chapter  2
83 Pages

Behavioral Factors Associated With Disease, Injury, and Death Among Men

A variety of factors have been found to infl uence health. Among these factors are access to care, economic status, and ethnicity (Adler et al., 1994; Angell, 1993; Department of Health and Human Services [DHHS], 1998a; Gibbs, 1988; Laveist, 1993; Pappas, Queen, Hadden, & Fisher, 1993). Gender, however, consistently emerges as the strongest predictor of health and longevity (see Chapter 1). A variety of explanations for the gender disparities in health and longevity have been advanced in the past several decades (Kandrack, Grant, & Segall, 1991; Ory & Warner, 1990; Verbrugge, 1985, 1990; Verbrugge & Wingard, 1987; Wingard, 1984; Wingard, Cohn, Kaplan, Cirillo, & Cohen, 1989). The explanatory power of biological factors in predicting gender differences in morbidity and mortality is comparatively small (Kandrack et al., 1991; Krantz, Grunberg, & Baum, 1985;

Neel, 1990; Ory & Warner, 1990; Verbrugge, 1985, 1990; Waldron, 1997, 2008). The possibility that poor health behavior on the part of men might account for the disparity was raised as early as the mid1970s (Goldberg, 1976; Harrison, 1978; Lewis & Lewis, 1977; Waldron, 1976; Waldron & Johnston, 1976). Many of these reviews remain the most frequently cited works on the topic. However, all of them lack the robust evidence provided by national surveillance systems and a large number of more recently published prospective studies and metaanalyses. In addition, these reviews focus principally on smoking, on the use of alcohol and other drugs, and to some extent on risk-taking behavior and occupational hazards. They are limited in their examinations of many other relevant health behaviors. One previous and more extensive review of mine suggested that the more than 5-year difference in the life expectancies of men and women is primarily the result of men’s less healthy lifestyle habits (Courtenay, 2000b). There are, however, no recent or thorough reviews that support this belief.