Sexist Celebration in British Medical Journal re Life Expectancies

Anonymous User writes "Check out this editorial in the British Medical Journal Life expectancy: women now on top everywhere and how the authors gloat over women now living longer all over the world. Also see the rebuttals people wrote in in the Rapid Responses."

Ed. note: Since the BMJ is a subscription service, I have copied the entire article (for educational purposes only, mind you) in the extended section, so click "Read More..." to see the entire thing.BMJ 2006;332:808 (8 April), doi:10.1136/bmj.332.7545.808

Editorial

Life expectancy: women now on top everywhere

During 2006, even in the poorest countries, women can expectto outlive men

The year 2006 should not be allowed to pass without at leasta quiet celebration that this is the first year in human historywhen—across almost all the world—women can expectto enjoy a longer life expectancy than men. That the trend ismoving in this direction will probably be confirmed this weekin the 2006 world health report.

In its world health report of 2002, the World Health Organization,using data for 2001, reported that male life expectancy exceededfemale life expectancy in only six countries: Nepal, Botswana,Zimbabwe, Lesotho, Bangladesh, and Swaziland.¹ A year later,the situation seemed to have reversed in all six countries,with two other countries (Qatar and the Maldives) reportingthat men were living slightly longer than women.² In its 2004report the WHO continued to report the same 2002 data and inonly those two tiny territories (the Maldives and Qatar) didwomen die younger than men.³ In the 2005 report, life expectancydata for 2003 were reported, but only to the nearest year ofage, making comparison difficult.⁴

In January this year the US Central Intelligence Agency (CIA)updated its World Factbook and reported its estimates for lifeexpectancy in 2005.⁵ According to the CIA, in Qatar and theMaldives women now lived longer than men. Elsewhere, however,women's fate had slipped back, by the CIA estimates which donot tally with the WHO data for earlier years. According tothe CIA, in Niger women could expect to live a dozen days lessthan men and in Botswana three dozen days less by 2005, butnearer to two years less in Zimbabwe and Kenya by 2005. Theunderlying source of the CIA data is vague, as befits a somewhatsecretive organisation. We will never know with certainty theexact year in which women everywhere can expect to live on averagelonger than men, but this year—2006—is as likelyas any.

Almost 30 years ago, amid much fanfare, the eradication of smallpoxwas announced.⁶ But when it becomes certain that women everywherecan expect to live longer than men, also a remarkable achievement,a similar announcement is unlikely. We tend to forget that inmany countries of the world women could expect, until recently,to live fewer years than men and that maternal mortality inparticular remains a big killer.

The most reliable historical mortality records are in Europe,where states were sufficiently affluent and interested to keepaccurate records. In Europe men last outlived women in the Netherlandsin 1860 and in Italy in 1889. Elsewhere females' life expectancyhas long exceeded males': in Sweden since 1751, Denmark since1835, England and Wales since 1841.⁷

But in all western European countries the life expectancy gapbetween women and men is now narrowing. Except in one aberrantyear, 1789, the gap reached its maximum in Sweden in 1978 (6.2years); in Denmark in 1979 (6.2 years); and in England and Walesin 1969 (6.3 years).

Greater emancipation has freed women to demand better healthcare and to behave more like men, and most importantly to smoke.A century ago it would have been hard to imagine such changes,or the fact that women now expect to live longer than men almosteverywhere. As this transition is so recent, the processes drivingit cannot be purely biological: they relate primarily to socialchange. In a way, women's life expectancy is an indicator ofhow well everyone can do, akin to the healthy districts identifiedin the 1850s by William Farr, the British epidemiologist whofirst reported on health inequalities.⁸ In 1990 Amartya Sen,Indian economist and Nobel laureate, concluded from an analysisof unequal rights between men and women and mortality in thedeveloping world that, worldwide, more than 100 million womenwere missing.⁹ The women who were born when Sen wrote this arecoming of age in a very different world. We must remember, though,that life expectancy data apply from birth onwards. The picturewould be different in some countries if life expectancy fromconception was considered: the first doctor to be imprisonedfor carrying out sex selective abortion in India was sentencedon 28 March 2006, which may be another landmark.¹⁰ Even thelife expectancy from birth may not be a permanent achievement,given that the largest remaining untapped market for cigarettesin the world is made up of women living in poorer countries.

Anna Barford, research fellow

Department of Geography, University of Sheffield, Sheffield S10 2TN

Danny Dorling, professor of human geography

Department of Geography, University of Sheffield, Sheffield S10 2TN
(Daniel.Dorling@sheffield.ac.uk

)

George Davey Smith, professor of clinical epidemiology,
Mary Shaw, reader in medical sociology

Department of Social Medicine, University of Bristol, Bristol BS8 2PR

References

1. World Health Organization. World health report 2002: reducing risks, promoting healthy life. Geneva: WHO, 2002. www.who.int/whr/2002/en/index.html (accessed 31 Mar 2006).

2. World Health Organization. World health report 2003: shaping the future. Geneva: WHO, 2003. www.who.int/whr/2003/en/index.html (accessed 31 Mar 2006).
   

3. World Health Organization. World health report 2004: changing history, Geneva: WHO, 2004. www.who.int/whr/2004/en/index.html (accessed 31 Mar 2006).
   

4. World Health Organization. World health report 2005: make every mother and child count. Geneva: WHO, 2005. www.who.int/whr/2005/en/index.html (accessed 31 Mar 2006).
   

5. Central Intelligence Agency. The world factbook, 2005. www.cia.gov/cia/publications/factbook/ (accessed 31 Mar 2006).
   

6. Fenner F. Smallpox and its eradication. Geneva: World Health Organization, 1988.
   

7. Human mortality database. University of California, Berkeley (www.mortality.org); Max Planck Institute for Demographic Research (www.humanmortality.de); (data downloaded 9 Dec 2005).
   

8. Lewis-Faning E. A survey of the mortality in Dr Farr's 63 healthy districts of England and Wales during the period 1851-1925. J Hygiene 1930; 30: 121-53.
   

9. Sen A. More than 100 million women are missing. N York Rev Books 1990 Dec 20: 61-6.
   

10. Srinivasan S. Challenges in implementing the ban on sex selection. Info Change Analysis. March 2006. www.infochangeindia.org/analysis121.jsp (accessed 3 Apr 2006).
    

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