The Bad Male Habit of Dropping Dead Early…

Pinkhasov, R., Shteynshlyuger, A., Hakimian, P., Lindsay, G., Samadi, D., & Shabsigh, R. (2010). Are men shortchanged on health? Perspective on life expectancy, morbidity, and mortality in men and women in the United States International Journal of Clinical Practice, 64 (4), 465-474 DOI: 10.1111/j.1742-1241.2009.02289.x

Pinkhasov et al. (2010) rehash that curious puzzle that juxtaposes women’s higher levels of morbidity in most developed countries with men’s lower life expectancy (p.465). Why is it that women tend to be sicker but nonetheless men, on average, tend to fall off the twig years earlier? The authors focus on the big four killers of men: coronary heart disease, hypertension, diabetes, and cancer (2010, p.465). They suggest promoting greater awareness of these conditions in men (2010, p.473) as well as addressing some of the underlying causative factors (obesity, poor diet, lack of exercise, etc.) (2010, p.472).

I rattled with disbelief when I read the huge claim by Pinkhasov et al. (2010) that the disparity in life expectancy between men and women ‘is consistent regardless of geography, race and ethnicity’ (p.473). That is patently untrue. For example, men from lower socio-economic status (SES) backgrounds are much more likely to drop dead years earlier than their uptown counterparts. Affluence is a protective factor against mortality for both men and women. Moreover, being part of particular cultural groups is a protective factor against poor health in men, since these groups encourage high levels of cohesion, and in-group support.

Pinkhasov et al. (2010) discuss the possibility that the biology of being male, coupled with our lower resistance to stress than women, the impact of sex-specific hormones, and our diminished autoimmune system, might account for our propensity to drop dead younger (pp.469-471). However, they conclude that these cause and effect possibilities ‘remain speculative’ (2010, p.473). I propose that beyond any biological or more strictly, biochemical explanations, we need to focus on how we raise boys to become men, inflicting upon them practices that are inherently stressful, and harmful to health…

• Men suffer for poor or absent attachment to their primary carers, leaving them vulnerable to fear, anxiety, stress, and trauma (eg. the fear of abandonment);
• Men are punished for showing any emotions that are considered to be effeminate or unmanly (eg. crying when sad);
• Men are raised in a robust drinking culture that reveres getting tanked regularly, and castigates any man who either does not drink, drinks too little or cannot hold his grog (ie. a ‘one pot screamer’);
• Men are taught that they must always defend themselves against violence, and themselves be proactively violent in certain situations (eg. on the footy field or battlefield); and
• Men are expected to tough out any physical or emotional pain that they might be experiencing, since suffering in silence is idealised as the mark of a ‘real man’ (noting that men’s resistance to seeking help is a relational dynamic as well as an individual behavioural characteristic).

To count heads, dead male heads, as due to disease x, y, or z, fails to contemplate the long and often tortured pathway that leads to any man going toes up perhaps years earlier than he should. It could be the case that men are supposed to disappear long before the curtain falls. The sharp reversal of mortality rates by gender observed in non-developed countries, and in other countries historically, might be due (or have been due) to the systemic oppression of women. What we could be observing now in developed countries might, in fact, be the ‘natural order’. That said, I think that stress is the precursor to men’s decreased longevity, and until such time as we wake to this ugly and ever-present reality, men will continue to shuffle off prematurely…