Female life expectancy now exceeds that of males in all countries. Although this gender difference has become accepted as normal, it is a relatively recent demographic phenomenon that emerged with the reduction of infections and the increase in the share of adult mortality attributed to cancer and cardiovascular disease. Heart disease is the main condition associated with increased excess male mortality, making the strongest contributions in birth cohorts of 1900–1935. Smoking behavior accounts for about 30% of male excess mortality at ages 50–70 for those born in 1900–1935. The remaining excess male mortality may be explained by underlying traits of vulnerability to cardiovascular disease that emerged with the reduction of infections and changes in diet and other lifestyle factors.

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