men more prone to heart attacks, for example. Also, there are studies that show that testosterone can facilitate the development of tuberculosis.

But there are social factors that also influence male mortality, such as that they smoke and drink more, tend to have professions in which they are more exposed to toxic substances, are more prone to risk, have more traffic accidents -twice the male mortality-, violent deaths -four times more than women- and suicides -75% more than women- “, adds Cibulskis.

The differences in life expectancy are lower in poor countries, where there is less access to health services.

One of the keys is births, in which in these contexts one out of every 41 women dies, a figure that in the rich is reduced to one out of every 3,300. Birth deaths are, after breast cancer, the cause that most contributes to shortening female life expectancy.

The report also shows that women take better care of themselves. In both poor and rich countries, men look less for professional help in the face of the same disease.

Where there are HIV epidemics, for example, men are less likely than women to get tested, access antiretroviral therapy and more likely to die from AIDS-related illnesses than women.

Something very similar happens with tuberculosis. “This is not only an individual problem for those who are not treated, but it is helping to spread these pandemics, so it is something that we must solve,” says Cibulskis.

The WHO launched the report to mark World Health Day, which is celebrated on April 7 and which this year focuses on primary care as the basis of universal health coverage.

“These statistics underscore the need to urgently prioritize primary health care to effectively manage non-communicable diseases and curb risk factors,” said Samira Asma, WHO data director.

“For example, something as simple as controlling blood pressure is not happening on the necessary scale. And the consumption of snuff remains one of the main causes of premature death,” she added.

To improve the data, the organization emphasizes the need to address differences that are appreciated by gender to give a better health response.

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