The Morbidity Paradox

By Franz Brotzen

The recent narrowing in the gap between men’s and women’s longevity could be due to women reaching the maximum potential for human life without genetic or other technological intervention.

A number of studies indicate women say they get sick more frequently than men do, but on average, men tend to die younger. This is the “morbidity paradox,” a puzzle being explored by Rice sociologist Bridget Gorman.

“Most measures show that women report poorer health than men,” Gorman explains, “and yet they outlive men.” In recent years, her research concerned itself with health disparities based on race, class and ethnicity. Now she is focusing on gender.

Although the gap between men’s and women’s life expectancies grew through the 20th century, it has been shrinking recently. One intriguing possibility that could explain the recent decrease in the gender mortality gap is that human beings may be approaching the upper limit of their natural life expectancies. While women’s life expectancies are still measurably longer than men’s, Gorman suggests women might be “closer to the wall” of human longevity than men are. In other words, the recent narrowing in the gap between men’s and women’s longevity could be due to women reaching the maximum potential for human life without genetic or other technological intervention.

But the question remains: why do females in the United States outlive males by more than five years, despite the fact that women tend to be poorer and have less access to health care? Gorman points to a wider use of alcohol, tobacco and illegal drugs by men, which leads to higher mortality. The fact that women are increasingly using such substances also may help explain why the mortality gap is shrinking. “Women are starting to misbehave the way men have misbehaved,” Gorman says.

Women’s relatively limited access to health care compared to men’s may play a role in why they report a higher incidence of illness. What Gorman calls “the chronic stresses of poverty” cause women to battle depression, anxiety and other mood disorders more frequently than men do. This phenomenon may be related to the theory that women tend to internalize emotions, while men tend to act out—even to the point of engaging in higher rates of dangerous behavior like drunken driving.

Gorman currently has a grant proposal before the National Institutes of Health to look at how gender affects the relationship between mental and physical health. One of the study’s goals is to shed light on how mental and physical health problems influence each other over time and how this varies by health measure for men and women. In addition, the research is designed to devote greater attention to alcohol abuse as the result of mental health problems. This new focus would raise awareness of a pathology—alcohol abuse—that tends to affect men more than women. By focusing on the gender disparities between mental and physical health, the study aims to contribute to better-informed policies to address men’s and women’s health issues.

Gorman’s articles about the morbidity paradox have appeared in the Journal of Health and Social Behavior and Social Science and Medicine.