Women still outlive men but the gap is narrowing and men can help themselves buck the statistics, writes MICHAEL KELLY.
THERE IS good and bad news for men in the recently published Central Statistics Office (CSO) report on life expectancy. The good news is that male life expectancy has increased and the gap between male and female life expectancy is narrowing.
The bad news is that we still don’t live as long as our female compatriots, and men from 11 other EU countries live longer than we do.
According to the latest CSO figures, in the four years between 2002 and 2006, life expectancy for men increased by 1.7 years – we can now expect to live to the ripe old age of 76.8.
Almost five years after we have shuffled off this mortal coil however, the women in our lives are likely to still be around – female life expectancy now stands at 81.6 years. The gender gap between the two – 4.8 years – has narrowed from a high of 5.7 years recorded in 1986.
There is a tendency for men to think that we are somehow hardwired to expire earlier than women, but there is nothing natural about a lower male life expectancy, according to experts.
In 1926 male life expectancy was 57.4 years and women lived just half a year longer. After that the gender gap started to increase and continued to do so until 1986, at which point we somehow managed to stop the rot. It has been decreasing gradually since.
So if men are not preprogrammed to die younger, why does their life expectancy lag behind women? Part (but certainly not all) of the problem is the way life expectancy figures are calculated, says Owen Metcalfe, associate director of the Institute of Public Health. “Life expectancy is based on the general population. There are a significantly higher number of young men involved in suicides and road traffic fatalities which has the effect of reducing life expectancy in men overall.”
A bigger problem, however, lies with what we might call the old reliables. “We are reluctant attenders with the medical profession,” says Metcalfe. “The classic macho male stereotype still exists to the point that many men still think that men’s health is a woman’s issue.
“In other words that it’s up to their partner to look after their health for them and they have to be dragged over the door kicking and screaming. A lot more men than women are overweight or obese which plays a significant role too.”
Gerontologists believe that less tangible benefits in terms of life expectancy come from religious belief and attendance, social contact and a sense of community. Male life expectancy also suffers from the fact that much of men’s identity is tied up in work which takes a crippling blow when they retire.
Women are far more comfortable with multiple roles throughout their lives and are more successful when it comes to maintaining social networks.
The improvement in male life expectancy in recent years is partly the result of shifts in these societal norms, according to Metcalfe. “Men are beginning to take more responsibility for their health and there is a growing awareness that it’s important to do so. Smoking rates have decreased slightly and, as a result, there has been a drop in coronary heart disease.
“Also we have increased affluence and we know that in general, the better off a society is, the longer people will live. There is a big gap in life expectancy between a poor man and a wealthier man.”
So will the gap continue to narrow? “We would hope that this trend will continue, but obviously not at the expense of women. We would have significant worries for the future, particularly around increases in obesity. We have seen in the United States how life expectancy has started to decrease and the gains made in public health have been eroded by this disease of affluence.”
Not only do Irish men lag behind women, they also lose out when compared with their European colleagues. Irish men rank 12th in terms of life expectancy across the EU – our fellow Europeans in Sweden and Cyprus can expect to enjoy an additional two years of life.
“There are countries in Europe that we can learn from,” says Metcalfe. “In Southern Europe, Italy is right up there at the top which might be a surprise to people. That would seem to be related to diet. In northern Europe you have the example of Sweden where they have excellent health policy and public health goals.”
The idea that socio-economic factors can impact life expectancy muddies the waters considerably. All of the factors we have discussed so far are things that men can control and take responsibility for. Socio-economic factors, on the other hand, are largely beyond people’s control and that leaves open an intriguing possibility – could it be that the most important factor in living to a ripe old age is being born in a country with an equitable health system?
“We now know of the importance of better education, a more secure and stable environment and the benefits of the welfare state in improving life expectancy,” says Prof Des O’Neill of Trinity College Dublin who is president of the Irish Gerontological Society.
“Universal healthcare, where it exists, is associated with dramatic improvements in health because it allows people who are poor or on the boundaries of being poor to be freed from worry about healthcare.”
Nevertheless, higher spending on healthcare does not necessarily equate to higher life expectancy. This point is emphasised nicely (and from a political perspective, controversially) by the fact that the average life span of a Cuban citizen is equivalent to that of a citizen of the United States, even though the US spends more on healthcare than any other nation.
The causes of this anomaly, says O’Neill, is something called a social gradient, as outlined in research by Sir Michael Marmot of the WHO’s Commission on Social Determinants of Health. “The WHO looked at what makes people healthy beyond medicine and tablets,” says O’Neill, “and they came up with some fairly revolutionary thinking. In countries where the gap between rich and poor is low or eliminated completely, life expectancy is higher. They called this a social gradient. This shows us that there is a much wider, deeper social trend at play in life expectancy.”
In that context, our current economic woes could have a considerable impact on male life expectancy, says O’Neill.
“As a gerontologist I was very alarmed when the Government took away the automatic entitlement of over-70s to the medical card. It showed a complete lack of knowledge of health economics in general. If we want to see happy and healthy older people in our society, we have to educate people on what they can do to help themselves but we also have to build a society where the social gradient is kept as low as possible.”
THE SECRET OF A LONG LIFE
The mountainous Russian region of Abkhazia apparently boasts the highest number of long-lived people in the world. About 2.5 per cent of its quarter-million people are thought to be over 90 years old compared with a total of 0.4 per cent in the US.
So what’s their secret? Russian anthropologists point first to the fact that growing old is considered a matter of pride and prestige in Abkhazia. There are extensive and close family ties in communities and traditions of mutual assistance which anthropologists believe may help to minimise stress. When ill, Abkhazian seniors are cared for by family – they rarely have recourse to nursing homes.
Family meals are a central part of Abkhazian life and the diet is rich in fruit and raw vegetables, with a moderate amount of dairy, meat and fish. Nuts are their primary source of fat and their diet is low in salt. They eat almost no sugar or butter. Overall calorie intake is low and obesity is almost unknown. Consumption of wine and vodka is widespread.