Évolution et variations géographiques de la surmortalité masculine : du paradoxe français à la logique russe

Meslé (France), Vallin (Jacques).- Evolution and geographical variations in excess male mortality: from the French paradox to the Russian logic The last century and in particular the period from the 1950s to the 1980s, has seen a considerable rise in excess male mortality in western countries at the same time as an increase in life expectancy, suggesting that women have gained more than men from health improvements. Throughout this period, however, an apparently contradictory phenomenon has been observed in the geographical variations -namely, the higher the life expectancy, the smaller the gender difference in mortality. This paradox -especially strong in France - is due to the fact that the causes of death which dominate the geography of mortality are not the same as those responsible for most of the increase in life expectancy. The former are primarily male causes of death, the most important of which is alcoholism, while the latter are primarily cardio-vascular diseases and cancers, progress in which has tended to benefit women. By contrast, in the Eastern European countries, and especially Russia, where mortality has risen during the last thirty years, the geography of mortality is entirely consistent with the evolution in life expectancy. The same causes of death (in particular those related to alcohol and violence) are responsible both for the geographical variations in the gender difference and in large part for the deterioration of the country's health condition.