[Causes of death responsible for international and intertemporal variation in sex mortality differentials]

Relative to a particular level of female mortality, male mortality is lower than expected, currently and historically, in Northwestern Europe, Southeastern Europe, and Tropical Latin America; it is higher than expected in Western-Central Europe and in the Far East. The geographical pattern of differentials is attributable primarily to variation in the masculinity of mortality from cardiovascular diseases, neoplasms, and influenza/pneumonia/bronchitis. Over time, male mortality has increased relative to a particular level of female mortality, and these same causes of death are principally responsible. In the 1960's, high masculinity of mortality was associated independently with low proportions in primary activities, high proportions hiring in large cities, and with high discrimination against females in school enrollment combined with poor nutritional standards. The former two variables once again operate primarily through cardiovascular disease, neoplasms, and the respiratory diseases, whereas the discrimination-nutrition interaction appears to operate through infectious diseases. Variations in levels of economic modernization are capable of accounting for a substantial portion of the regional differences, although certain constitutional factors such as physiotype are also plausibly implicated, and they are also congruent with trends in sex mortality differentials.