'Happy birthday' rings true more for women than men

September 22, 1992|By New York Times News Service

An approaching birthday seems to prolong life in women and precipitate death in men, according to the largest study ever done on psychological factors and time of death.

The study, based on 2,745,149 deaths from natural causes, found that women are more likely to die in the week after their birthdays than in any other week during the year, whereas men tend to die shortly before their birthdays.

It is the first study to show sex differences in so-called anniversary effects -- changes in behavior on birthdays, holidays, or other personally meaningful occasions.

Birthdays can be either "a deadline or a lifeline," said Dr. David P. Phillips, a sociology professor at the University of California in San Diego who conducted the research. They are a "time for taking stock of your life. In our achievement-oriented society, men may find themselves wanting. They don't want to go through another one of these stock-taking periods" and, if they are near death, do not try to hang on, he said.

The study -- published in the current issue of Psychosomatic Medicine, the journal of the American Psychosomatic Society -- found 3 percent more deaths than expected among women in the week after a birthday and a slight decline the week before. For men, deaths peaked just before birthdays and showed no rise afterward.

"For decades, we have appreciated that symbolic life events have impressive impact on illness and occasionally even on mortality," said Dr. Joel Dimsdale, a psychiatrist at the University of California at San Diego and editor of the journal. This paper suggests that men and women may "package reality differently," and that "for some, a birthday may be relatively positive, but for others may carry a powerful sting."

The findings are "very interesting," said Dr. David Jenkins, a psychiatrist who conducts similar research at the University of Texas Medical School, in Galveston. "But people should not worry that they will die just because a birthday is coming. The overall percentage of excess death is not that alarming and probably applies to people who are already gravely ill."

Dr. Phillips, a leading expert on anniversary reactions, said that when an occasion was dreaded and anticipated with pain, it could serve as a deadline. Thus, a woman may fall ill on the due date of an aborted fetus. A man may sicken or die when reaching the age at which his father died.

But when a symbolic occasion is anticipated with pleasure, he said, it seems to function as a lifeline. Thus Dr. Phillips found in an earlier study that Jewish mortality dipped 31 percent below normal before Passover and peaked by the same amount just afterward. Similarly, Chinese mortality dips and peaks around the Harvest Moon Festival.

In the current study, Dr. Phillips and two students examined computerized California death records for all adults who died of natural causes from 1969 to 1990. They omitted anyone who underwent surgery that contributed to death and those born Feb. 29 because they celebrate their birthdays on a date not known to the researchers.

But why do men tend to die before their birthdays while women die soon after?

"We have no inkling of how women postpone dying," Dr. Phillips said. But he went on to speculate that the explanation might lie in the ways people take stock of their lives and accomplishments on their birthdays. In American culture, men are encouraged to base their self-esteem on workplace achievements, but not everyone can become chairman of the board. Thus, stock-taking may remind men of their failures, thus it becomes a dreaded event, he said.

American women are encouraged to value, develop, and maintain social relationships, Dr. Phillips said. So if birthdays are a time of increased attention from family and friends, they may become a lifeline event.

This view is confirmed, Dr. Phillips said, by a part of the study involving the timing of death for 390 famous Americans -- highly accomplished men and women who were likely to receive substantial attention on their birthdays. He found 20 percent more deaths than expected after the birthday, for both sexes.

Famous men and women are more likely than others to feel comfortable when taking stock and receive flattering attention on their birthdays, he said.

The study may have a few practical implications, Dr. Phillips said. "If I were a surgeon," he said, "I would hesitate to schedule elective surgery near a symbolic meaningful occasion. And if I were a nursing home administrator, I would try to support people during significant occasions like birthdays."

At this point, Dr. Phillips said, the biological causes of prolonging or shortening life around birthdays are not understood. But he said it might be fruitful to examine blood and urine tests before and after deaths around birthdays to see if there were marked variations.

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