Kruger, Daniel J.; Nesse, Randolph M.
doi: 10.1177/147470490400200112
This paper extends the evolutionary understanding of sex differences in mortality rates by quantifying and graphically examining the overall Male to Female Mortality Ratio (M:F MR) for 11 specific leading causes of death across age groups in the USA, over the course of the lifespan in 20 different countries, and across the past 70 years in 5 countries. The resulting quantitative descriptions of rates, trends, and the relative contributions of various proximate causes of death to the M:F MR provide an initial exploration of the risks associated with being male. This analysis also illustrates how sex differences shaped by sexual selection interact in complex ways with multiple aspects of culture and environment to yield a pattern that has some consistency across decades and societies, but also has variations arising from differences among cohorts and cultures. The results confirmed our expectations of higher mortality rates for men than for women, especially in early adulthood, where three men died for every woman who died. For external causes the ratios were even higher. Historical mortality data reflect an epidemiological transition in which discrepancies between male and female mortality rates increase as general mortality rates fall. Cross-national variation in the modern M:F MR further suggests a universal pattern that is influenced by cultural and environmental context. Being male is now the single largest demographic risk factor for early mortality in developed countries.