The male-female health-survival paradox in rural Ghana: what is the evidence and what do community members think?

Worldwide, female life expectancy is higher relative to males. However, survey reports indicate that men generally rate their health better than women. Herein lies the paradox – males are healthier but females live longer. What is the extent of this discrepancy in rural Ghana, and what accounts for the discrepancy between the health and survival of men versus women in such communities? How do ordinary members of the community view the health and survival of men vis-à-vis women? Such information would be useful in guiding public health policies and programs, especially those aimed at promoting the health of women.

This paper combines quantitative and qualitative data from the Kassena-Nankana District in exploring this paradox in the context of a rural Ghanaian community. We use demographic surveillance data to examine trends (1995-2010) in mortality and life expectancy for males and females. Data from a recent survey of 5300 adults allow us to compare the self-rated health of males and females in the district. Qualitative data from focus group discussions (16) and key informant interviews (14) are used to examine community perspectives on the health of men and women, and what accounts for the differences in the health and survival of men and women.