When it comes to male life expectancy, nature and nurture work together

Dear Healthy Men: I know men’s lifespan is shorter than women’s. But how much of that has to do with biology and how much with males’ behavior and socialization?

A: Although the simple biological fact (nature) of being born male increases boys’ and men’s overall health risks, the behavioral choices (nurture) they make are at least as important. This means that trans men and others who identify as men, while not biologically male, may also experience the behavioral disadvantages of being male.

On average, males of all ages are more likely than females to engage in behaviors that increase the risk of disease, injury and death. They also generally have less healthy lifestyles than women and girls, and they engage in far fewer health-promoting behaviors.

According to the Centers for Disease Control and Prevention, half of men’s deaths each year in the United States could be prevented through changes in personal health habits. Here are some of the behaviors that negatively affect men’s health and longevity.

• More men than women are overweight and obese (77.1% vs. 68.4%).
• Obesity rates in boys are significantly higher than in girls (9% vs. 6%).
• Men have poorer eating habits, consuming more meat, fat and salt, less fiber, and fewer fruits and vegetables than women.
• Men are 33% less likely than women to visit a doctor for routine care, and half as likely to get recommended screenings, to receive routine preventive care or get care early in the disease process.

• Men generally take longer to engage the health care system when a medical problem appears. A survey by the American Academy of Family Physicians found a full 30% of men would wait “as long as possible” before seeking medical care for an evolving problem.
• A recent study by the Cleveland Clinic found 72% of men would rather do household chores, like cleaning the bathroom or mowing the lawn, than go to the doctor. Even among men who take their health more seriously, some are holding back: 20% of men admit they have not been completely honest with their doctor before.
• More males smoke. In the U.S., 13.1% of men and 10.1% of women smoke. Worldwide, it’s 37% of men vs. 7.8% of women.
• Males are roughly twice as likely as females to binge drink (31% vs. 15%) and use illegal drugs (11.5% vs. 6.4%). Drug use increases their risk of car accidents and of contracting HIV or AIDS and hepatitis.
• Males engage in more reckless and illegal driving, and drive drunk more frequently than females.
• They are also more likely than women and girls to carry guns or other weapons, and more likely to be arrested for criminal activity.
• Men often have much smaller social networks. Over the past 30 years, the number of men with at least six close friends fell from 55% to just 27% today, while 15% of men have no close friends at all. For young men, these shrinking — or disappearing — social networks are especially bad, with 28% of guys under 30 having no close social connections. Adolescent boys are more likely than girls to have no one to turn to for support at times when they feel stressed, overwhelmed or depressed. This has had a dramatically negative effect on men and boys in most aspects of life, interpersonal relationships, education and career development.

• Regardless of age, in times of stress, males are less likely to turn to family, friends, clergy or counselors for support.
• Even if they do have friends and family to turn to, males typically refuse to seek help from others during difficult times because they don’t want to appear weak, or they want to show others that they can handle their problems on their own.
• Males who lack social support are less likely to maintain positive health behaviors or adhere to medical treatments. And men with the lowest levels of social support are 2-3 times more likely to die of any cause than men with the highest levels of support.
• According to a study in the journal Heart, loneliness and social isolation are linked to a 29% increased risk of heart attack and a 32% increased risk of stroke. Other studies have found that loneliness and social isolation can be as damaging as being obese or smoking 15 cigarettes a day.