The male–female health-survival paradox and sex differences in cohort life expectancy in Utah, Denmark, and Sweden 1850–1910

Abstract Purpose In Utah, the prevalence of unhealthy male risk behaviors are lower than in most other male populations, whereas women experience higher mortality risk because of higher fertility rates. Therefore, we hypothesize that the Utah sex differential in mortality would be small and less than in Sweden and Denmark. Methods Life tables from Utah, Denmark, and Sweden were used to calculate cohort life expectancies for men and women born in 1850–1910. Results The sex difference in cohort life expectancy was similar or larger in Utah when compared with Denmark and Sweden. The change over time in the sex differences in cohort life expectancy was approximately 2 years smaller for active Mormons in Utah than for other groups suggesting lifestyle as an important component for the overall change seen in cohort life expectancy. Sex differences in cohort life expectancy at the age of 50 years were similar for individuals actively affiliated with the Church of Jesus Christ of Latter-day Saints and for Denmark and Sweden. Conclusions The hypothesis that a smaller sex difference in cohort life expectancies in Utah would be detected in relation to Denmark and Sweden was not supported. In Utah, the male–female differences in life expectancy remain substantial pointing toward biological mechanisms or other unmeasured risk factors.