ABSTRACT

Cardiovascular disease (CD) is a leading cause of death and suffering both in men and women. In the industrialized world, the incidence of CD is closely related to the expected longevity at birth in a population. Development during the 20th century in 21 countries in Northern, Western, and Southern Europe as well as North America, Australia, New Zealand, and Japan (Statistical Year Book, 1995) has been less egalitarian with regard to gender than expected. The average difference between men and women with regard to expected longevity at birth was evident already at the start of the century—it was statistically significant and amounted to 2.8 years—with women living longer than men. This difference has become more pronounced and clear. The expected longevity has increased for both men and women in these countries, but the female advantage has become even more pronounced—6.4 years. The distributions of expected longevity have become more narrow which means that the variation between countries is smaller. The distributions for men and women show almost no overlap. Possible reasons for this development could be:

that the material conditions have improved in general for men and women during the 20th century. In this situation, the “biologically possible” longevity becomes more evident than it has been in the history of mankind.

that child bearing has decreased during the period. Particularly in the beginning of the century birth was associated with mortality. Many mothers died during delivery due to infections and other illnesses related to pregnancy.

that women's increased participation in the labor force means that women have a better balance between the work life and private spheres than most men have. According to this “expansion hypothesis,” women's paid work might have a buffering effect in the association between strain and ill health. When women enter the labor force, they may gain increased control over their entire life situation, achieve a higher socioeconomic status (SES), and be more apt at social integration. Thus, increased gender differences in longevity might be an effect of more women than men having an active function in work life and private spheres. The strain of combining paid work with family responsibilities might be counterbalanced by a stronger supportive effect of expanding life's possibilities.