This book is worth reading, if you know little or nothing about men, men's health, and the Feminist view of what men should be like. It is easy to read, which is another plus. Not only is it clearly and simply written, but the type is large.
However, its subtitle, How to Lengthen your Lifespan, is misleading. The conclusion I came to after reading this book was that the author's main advice to males as to how to lengthen their lifespans was to believe in reincarnation and try to be reborn as females!
In other words, it is not really full of suggestions about lengthening your life, as you might expect from the subtitle. There are not many actual suggestions for the individual male, and many of the suggestions are for non-fatal conditions.
In fact, even the title itself (Why Men Die First) is not a very good guide to the contents of this book, because some chapters (e.g. Chapter Eleven: "Andropause and the Aging Male") and some sections of other chapters have little or nothing to do with death, as such.
My main objection to this book, however, has to do with the reason why I bought it in the first place. I bought it in order to find out why some people go around saying that men are more "vulnerable" than women. I was suspicious of this claim, because I have often found that Feminist, anti-male claims don't stack up when you actually investigate them. I suspected that this might be just another of these Feminist, man-hating claims. And so it was. The word "vulnerable," in this book, is used to cover a wide range of aspects of the male -- many of which would be better described using a different adjective. The author exaggerates her case -- playing down female vulnerabilities and doing a beat-up on male problems. This approach no doubt finds a happy readership amongst the man-haters so prevalent in Western culture today.
Right at the beginning of her book (page xi), Legato states her thesis:
The biggest surprise of all, perhaps, is that men, from conception until death, are inherently more fragile and vulnerable than women. In virtually every society in the world, men die first. Women have a hardiness that men simply don't possess.
First of all, women are not hardy. The article Human longevity at the cost of reproductive success, by Rudi Westendorp and Thomas Kirkwood (Nature 396, 743-746 (24 December 1998)), points to delaying childbirth as a factor that increases female longevity. It would be a misuse of the word hardy to say that women are inherently hardy because they can delay childbirth and thereby live longer! Feminism has driven women out into the workplace and so encouraged them to have children later, and thereby live longer. In addition, childbirth itself used to constitute a serious mortality risk for women in Western countries. The article Excess Female Mortality in Nineteenth-Century England and Wales: A Regional Analysis, by Kirsty McNay, Jane Humphries and Stephan Klasen, for example, states:
In mid-nineteenth-century England and Wales, although women and girls enjoyed an overall longevity advantage, they tended to die at higher rates than males at ages when modern life tables show female advantage.
Women have not become inherently more hardy over a period of 150 years! What has changed has been the social and medical context of women's lives.
Legato misuses the word vulnerable in relation to issues relating to the male brain and male behaviour. On page 6, she states:
In fact, boys are physiologically inclined to die violent deaths. The area of the brain responsible for judgement and considered decision-making are (sic) less developed in adolescent boys than in girls.
As far as I know, what she says is true, but it is stretching the word vulnerable to use it in this way, since boys have to actively put themselves at risk of violent deaths (including teh case of war), before any actual vulnerability to violent death comes into play. Many people carry out dangerous activities for the "adrenalin rush" they get from them. Whole tourism industries are built around people's desire to go bungy-jumping, mountain-climbing, and so on. Are these tourists vulnerable?
Moreover, after stating that males are more vulnerable to death in the womb, she then states (page 23) that one reason for this fact may be that "Mothers are sometimes allergic to the male fetus they carry. Their immune response takes the form of an inflamed placenta, thus compromising fetal nutrition and making miscarriage more likely." Both male and female fetuses are inherently vulnerable, of course. But if mothers are sometimes selectively allergic to male fetuses, that is not properly described as a vulnerability of the fetus -- it is an attack on the fetus by the mother!
Legato lists a lot of health issues, but many of them are not fatal conditions, the reasons for some of them are not clear, and she does not balance the picture by looking at female health issues to the same extent.
Marianne Legato exaggerates the vulnerability of males, since it is now customary in Western culture for women to take a female supremacist approach towards men. She misuses the word vulnerable. This is not to say that she is not concerned about men's well-being. She is a doctor, after all. However, her concern for men comes down from the heights, as it were, in a patronising assumption of female superiority.
The areas where males are more vulnerable to death than females are limited, and much of what Legato discusses does not involve fatal conditions. She makes few suggestions about how men could live longer.
Nevertheless, this book is interesting and worth reading -- as long as you are not misled by the title!