348 Chapter 10rheumatoid arthritis is an example of a non-
fatal chronic illness, and cancer and heart dis-
ease are examples of chronic illnesses that can
be fatal—in fact, they are the top two leading
causes of death. The increase in chronic dis-
eases accounts for the increase in morbidity,
that is, the increase in illness, disability, and
activity restriction among the U.S. population.
Women have higher morbidity rates
than men. In fact, the morbidity-free life ex-
pectancy (i.e., life without chronic disease) has
declined for both women and men but more
so for women than men (Perenboom et al.,
2005). In 1989, women and men could expect
55 morbidity-free years. By 2000, women’s
morbidity-free years had declined to 51, and
men’s had declined to 54. Although men have
higher incident rates (i.e., men contract dis-
eases more than women do) and death rates
from the top two leading causes of death (heart
disease and cancer), women suffer from more
acute illnesses and more nonfatal chronic ill-
nesses compared to men (Case & Paxson,
2005). Women suffer higher rates of arthritis,
immune disorders, and digestive conditions
compared to men. Women suffer from more
painful disorders compared to men, such as
migraines, tension headaches, musculoskel-
etal pain, back pain, abdominal pain, carpal
tunnel syndrome, irritable bowel syndrome,
rheumatoid arthritis, multiple sclerosis, and
Raynaud’s disease. Thus at any given point in
time, women are more likely than men to be
ill and to be living with a chronic disease.
Not surprisingly, women perceive their
health to be worse than men do, although the
sex difference decreases with age (Gorman
& Read, 2006). Subjective health perceptions
are typically measured by a single question
that asks respondents to rate their health as
poor, fair, good, very good, or excellent. Be-
cause women have a higher rate of nonfatal
chronic diseases causing daily symptoms,TAKE HOME POINTS
■ Males die younger than females at all ages.
■ The sex difference in longevity increased over the 20th
century to a record 7.8 years in 1979 but more recently
has decreased. Today, women outlive men by five years.
■ The leading causes of death are heart disease, can-
cer, cerebrovascular disease, chronic lower respiratory
disease, and accidents—all causes for which lifestyle
factors play a role.
■ Men are more likely than women to die of most of the
leading causes of death.
■ Men are more likely than women to commit violent crimes
and to be victims of violent crimes, including homicide.
■ Women are more likely than men to be killed by some-
one they know.Sex Differences in Morbidity
Morbidity reflects illness. Whereas mortal-
ity rates have decreased and the life span has
lengthened, morbidity rates have increased.
People are living longer, but partly because
they are living with diseases rather than dying
from them. During the early part of the 20th
century, the leading causes of death were from
infectious diseases. The causes of these diseases
were relatively simple to understand; typically,
there was a single causal agent, the germ. With
the development of penicillin and vaccina-
tions, people began to live longer; thus they
had more time to develop and subsequently die
from chronic diseases. Whereas an acute illness
lasts a short time and is either fatal (a possibil-
ity in the case of tuberculosis or pneumonia) or
nonfatal (the common cold), achronic illness
is long lasting and typically does not disap-
pear. A chronic illness can be fatal or nonfatal;M10_HELG0185_04_SE_C10.indd 348 6/21/11 8:54 AM