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      Women live longer than men even during severe famines and epidemics

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          Significance

          Women live longer than men in nearly all populations today. Some research focuses on the biological origins of the female advantage; other research stresses the significance of social factors. We studied male–female survival differences in populations of slaves and populations exposed to severe famines and epidemics. We find that even when mortality was very high, women lived longer on average than men. Most of the female advantage was due to differences in mortality among infants: baby girls were able to survive harsh conditions better than baby boys. These results support the view that the female survival advantage is modulated by a complex interaction of biological environmental and social factors.

          Abstract

          Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men. Gender differences in infant mortality contributed the most to the gender gap in life expectancy, indicating that newborn girls were able to survive extreme mortality hazards better than newborn boys. Our results confirm the ubiquity of a female survival advantage even when mortality is extraordinarily high. The hypothesis that the survival advantage of women has fundamental biological underpinnings is supported by the fact that under very harsh conditions females survive better than males even at infant ages when behavioral and social differences may be minimal or favor males. Our findings also indicate that the female advantage differs across environments and is modulated by social factors.

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          Most cited references93

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          Sex differences in autoimmune disease.

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            Testis weight, body weight and breeding system in primates.

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              Sex differences in parasite infections: patterns and processes.

              M Zuk (1996)
              Sex differences in parasite infection rates, intensities, or population patterns are common in a wide range of taxa. These differences are usually attributed to 1 of 2 causes: (1) ecological (sociological in humans); and (2) physiological, usually hormonal in origin. Examples of the first cause include differential exposure to pathogens because of sex-specific behavior or morphology. The second cause may stem from the well-documented association between testosterone and the immune system; sexually mature male vertebrates are often more susceptible to infection and carry higher parasite burdens in the field. Although many researchers favor one explanation over the other, the requisite controlled experiments to rule out confounding variables are often neglected. We suggest that sex differences in disease have evolved just as sex differences in morphology and behavior, and are the result of selection acting differently on males and females. Research has often focused on proximate mechanistic explanations for the sex difference in infection rates, but it is equally important to understand the generality of the patterns in an evolutionary context. Because males potentially gain more than females by taking risks and engaging in competition, sexual selection pressure has shaped male behavior and appearance to maximize competitive ability and attractiveness. Many of the classic male attributes such as antlers on deer are testosterone-dependent, putting males in what appears to be a cruel bind: become vulnerable to disease by developing an attractive secondary sexual ornament, or risk lowered mating success by reducing it. A variety of hypotheses have been put forward to explain why males have not circumvented this dilemma. The mating system of the host species will influence the likelihood of sex differences in parasite infection, because males in monogamous species are subject to weaker sexual selection than males in polygynous species. Whether these evolutionary generalizations apply to invertebrates, which lack testosterone, remains to be seen.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                23 January 2018
                8 January 2018
                8 January 2018
                : 115
                : 4
                : E832-E840
                Affiliations
                [1] aMax Planck Odense Center on the Biodemography of Aging, University of Southern Denmark , DK-5230 Odense, Denmark;
                [2] bDepartment of Public Health, University of Southern Denmark , DK-5000 Odense, Denmark;
                [3] cMax Planck Research Group Gender Gaps in Health and Survival, Max Planck Institute for Demographic Research , 18057 Rostock, Germany;
                [4] dDepartment of Clinical Genetics, Odense University Hospital , DK-5000 Odense, Denmark;
                [5] eDepartment of Clinical Biochemistry and Pharmacology, Odense University Hospital , DK-5000 Odense, Denmark;
                [6] fMax Planck Institute for Demographic Research , 18057 Rostock, Germany;
                [7] gDuke University Population Research Institute, Duke University , Durham, NC 27708
                Author notes
                1To whom correspondence should be addressed. Email: jwv@ 123456demogr.mpg.de .

                Contributed by James W. Vaupel, November 22, 2017 (sent for review February 6, 2017; reviewed by Tommy Bengtsson and France Mesle)

                Author contributions: V.Z., R.L.-J., and J.W.V. designed research; V.Z. performed research; V.Z. analyzed data; J.A.B.J. interpreted and discussed the results from an evolutionary biology perspective; and A.O. contributed to the literature review and the discussion about biological explanations for the women’s survival advantage (based on human studies); and V.Z., J.A.B.J., A.O., K.C., and J.W.V. wrote the paper.

                Reviewers: T.B., Lund University; and F.M., Institut National d’Études Démographiques.

                Article
                201701535
                10.1073/pnas.1701535115
                5789901
                29311321
                387786a2-a2a0-4d87-bff4-d0673ee7b78a
                Copyright © 2018 the Author(s). Published by PNAS.

                This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).

                History
                Page count
                Pages: 9
                Categories
                PNAS Plus
                Biological Sciences
                Population Biology
                Social Sciences
                Social Sciences
                From the Cover
                PNAS Plus

                famines,epidemics,mortality,survival,gender
                famines, epidemics, mortality, survival, gender

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