Gender and Death

All people die, men and women alike, but there are some interesting differences in how men and women approach death and dying. In the past, men and women had different experiences with the dying process. Historically men experienced death by seeking it out or confronting it in a predominantly male context. Men were more likely to be employed in hazardous occupations such as mining, to be engaged in military combat, or to pursue dangerous lifestyles. Women encountered death at home, by caring for seriously ill family members, preparing the dead, and comforting the bereaved.

Currently most Americans die in an institutional setting, with nearly one in five older adults dying in a nursing home, and many more die in a hospital than at home. Death in late life is often the result of a decision to halt futile or unwanted medical treatment after a period of chronic illness and dependency. Whereas the circumstances of death may be similar for men and women, the response to one's own terminal illness, socially constructed attitudes toward death, the experience of caring for dying people, and the response to loss, grief, and bereavement are likely to be quite different for men and women. This entry explores differences in life expectancy and primary causes of death between men and women, how gender might affect one's desire for a hastened death through suicide or physician-assisted suicide, and gender differences in grief and bereavement.

Life Expectancy

On average women live longer than men. Worldwide life expectancy for all people is 64.3 years; for males it is 62.7, and for females it is 66 years. Around the globe women live longer than men, except in 10 countries, including Pakistan and Bangladesh, in part due to female infanticide. The sex difference ranges from 4 to 6 years in North America and Europe to more than 13 years between men and women in Russia. Women's greater longevity means that elderly women are forced to live with death longer than men. Having faced the death of partners, peers, and family, women must then face their own death, often without the support of a spouse.

The decisive advantage females have in life expectancy is the result of excessive male mortality at all ages, beginning with fetal deaths. More males than females die during childhood, primarily due to infection, which suggests immune system differences. By early adolescence numerical parity is achieved, but in early adulthood more males than females die due to accidents and violence. Eighty-five percent of centenarians are women, but the men in that group are in better shape physically and cognitively. Gender differences in life expectancy disappear at age 105. Men who survive to age 105 represent the fittest of their sex and have outlived the disadvantages of being male.

The reasons for the difference in life expectancy between males and females are not fully understood. Women appear to outlive men due to both lifestyle and biological factors. Lifestyle factors [Page 506]that disadvantage males include their greater likelihood of employment in hazardous occupations and the fact that men generally drive, smoke, and drink more than women do. Men are more often the victims of homicide and also have higher rates of suicide.

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