摘要：Objectives. The purpose of this study is to update knowledge about gender differences in injury mortality. Methods. Data were drawn from the Web-based Injury Query System, which contains US injury mortality data from 1981 to 2007. Male-to-female rate ratios in injury mortality are calculated for key variables, and age and ethnic group comparisons are made. Results. Boys and men were more likely than girls and women to die of injury. From 1981 to 2007, the male-to-female age-adjusted rate ratio decreased by 20% to 2.15 for unintentional injury and increased by 11% to 3.91 for violence-related injury. Excess male mortality existed in manner of death, cause of death, and within ethnic and age groups. Additionally, with rare exception, the gender disparity was greater than ethnic and age disparities in unintentional and violence-related injury mortality. Conclusions. Gender disparities in injury mortality are consistent and persistent. Gender patterns in injury mortality do not follow typical social justice analyses of health, in that men are at greater risk. Lifestyle and behavioral risks as well as masculine socialization merit consideration. Males are born with a numerical advantage, an advantage that decreases over time. At birth there are 105 boys for every 100 girls. 1 There would be even more, but fetal death is 7% higher for boys than girls. 2 The mortality gap widens immediately; by their first birthday, 21% more boys than girls die. 3 Excess male demise continues throughout life, such that by age 65 years or older, there are 75 men for every 100 women. 4 These numbers from the United States represent a pattern noted around the globe. Among 229 countries, all have more male than female births, such that the world's gender ratio at birth is 107. 4 However, the male advantage is not maintained in most locales; 93% of those same 229 nations report more women than men older than 65 years. 4 Moreover, in relative terms, the gender gap in premature mortality in 187 countries has widened since 1970. 5 Men are more likely than women to die of almost every disease and illness and to die earlier. Injury, a leading cause of premature death, was no exception. 6 , 7 Men's higher unintentional injury, suicide, and homicide mortality rates are observed in all age groups in low-, middle-, and high-income countries. 8 The sole exception is for homicide of children under the age of 15 years in low- and high-income countries, where the rates for girls are similar to or higher than those for boys. Mortality risk is not stagnant. In the United States, total injury mortality rates decreased from 1979 to 1999, then increased through 2005. 9 From 1999 to 2005, unintentional injury mortality increased only for Whites, and increased more for White women than White men (19%–20% vs 7%–15%). 10 , 11 The most recent reviews of gender differences in injury mortality, based on data from the 1980s, 6 , 7 merit being updated to consider the subsequent gender-related trends. The purpose of this study is to update knowledge about gender differences in injury mortality, to examine the stability of the differential (over time, across types of injuries, and within 2 key population groups), and to place the resulting information in the context of other injury disparities.
