Project 2

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Empirical evidence accumulated over many decades revealed an apparent contradiction between the health and survival of men and women. Women enjoy a longer life than men in all countries of the world, but women tend to report poorer self-rated health, they have higher disability levels at all ages and perform more poorly on physical tests than men. This so-called male-female health-survival paradox has far-reaching economic, sociological, and medical implications for human societies. We have spent the past five years investigating the health-survival paradox using an exceptionally rich data resource of Danish register and survey data (Oksuzyan et al., 2008, 2009, 2010a, 2011, 2013; Jacobsen et al. 2008). Generally, we have not been able to confirm any major impact of many of the suggested underlying mechanisms such as male underreporting of health problems and medication use (Oksuzyan et al., 2009). We also performed cross- national comparisons with other high-income countries (Japan and US) and found consistent sex differentials in survival and health (Oksuzyan et al., 2010b). Finally, we extended our analyses to the Utah population and found that, despite high female fertility and a healthy male life style (low tobacco and alcohol consumption), females in Utah have very substantial survival advantages (Lindahl-Jacobsen et al., 2013). In this renewal we intend to expand this research to test how universal are the sex differences in health and survival in populations that experience living conditions and cultures very different from contemporary Western societies (China and Russia). In these studies we will focus on the same theme as in the primate study, namely social status and how it contributes to male-female differences in health and survival and compare them to the rich data available in Denmark. Furthermore, we intend to use the comprehensive cause of death data available in Denmark and Utah to test how male-female differences in causes of death may contribute to the paradox. By focusing on the outstanding, already existing human data resources that were created in our previous P01 work and also used in project 1, and by making explicit cross-species comparisons between our study population and the primate population that will be examined in Project 3, we propose to shed new light on potential mechanisms underlying the male-female health-survival paradox.