Why do women live longer than men?

As of 2024, while the average life expectancy in the U.S. climbed to 79, there was a striking and persistent gap between men and women. Women lived an average of 81.4 years, men 76.5. This five-year difference has been consistent over recent decades.

Why do women live so much longer than men?

Some of the difference is biologic and not anything men can change. Women have two X chromosomes, men one. This means that women have “backup” for loss of X chromosome gene deletions or losses. There is some animal data suggesting that the male Y chromosome has deleterious effects.

Women have stronger immune responses, letting them better fight off infections (but also making them more prone to auto-immune diseases like lupus).

Women have much more circulating estrogen than men, which seems to delay the onset of coronary disease, though women “catch up” after menopause when their estrogen levels drop.

There are many factors over which men do have control. Men are more likely than women to smoke and drink heavily, both negative factors for longevity.

Men are more likely to work in hazardous occupations (construction, fishing , forestry, police and fire, etc.) than women. Men also engage in more risky behaviors such as speeding in cars, fighting and extreme sports.

Women are much better than men at looking after their health – getting regular checkups, seeing a doctor if something seems wrong. Men tend to avoid doctors until forced to.

Women generally have much better social networks, a consistent factor promoting longevity. Men’s friendships tend to be less intense and less personal.

So, while we cannot (yet) engraft a second X chromosome into men, there are a lot of things men can do to emulate women and hopefully add a few years to their lives.


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TrumpRx - what is it good for?

In February, with much fanfare, TrumpRx was launched, claiming the ability to save US residents money on prescription drugs. Does it do so? Are there better ways to save money?

If you go to trumprx.gov, you are greeted by a glossy picture and a claim that “TrumpRx is rewriting the script, bringing major savings on essential medications to all Americans.”

Reality is less impressive than the rhetoric.

The site does not sell medications. Rather it directs you to manufacturers’ websites where you can (with a prescription) buy the medications directly from the companies, for cash – no insurance accepted. The list price is contrasted with the lower “TrumpRX” price.

43 medications are listed. All are brand name drugs. At least 18 are old-timers with much cheaper generic versions available at your local drug store, not only far cheaper than the list price but even cheaper than the discounted price offered.

An example: Protonix, an acid-suppressing medication, is shown with “an original price” of $497.28 for 30 tablets and a TrumpRx price of $200. Sounds good, no? Almost 60% off. It sounds good until you go to Amazon and see you can get the generic version, 30 tablets for $11.60.

Even for drugs where there is no generic yet available, you may well pay less at your pharmacy than the supposed savings offered via TrumpRx. Moreover, at the pharmacy you can use your health insurance, while using TrumpRx does not allow any insurance.

So, can you really save money on prescriptions? Yes, by following some commonsense rules.

First, always ask your prescriber if a generic is available for your condition. There are a few illnesses for which only one or a limited number of branded products will work, but such conditions are rare. For common conditions there are usually generic versions that are similarly effective.

Beware of manufacturer coupons that claim to let you pay little or nothing for a new branded drug – these have a limited lifetime, and when the promotion runs out you will be on an expensive medication for a long time.

Check the Mark Cuban Cost-plus Pharmacy (costplusdrugs.com). This has a large and growing number of medications at very reasonable prices.

Look for savings coupons on GoodRx.com.

If you have a condition for which only a very expensive drug will work, and your share will be financially stressful even using your insurance, call the manufacturer directly. Many have patient assistance programs that will lower your cost.

For a few items, including fertility drugs and weight loss drugs, TrumpRx may save you money – it does not take much time to look.


Prescription for Bankruptcy. Buy the book on Amazon