Are men programmed to live shorter lives?

A man jumps into a small pool from the second floor of a house. Professor Lars Forsberg of Uppsala shows this photo at a TEDx conference and says that the Internet is full of such ‘evidence’ explaining why men live shorter lives. Men are more likely to die in accidents. But this is not enough to explain the global pattern – in various countries women can expect a statistically longer life. The world average for this difference is five years, in Sweden – three, in Poland – as many as eight.

‘The stereotype of masculinity promoted in popular culture is harmful to men’, says sociologist Dr Olga Czeranowska of the SWPS University in Warsaw. She describes the image of a man known, for example, from films: ‘It is a man who is always strong, shows no emotions, and chooses risky behaviour. He doesn’t go to the doctor, he takes the bullet out of his leg with his fingernails if necessary. He doesn’t talk about his mental health crisis, confide in others, or seek support’.

Andrzej Gryżewski, a psychotherapist and sexologist from the ‘Arte Vita’ Institute of Psychotherapy, believes that many men have not been taught to have insight into their emotions. ‘It may sound trivial, but it’s something that shortens their lives considerably. Emotions are clues, they tell us what our needs are. Without understanding our own emotions, we function automatically’, he explains.

The gap between a Pole and a European

‘According to the latest data from the Polish Central Statistical Office, the life expectancy of a man in Poland is 72.6 years, and a woman – 80.7 years. Life expectancy has decreased due to the pandemic. In the case of women – by a year; men lost more because they tend to be the most severely ill. In 2019, a man in Poland lived statistically for 74.1 years. At the same time, the average life expectancy for a man in the European Union was 78.5 years’, says Professor Bogdan Wojtyniak, deputy director of the National Institute of Public Health PZH – National Research Institute. Professor Wojtyniak has been analysing data on the health condition of Poles for years. He does not have good news: ‘Based on data coming in from individual countries, we see that the pandemic has further widened the gap in male life expectancy in Poland compared to most regions of Europe’.

We like to blame our health system – difficult access to doctors and tests – for illnesses and shorter lives. But this is not the reason for the huge difference in life expectancy between Polish men and women. ‘Men’s lives are shorter largely due to cardiovascular diseases. Men are also more likely to die from injuries and poisoning. Cancer is the third cause. According to researchers from the University of Washington in Seattle who analyse causes of death worldwide, 51% of male deaths can be attributed to behavioural factors. That is, they are caused by habits and decisions, i.e. smoking, poor diet, drinking alcohol, lack of exercise’, explains Prof. Wojtyniak. ‘Metabolic factors, such as hypertension, high blood sugar, obesity, and high cholesterol, are less likely to be the cause. But controlling these factors is also within everyone’s reach. All these parameters can be changed by lifestyle. Smoking cigarettes causes the biggest damage to Polish men. This addiction is hard to quit, and we lack stop smoking clinics. If you compare Poland with Scandinavia, you can see that fewer people smoke there, more people are physically active, which results not only in a longer life, but also in a longer healthy life’.

Alcohol, sex and a sick stomach

‘Men lack contact with their own bodies. They only use them. It is supposed to help them achieve something’, says Andrzej Gryżewski, who sees patients as a psychotherapist and sexologist. ‘When men rush into the marathon or triathlon, it is also a leap to the extreme. This can be seen in the film “Breaking the Limits” (“Najlepszy”) – first, the main character is a drug addict, and then he trains for the double Ultra-triathlon competition. Neither one is healthy. I’ve been going to combat sports for a while now. I see a lot of men there who are trained, eat well, and at the same time take drugs. They use them to get away from the things in their lives that bother them. This is a huge inconsistency’.

Gryżewski believes that many men cut themselves off from their emotions and that this is the beginning of all their problems. ‘When such men are given a goal to pursue, they get down to it and don’t think about the discomfort they feel. When there is a feeling of frustration, sadness or regret that they have abused themselves, that they have done something that was far from them, they reach for something that will drown out these emotions. Suppression of emotions is common – alcohol, marijuana, cocaine, and pornography are used to this end. So such men do not know what is really theirs, what their needs, goals, passions are’, says Gryżewski. He says that this is a model of action that he observes in many men who have sought his help. ‘Directors, CEOs, politicians come to me with sexological problems – erectile dysfunction, decreased libido or inability to reach orgasm. In the background is this maximum exploitation, not being in touch with their emotions or body. When doing so, it is easy to cross the line of professional burnout, not respecting the need for sleep, not taking care of the hygiene of meals and sports activities. Many patients have psychosomatic problems. Once they are with their back to the wall, they let their partners make an appointment for them. They go to a gastrologist with stomach problems or to a neurologist with migraines, and when the tests show nothing, the symptoms are still there, they go to a psychotherapist as a last resort. I hear, for example: ‘This is the 15th night that I’ve slept for two hours’. I educate them from the ground up. I explain that their body is applying the handbrake, trying to relieve the stress that you experience during the day. You work with a telephone and a laptop until 10 p.m., and at 11 p.m. you want to go to sleep – the braking distance is too short. You should finish work by 5 p.m. and have time for other things. A man is not made to work for 16 hours and then sleep. Initially, this is met with great indignation. But the eight-eight-eight rule is not coaching nonsense, it’s the truth. We need rest, time for relationships and passions. I think the younger generation already knows that. Free time is just as valuable as professional time, if not more so’, says Andrzej Gryżewski.

Biological destiny or habits

Where do the differences in attitudes towards health come from? Are men programmed to live shorter lives? ‘There are many theories trying to explain these differences. One speaks of biological destiny’, replies Prof. Marek Postuła, internist, cardiologist and clinical pharmacologist. He treats patients who are at risk of heart attacks, those who have had a heart attack, and those who are in the best shape of their lives. He looks after athletes – long-distance runners and triathletes. He also conducts research with their participation, looking for a pattern determining how much sport is too much sport.

What is biological destiny about? ‘Brain scientists explain that men mature later, our frontal lobes develop more slowly, which makes us more prone to risky behaviour. Hence the more frequent passion for extreme sports or alcohol abuse among men’, says Prof. Postuła. ‘There is also a hypothesis regarding telomeres, which are a kind of protective caps that protect the ends of DNA strands from damage. We have the same length of telomeres at birth, but it is in men that telomeres shorten faster, and studies show that telomere length translates into lifespan. Although, of course, lifestyle affects telomere length – stress, unhealthy diet, poor quality of sleep, lack of exercise. But it all interlocks. Prof. Lars Forsberg (the one who thinks the internet is full of answers as to why men live shorter lives) advocates a theory about the LOY genetic factor. It stands for loss of the Y chromosome in male blood cells. But, he argues, it is largely related to lifestyle, especially smoking’.

‘In the context of heart disease, there is talk of the protective role of oestrogen. Female hormones work until menopause, then this protection disappears and heart diseases develop dynamically also in women’, says Prof. Postuła. Cardiovascular differences between men and women are determined by the SCORE2 scale. ‘According to this scale, the risk of developing cardiovascular disease and dying from it within 10 years in the Polish population is 6.9% for a 50-year-old female smoker, and 8.1% for a 50-year-old male smoker. With the same cholesterol and blood pressure levels’, says Prof. Postuła. He emphasises that men are more likely to have what is called multimorbidity, meaning they don’t come to him with just one problem. They come because they are urged to do so by others. ‘Either their partner persuades them, or some critical, dangerous moment occurs in their lives’, says the cardiologist.

Doctor? What for?

‘Women are taught by their mothers that contact with a doctor is something natural. That you go to a gynaecologist, for example, also preventively, and not just with a problem. And I meet 40- or 50-year-old men who don’t go to the doctor, who don’t know who a urologist or an andrologist is’, says Andrzej Gryżewski.

Girls and women are more likely to talk about the body, to look for such information on the Internet. It is not always good for their health, but as a result they are less reluctant to seek professional advice. ‘The stereotype of femininity and the associated focus on ideal appearance is not a positive phenomenon, as it can lead to eating disorders and self-esteem issues. Popular culture sends the message to girls that first and foremost they’re supposed to be thin and pretty. But a side effect of these obsessions is the presence of health topics in women’s magazines and in the conversations of female friends. So there is more awareness among women to drink water, exercise or eat vegetables. As a result, the stereotype of femininity may, to some extent, reinforce health-promoting behaviours’, claims Dr Olga Czeranowska. ‘In addition, the caring role of a woman, present in the traditional division of gender roles, also requires her to know the rules of a healthy lifestyle in order to be able to properly care for her relatives. In the case of boys and men, stereotypical messages do not have such positive side effects’.

More and more men and women are taking up exercise. Sport is naturally connected with health, or at least it should be.

‘Men are often driven to sports activities by the desire to improve their appearance or the need to prove to themselves that age does not limit them, that they can achieve their goals. It is rarely associated with the desire to improve health’, claims Prof. Postuła. ‘At one time, the attribute of manhood was a cigarette. Now, more often than not, it’s a slim figure’, he concludes.

How to give boys a chance for a longer life

The Polish National Health Service runs a prevention program called ‘Planuję długie życie’ (‘I plan a long life’). Most of the texts on the program’s website are illustrated with photos of men. The slogan is good, the content is right, but will they improve death statistics? ‘It is terribly difficult to change the behaviour and habits of adults. One could say that adult education is an overdue action. It is necessary to start convincing children to take care of their own health already when they’re young’, says Prof. Bogdan Wojtyniak. For many years, experts have argued that there should be mandatory lessons on health in the school curriculum. Such activities could be appealing – you could explain to the children the path of their breakfast from their mouths to the toilet, or put together a shopping list for a week and let the children discuss what should be on it and what should not, and why. Children could learn what their parents won’t tell them. ‘The behaviours we see in our own environment are the key, and in Poland there are huge social differences that translate into health-related habits’, explains Prof. Wojtyniak.

The introduction of health lessons is unlikely to happen. In a nutshell, it’s all about high costs. To see a profit, you must first invest. And in Poland, the slogan ‘prevention is better than cure’ is only applied in theory. That is the kind of ‘unnecessary’ spending our governments don’t like. What else might work besides school classes?

Sport helps level out health-related social inequalities. Physical activity started in childhood can become a lifelong habit. Also, it’s easier to combine nutrition information with activity. Unfortunately, nowadays exercising needs to compete with a computer and a phone. This is why it is important to build sports fields between houses, especially in poorer neighbourhoods. It is worth paying extra for a trainer who will organise classes at such a facility, because it will pay off over time. In the future, we will spend less on treating illnesses caused by sitting at home’, argues Prof. Wojtyniak.

What can you do right away for a boy close to you who you want to give a chance to live longer than a statistical destiny? The minimum version is to give him a book that encourages you to take care of your body in an interesting way. Barbara Pietruszczak’s best-selling ‘Your Body-Positive Puberty’ was first created in a version for girls and then for boys. Teenagers may also like Adam Key’s funny ‘Your Anatomy’. However, man does not live by his body alone, as Andrzej Gryżewski reminds us. ‘It would be nice if men were taught to get in touch with their emotions, because they could make better career, relationship and health choices’, says the psychotherapist. ‘Automatic task performance in men isn’t just about work, it affects all spheres of life. When a daughter or son comes to them with a problem, with their emotions, they can’t take it. They don’t talk to their child about how they feel, but about why they haven’t done more, haven’t done it better. The most important thing is the effect’.

Dr. Olga Czeranowska believes that young men can improve their life expectancy statistics. ‘Men of younger generations reject the harmful macho archetype. There are more and more guides and lifestyle publications aimed at men. General health awareness is growing and medicine is advancing, so in theory we can all look forward to living longer. The question is whether men will catch up with women here or whether biological factors will be an insurmountable limit’, wonders the sociologist.

Even those who want to believe that differences in life expectancy are not the fault of culture but biological destiny (‘that’s the way it is’) must admit that this biology works better in Sweden. By a whole five years better than in Poland. Sweden has the highest gender equality index in the European Union. They care about equal rights for all citizens, and when it comes to life expectancy, they also manage to reduce the gap between men and women. In our country, the trend is reversed.

 

Author: Katarzyna Staszak

Photo: pexels.com

The text was published in „Wolna Sobota” a magazine of „Gazeta Wyborcza” on 12 February 2022