Variation in the sex ratio in cardiovascular mortality.

The favorable mortality rate of adult women compared with that of men is well known in western countries. The sex difference varies in different population groups. In Israel there is a low male:female ratio, as compared with Greece, Holland, and England and Wales. This is due to the relatively high female mortality rates in Israel. Within Israel, the Jewish population of North African origin has a relatively low male:female ratio. In this group, the marked increase in mortality due to ischemic heart disease has occurred in both women and men, in contrast to various western countries in which the male:female ratio increased during the 20th century with the rise in the death rate from ischemic heart disease, especially in middle-aged men. Social disequilibrium, especially family disorganization with its selective stressful effects on women, is suggested as an hypothesis on which to base further study in communities with a low male:female ratio associated with high mortality rates in women.