Male Mortality Trends in the United States, 1900-2010: Progress, Challenges, and Opportunities

Abstract

Objectives: Male mortality fell substantially during the past century, and major causes of death changed. Building on our recent analysis of female mortality trends in the United States, we examined all-cause and cause-specific mortality trends at each decade from 1900 to 2010 among US males.

Methods: We conducted a descriptive study of age-adjusted death rates (AADRs) for 11 categories of disease and injury stratified by race (white, nonwhite, and, when available, black), the excess of male mortality over female mortality ([male AADR - female AADR]/female AADR), and potential causes of persistent excess of male mortality. We used national mortality data for each decade.

Results: From 1900 to 2010, the all-cause AADR declined 66.4% among white males and 74.5% among nonwhite males. Five major causes of death in 1900 were pneumonia and influenza, heart disease, stroke, tuberculosis, and unintentional nonmotor vehicle injuries; in 2010, infectious conditions were replaced by cancers and chronic lower respiratory diseases. The all-cause excess of male mortality rose from 9.1% in 1900 to 65.5% in 1980 among white males and a peak of 63.7% in 1990 among nonwhite males, subsequently falling among all groups.

Conclusion: During the last century, AADRs among males declined more slowly than among females. Although the gap diminished in recent decades, exploration of social and behavioral factors may inform interventions that could further reduce death rates among males.

Keywords: chronic disease; male health; mortality trends; sex and gender disparities.

Figure 1.

Age-adjusted death rates by cause of death among US males, 1900-2010. Rates are per 100 000 US 2000 standard population. Data for 1900-1930 are from death registration states; data for 1940-2010 are from the United States. The states providing mortality data are known as “death registration states”; they included 10 states and the District of Columbia in 1900 (40.5% of the US population) and gradually expanded to include all 48 states and the District of Columbia by 1933. Data source: tabulations of causes of death from published compilations and from public-use computer data files, as previously described. Abbreviations: MVI, motor vehicle injuries; UNMVI, unintentional nonmotor vehicle injuries.

Figure 2.

Age-adjusted death rates for selected chronic diseases, selected infectious diseases, and unintentional injury, US males, 1900-2010. Selected infectious disease totals are the sum of the rates for influenza and pneumonia, tuberculosis, and enteritis and diarrhea. Selected chronic disease totals are the sum of the rates for heart disease, stroke, and all cancers; they do not include chronic lower respiratory diseases. Unintentional injury totals are the sum of the rates for unintentional motor vehicle injuries and unintentional nonmotor vehicle injuries. Rates are per 100 000 US 2000 standard population. Data for 1900-1930 are from death registration states; data for 1940-2010 are from the United States. The states providing mortality data are known as “death registration states”; they included 10 states and the District of Columbia in 1900 (40.5% of the US population) and gradually expanded to include all 48 states and the District of Columbia by 1933. Data source: tabulations of causes of death from published compilations and from public-use computer data files, as previously described.

Figure 3.

Relative difference between male and female age-adjusted death rates (AADRs) for all causes and selected causes, by race (white, black, and nonwhite), calculated as ([male AADR − female AADR]/female AADR), 1900-2010, United States. Rates are per 100 000 US 2000 standard population. Data for 1900-1930 are from death registration states; data for 1940-2010 are from United States. The states providing mortality data are known as “death registration states”; they included 10 states and the District of Columbia in 1900 (40.5% of the US population) and gradually expanded to include all 48 states and the District of Columbia by 1933. Not all data were available in all years. Disaggregation of race beyond white and nonwhite did not occur until 1970. Data source: tabulations of causes of death from published compilations and from public-use computer data files, as previously described.