---
title: "Health survival paradox"
chunk: 3/3
source: "https://en.wikipedia.org/wiki/Health_survival_paradox"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T03:57:59.615345+00:00"
instance: "kb-cron"
---

Records of the female survival advantage can be traced back to the 18th century, but the phenomenon gained popularity and caught the eyes of researchers in the 19th century. Females outlive males for all age groups and every year for which reliable records exist. Specifically, in "contemporary industrialized countries", female survival is 1.5-2.0 times higher than that of males.
A female survival advantage is found in some, but not all species. Various explanations for this have been proposed but none are strongly supported. Most species studied for differences in morbidity and mortality between sexes show conditional sex differences in life span, with both male and females experiencing advantage depending on the species. In humans, females appear to have a consistent survival advantage. Females outlive males in 176 of 178 countries for which records are available, both at age 5 and at age 50.  In a study in the UK, males scoring higher "femininity scores", when compared to their more stereotypical "masculine" male counterparts, had lower death rates from heart disease, suggesting that masculine behavior increases the risk of premature mortality.
The female survival advantage holds true among humans, but the same can not be said for baboons and birds. In a study conducted on Amboseli baboons, it was found that although females outlive their male counterparts, both sexes had either similar rates of age-related declines in health, or greater health declines in males compared to females. In another study focused on Eurasian Blackbirds found lower survival in females due to more passive phenotypes that increased predation susceptibility.
A significant biological factor that may contribute to the female survival advantage is the difference in sex chromosome composition in males and females. The male sex is biologically defined by having one Y sex chromosome, and is heterogametic, while females only have X chromosomes. Typically females have two X chromosomes, one active and one inactive, that can compensate one another for X chromosome gene mutations. In a longitudinal study following identical female twins and changes in X chromosome inactivation, skewed X chromosome inactivation patterns present at later stages of life suggested homologous sex chromosomes to benefit survival. Without multiple X chromosomes, males are more susceptible to X-linked diseases, or the effects of X chromosome mutations. These X-linked diseases include color blindness, hemophilia, and Duchenne muscular dystrophy.

== Male morbidity advantage ==
Although males experience greater mortality, they appear to have the advantage of lower morbidity. Females tend to report poorer health and more hospital visits than males. Females also have a greater tendency to develop psychological disorders compared to males.  Females spend more years in good health than males; however, females spend more years in poor health than males as a proportion of their life expectancy. This implies that the male morbidity advantage is linked to the female survival advantage.

== Potential bias ==
Data collected from a research study in Denmark indicated that the paradox is likely due, in part, to selection bias. Females have higher preferences for absenteeism. On average, they are absent from work for health reasons more often than males, including when they do not have objectively worse health.
It may also be a possibility that under-reporting and selective non-participation of health problems, and delaying medical attention and treatment may make it appear that males have less medical problems than females. Misperceptions, such as females being more protected from cardiovascular diseases, may contribute to the morbidity-mortality paradox; females tend to have less aggressive treatment regimens, shown by having lower diagnostic angiograms and interventional procedures when compared to males.
Researchers also suggest that because males have been shown to have an increased likelihood of suddenly dying, females may appear to have higher incidence of morbidity when surveyed in research studies; in other words, females tend to outlive males, and the females carry diseases that are counted as morbidity in studies while males die earlier from these morbidities and leave healthier male counterparts in the study, which makes it appear that they have lower morbidity than females. However, in a systematic review encompassing over 37,000 adults from developed and developing countries, this confounder appeared to be discredited since females experienced higher frailty index scores (used as a surrogate to measure morbidity) than males for any age group.

== Statistics ==

== See also ==
Health equity#Sex and gender in healthcare equity
Homicide statistics by gender
Mental disorders and gender
Gender differences in suicide
Sex differences in medicine
Frailty syndrome

== References ==