Females have a longer life expectancy than males, and Missourians are no exception. In recent years, that longevity gap has narrowed somewhat. The difference in life expectancy between Missouri males and females decreased sl ightly between 1980 and 1994, from 7.7 to 6.9 years. The life expectancy for males gained 1.8 years during that time period (from 69.9 to 71.7 years), while females gained only one year (from 77.6 to 78.6 years). The primary reason the longevity gap is na rrowing is that smoking-related death rates increased more for females than for males. This article also examines other trends in leading causes of death and how they differ by gender.

Table 1 displays age-adjusted rates by gender for leading causes of death during two recent periods ten years apart. Males have higher age-adjusted death rates for all of the 13 leading causes of death during 1980-1984 as well as 1990-1994. However, th e top ten causes of death ranked by number of deaths for the two time periods vary somewhat by gender. The top three leading causes (heart disease, cancer, and stroke, respectively) appear in the same order for both genders in each of the time periods. Ch ronic lung disease, pneumonia and influenza, and unintentional injuries, the fourth, fifth and sixth leading causes of death in 1990-1994, had those ranks for both sexes during each five year period, but in different orders. Suicide and homicide ranked in the lower half of the top ten for males during both 1980-1984 and 1990-1994, and AIDS ranked tenth for men in the latter period. (It was not recognized as a leading cause of death until 1989.) None of those three causes made the list for women. Accidenta l deaths also ranked higher for men than for women. On the other hand, atherosclerosis and nephritis and nephrosis were ranked for women, but not for men.

The changes between the decades for individual leading causes of death are generally similar between sexes. For example, age-adjusted death rates for heart disease and atherosclerosis went down, and rates for diabetes and respiratory problems went up. However, a few causes stand out as having changed quite differently by gender. Suicide mortality for males increased 14.3 percent from 1980-1984 to 1990-1994 while female suicide rates decreased 24.9 percent. Changes in other causes of death differed subs tantially between the genders, although the trend was in the same direction. Such is the case with nephritis and nephrosis, which showed a greater decrease for females (27.2 percent) than males (3.9 percent). Even more dramatically, chronic obstructive pu lmonary disease (COPD), increased 64.5 percent for females and only 8.6 percent for males.

Another way to look at this data is by comparing the ratio between the sexes' age-adjusted death rates (Table 2 and Chart 1). Again we see the different changes in smoking-related deaths: the male to female ratio for smoking-related diseases dropped fr om 2.58 in 1980-1984 to 1.65 in 1990-1994, and the ratio for COPD dropped from 2.80 to 1.85. For 1990-1994 AIDS had the highest male-to-female ratio (17.35). Suicide deaths were next with a ratio of 5.22, followed by homicides (4.04) and accidental deaths (2.59). This is somewhat different from the ratios during the 1980-1984 time period: homicide (3.79), suicide (3.44), and unintentional injuries (2.75). The male-to-female death ratio for injury causes (homicide, suicide, and unintentional injury) increa sed between the early 1980s and the early 1990s because the rates decreased 6.2 percent for females but only 0.4 percent for males. Injury causes account for about nine percent of total male deaths but fewer than three percent of all deaths to females.

Females continue to have a longer life expectancy and lower death rates for all leading causes of death and all age groups. Males continue to die at much higher rates for homicides, suicides, accidental deaths, and AIDS, but females are losing some of their lead in longevity, primarily because of a faster increase in mortality for smoking-related causes.

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