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New book examines ‘Why Men Die First’

Dr. Marianne J. Legato, an expert in gender-specific health, explores men's various health problems, what is conspiring against male longevity and offers advice on how men can lengthen their lifespan. Here's an excerpt:
/ Source: TODAY

Dr. Marianne J. Legato, an expert in gender-specific health, explores men's various health problems, what is conspiring against male longevity and offers advice on how they can live longer. Here's an excerpt from "Why Men Die First: How to Lengthen Your Lifespan":

It’s time to talk about men — and in a whole new way, paying close attention to unique male qualities, particularly those that explain why at all ages, men die in greater numbers than women do. Since the time I was a medical student, I never once remember anyone asking why this is true; as one man said to me recently, “I never thought about why. I thought it was a given.”

If it’s true that men rule the world, it comes at a heavy cost. Women survive and live almost a decade longer. It’s time to ask about the nature of men’s vulnerabilities. Are they biological, that is, inbuilt and unalterable, or a function of the roles men play and how they play them? Men are trained not to complain, to shrug off pain and injury, and never, never refuse to do the most dangerous and difficult tasks required to keep societies stable. It turns out that these elements, too, contribute to premature death.

The biggest surprise of all, perhaps, is that men, from conception until death, are inherently more fragile and vulnerable than women. In virtually every society in the world, men die first. Women have a hardiness that men simply don’t possess. As you will read about here, some of their vulnerability is the consequence of biology, schooling, and socialization. Men are expected to take risks. You go to war, you fight fires, bring order to our cities, sail our ships, and build our buildings. We encourage you to feats of daring and valor, and at the same time, we tell you never, never complain of or even mention the pain you might sustain in agreeing to do all these things. Certainly male biology, particularly in youth, seems fit for these risks. The adolescent and young adult male has a peculiar combination of recklessness, conviction of invulnerability, and a willingness to bear pain and deprivation. This combination can make men susceptible to committing violence. Statistics show that murder and homicide are among the top four killers of men from the time they are born until heart disease and cancers begin to claim those who survive into middle age.

The fundamental male biology makes you an underdog. You are less likely to survive the womb than your sisters; you are six weeks behind in developmental maturity at birth compared to girls. Men have four times the developmental disabilities of females. Men suffer more severely than women from seven of the ten most common infections that humans experience, as you simply don’t have the vigorous immune systems that defend women. Men are likely to experience the first ravages of coronary artery disease in their mid-thirties, a full 15 or 20 years before women. And twice as many men die of the disease than do women.

One of the most important issues that face us all is the subject of depression: Women are said to suffer from this disease twice as often as men in virtually every country in the world. I think this is because men hide their pain. Women are permitted to talk about their sadness, to consult their friends and advisors about the experiences they have and how to deal with them. They seek and get counseling more often than their brothers. Men are forbidden this luxury: “Suck it up,” men are told by their parents, teachers, and sports instructors — and by the commanders who send them into battle. I have asked many men if they think women underestimate the extent and depth of their sadness and the resounding answer is “yes.”

It is time to spend some concentrated thought on you, on what in your biology makes you unique, and on how society conditions and trains you. It is time to think about how we can protect you from premature, violent death and debilitating illness. Chapter one

This is a book about the relative fragility of men. A male fetus is less likely to survive to term than a female. When he is born, a baby boy’s lungs are especially vulnerable, so that boys are less likely to survive the challenges of the first weeks of postnatal life. The rate of violent death for baby boys is higher, too. At least six percent of males who die between the ages of one and four are murdered. In their teen and adolescent years, 20 percent of boys who die do so because of suicide, murder, or reckless behavior. In fact, boys are physiologically inclined to die violent deaths. The area of the brain responsible for judgment and considered decision-making are less developed in adolescent boys than in girls.

Societal attitudes play an enormous role in this dreadful toll on men’s lives. We encourage boys to “hang tough” and drive through pain, unhappiness, and discomfort of all kinds no matter what the personal price. We discourage them from asking for help or advice about how to alleviate the consequences of this societal pressure. The result is unrecognized, untreated depression in males of all ages.

Coronary artery disease reaps a grim harvest as well: The first symptoms of coronary artery disease appear in some men when they are only 35. It kills more than 24 percent of men and is the chief cause of male death after the age of 35. By contrast, it is only when they reach the age of sixty that women are as likely to have a heart attack as a man. Most women have no symptoms of heart disease until they are menopausal. Men have different and more vulnerable immune systems than women; they suffer more intensely from seven of the ten most common infections that afflict humans.

Despite the significant opportunities and advantages most societies afford men, they remain shockingly vulnerable on many levels. Researchers have largely ignored this phenomenon, with tragic consequences. Simply put, we have never turned a gender-specific lens on men. We have not thought enough — if at all — about why they are uniquely prone to disability and premature death. Excerpted from “Why Men Die First: How to Lengthen Your Lifespan” by Dr. Marianne J. Legato with permission from Palgrave Macmillan. Copyright © 2008. All rights reserved.