This paper advances the hypothesis that the future of sex mortality differentials in industrialized countries may depend on the future mortality rates of blue collar men. Data are presented to support the argument that mortality rates from ischemic heart disease for this population subgroup play a significant role in current differentials and, furthermore, that sexsocial class-mortality differentials correspond to social structural differences in protection against and/or exposure to health risks. Research and policy implications of this argument are addressed briefly.
The relative longevity of the female sex was observed as early as 1662 (by John Graunt, cited in Lopez and Ruzicka, 1983). However, it is only in the 20th century that sex differences in mortality have commanded sustained scientific, as well as popular, attention. AS the expectation of life for persons living in industrialized countries increased overall, the significant and (until recently) widening male mortality disadvantage became increasingly salient, demanding not only explanation but intervention. The objective of this paper is to suggest an approach to predicting the future of sex mortality differentials based on the hypothesis of social structural variations in men's and women's exposure to protection against mortality and to mortality risk.
Prediction is a hazardous undertaking, and few serious attempts have been made to predict the future of sex mortality differentials in industrialized countries. Speculation about future trends, by and large, has been based on two premises: first, that the substantially higher male death rates relative to females observed in these countries are caused by social and environmental, not biological, factors, and, second, that they are the consequence of gender role differences in vulnerability and/or exposure to injurious lifestyles (House, 1974;Lewis and Lewis, 1977;Garbus and Garbus, 1980;Verbrugge, 1980). 1 This reasoning has led to the hypothesis that changes in gender roles in the direction of increased participation by women in extrafamilial activities associ-
The views expressed in this paper are those of the authors and do not necessarily reflect the policy or views of the World Health Organization.