All but one of these causes of death — stroke — claim proportionately more men's lives than women's lives at all ages. As a result, the average American man lives 5.4 years fewer than does the average woman. In 2002, male life expectancy was 74.5 years. Female life expectancy was 79.9 years.

It's unclear why men — statistically speaking — are the weaker sex. Heredity and male sex hormones may play a role, affecting such characteristics as body fat distribution. Specifically, men are more likely to accumulate fat around the abdomen (apple-shape obesity), which is associated with an increased risk of heart disease, diabetes, cancer and stroke. Women, on the other hand, are more likely to put on extra weight around the hips. This pear-shape obesity, while unhealthy, is not linked as closely to potentially fatal conditions.

Socially sanctioned "male" behavior may also predispose men to premature death. Men are more likely to smoke, drink, use illicit drugs and engage in casual sex — all of which can increase their risk of serious diseases. They're also conditioned from an early age to take risks and behave aggressively, which may partly explain why they have a higher risk of dying from accidents, suicide and homicide.

One thing is clear, though: You don't have to become a statistic. By recognizing the leading threats to your life, you can take steps to reduce your risks.

No. 1 — Heart disease

In 2002, 429,682 men died of heart disease, the leading cause of death in both sexes. Because men usually develop heart disease 10 to 15 years earlier than women do, they're more likely to die of it in the prime of life. About one-fourth of all heart-disease-related deaths occur in men ages 35 to 65. Only after age 80 do men and women have an equal risk of developing heart disease.

You can reduce your risk of heart disease by making healthier lifestyle choices and getting appropriate treatment for other conditions that can damage your heart, such as high cholesterol, diabetes and high blood pressure. Some preventive measures you can take:
Don't smoke or use other tobacco products.
Eat a varied diet, rich in fruits, vegetables, and low-fat foods.
Maintain a healthy weight.
Get at least 30 minutes of exercise most days of the week.
Keep your cholesterol levels in normal ranges.
Control your blood sugar if you have diabetes.
Control your blood pressure.
Talk to your doctor about a low daily dose of aspirin.

No. 2 — Cancer

In 2002, 288,768 men died of cancer, the second-leading cause of death for both sexes. Lung cancer — 90 percent of it caused by cigarette smoking — is the most common cause of cancer death in both sexes. In 2002, it killed 90,171 men.

Prostate cancer and colorectal cancer — both of which are associated with a high-fat diet — are the second- and third-leading causes of cancer death in men. In 2002, they claimed 30,466 and 28,501 men's lives, respectively.

Some preventive measures you can take:
Don't smoke or use other tobacco products.
Eat a varied diet, rich in fruits, vegetables and low-fat foods.
Maintain a healthy weight.
Get at least 30 minutes of exercise most days of the week.
Limit your exposure to sun and use sunscreen.
Drink alcohol only in moderation, if at all.
Be aware of potential cancer-causing substances (carcinogens) in your home and workplace, and take steps to reduce your exposure to these substances.
Have regular preventive health screenings.
Know your family medical history and review it with your doctor.

No. 3 — Accidents (unintentional injuries)

In 2002, accidents killed 69,257 men. Motor vehicle crashes were the leading cause. More than twice as many men (31,064) as women (14,316) died in traffic accidents. Male drivers involved in such accidents were almost twice as likely as female drivers to be intoxicated. To reduce your chances of a fatal crash:
Use your seat belt.
Keep your speed down.
Don't drive while sleepy or under the influence of drugs or alcohol.

Poisoning was the second-leading cause of fatal injury to men. In 2002, 12,059 men died of poisoning. In comparison, 5,491 women died of poisoning that year. To reduce your risk of poisoning:
Place carbon monoxide and smoke detectors near bedrooms in your house.
Have fuel-burning appliances inspected each year.
Store household products in their original containers.
Read and follow label instructions for household products.
Turn on a light when giving or taking medicine and follow label instructions.
Ventilate areas in which you use chemical products.
Post the poison control number, (800) 222-1222, by each telephone in your home.

Falls and drowning were the third- and fourth-leading causes of fatal injury to men. In 2002, falls caused 8,463 deaths among men, compared with 7,794 deaths among women. Drowning accounted for 2,761 deaths among men and 686 deaths among women.

Common-sense precautions such as using a safety ladder, placing nonskid mats in showers and tubs, and never swimming alone in a large or unfamiliar body of water can reduce the risks.

Workplace accidents — which include some vehicle crashes, poisonings, falls and drownings — are a significant cause of fatal injury to men, partly because men are concentrated in dangerous occupations such as agriculture, mining and construction. Although men hold 53.7 percent of all American jobs, they account for 92 percent of workplace fatalities. In 2002, workplace injuries killed 5,081 men and 443 women.

No. 4 — Stroke

In 2002, 62,622 men died of stroke. Although stroke occurs in equal proportions of men and women, men have better chances of surviving than women do. You can't control some stroke risks, such as family history, age and race, but you can control the leading cause — high blood pressure — as well as contributing factors such as smoking and diabetes.

Additional preventive measures:
Lower your intake of cholesterol and saturated fat.
Don't smoke.
Control diabetes.
Maintain a healthy weight.
Get at least 30 minutes of exercise most days of the week.
Manage stress.
Limit alcohol consumption.
Talk with your doctor about taking a daily dose of aspirin.

No. 5 — Chronic obstructive pulmonary disease (COPD)

In 2002, 60,713 men died of chronic obstructive pulmonary disease (COPD), a group of chronic lung conditions that includes emphysema and chronic bronchitis. It's strongly associated with lung cancer, the leading cause of cancer deaths among men. The main cause is smoking. Men who smoke are 12 times as likely to die of COPD as are men who've never smoked.

Some preventive measures you can take:
Don't smoke.
Avoid secondhand smoke.
Minimize exposure to workplace chemicals.

No. 6 — Diabetes

In 2002, 34,301 men died of diabetes, a disease that affects the way the body uses blood sugar (glucose). Excess body fat, especially around the middle, is an important risk factor for diabetes. About 80 percent of people who have the disease are either overweight or obese.

The diabetes complications most likely to be fatal are heart disease and stroke, which occur at two to four times the average rate in people with diabetes. Men with diabetes haven't benefited as much from recent advances in heart disease treatment as have men without diabetes. During the past 30 years, deaths from heart disease have fallen 36 percent in men without diabetes, as compared with only 13 percent in men who have diabetes.

An estimated one-third of men with the most common form of diabetes don't know they have it. Many are unaware of the disease until they develop complications such as impotence (erectile dysfunction), nerve damage causing pain or loss of sensation in the hands or feet, vision loss or kidney disease.

Some preventive measures you can take:
Maintain a healthy weight.
Eat a varied diet, rich in fruits, vegetables and low-fat foods.
Get at least 30 minutes of exercise most days of the week.
Get your fasting blood sugar level checked periodically.
Know your family's diabetes history and discuss it with your doctor.

No. 7 — Pneumonia and influenza

In 2002, 28,918 men died of pneumonia and influenza. These lung infections are especially life-threatening to people whose lungs have already been damaged by COPD, asthma or smoking. The risk of death from pneumonia or influenza is also higher among people with heart disease, diabetes or a weakened immune system due to AIDS or immunosuppressive drugs.

You can reduce your risk of complications and death from pneumonia and influenza by getting immunized. A yearly flu shot is up to 90 percent effective in preventing influenza in healthy adults. The pneumococcal vaccine can reduce the risk of getting pneumonia by more than half.

No. 8 — Suicide

In 2002, 25,409 men committed suicide. Men commit suicide four times as often as women do, partly because they're more likely to use deadlier means — such as firearms — when they set out to take their own lives. Depression — which is estimated to affect 7 percent of men in any given year — is an important risk factor for suicide. But male depression may be underdiagnosed, partly because men are less likely than women are to seek treatment for it. In addition, men don't always develop standard symptoms such as sadness, worthlessness and excessive guilt. Instead, they may be more likely to complain of fatigue, irritability, sleep disturbances and loss of interest in work or hobbies. Substance abuse — which is more common in men — can mask depression and make it more difficult to diagnose.

People at risk of suicide may:
Be depressed, moody, socially withdrawn or aggressive
Have suffered a recent life crisis
Show changes in personality
Feel worthless
Abuse alcohol or drugs
Have frequent thoughts about death
Talk about death and self-destruction

If you find yourself avoiding others, feeling hostile and worthless, thinking about death and using alcohol and drugs to numb your pain, talk with your doctor. In an urgent situation, an emergency room or crisis center can help. Friends or family members may be the first to notice your uncharacteristic behavior. Take their advice and seek help.

No. 9 — Kidney disease

Kidney failure, most often a complication of diabetes or high blood pressure, took the lives of 19,695 men in 2002. Control of diabetes and high blood pressure can prevent or slow the progression of kidney disease. Another cause of kidney failure is overuse of medications such as aspirin and ibuprofen (Advil, Motrin, others) that are toxic to the kidneys.

Some preventive measures you can take:
Drink plenty of fluids.
Exercise regularly.
Maintain your proper weight.
Don't smoke.
Get checked regularly for diabetes and high blood pressure.
Limit your use of over-the-counter pain relievers.
Take all medications only as directed.

No. 10 — Chronic liver disease and cirrhosis

In 2002, 17,401 men died of chronic liver disease and cirrhosis. The leading cause is alcoholism, which takes a heavy toll on men in general. Men account for more than 70 percent of the 75,000 alcohol-attributable deaths that occur each year in the United States. Other leading causes of chronic liver disease and cirrhosis include hepatitis B and C and certain inherited diseases such as hemochromatosis, in which abnormal amounts of iron accumulate in the liver. Nonalcoholic fatty liver disease, which is associated with obesity, also sometimes leads to cirrhosis.

Some preventive measures you can take:
Don't drink alcohol to excess.
Take precautions when using possibly hazardous chemicals.
Practice safe sex.
Don't inject street drugs.
Take medications only as directed.
Get a hepatitis B vaccination if you're at risk.
If you develop viral hepatitis, remain under the care of your doctor until you've recovered.
Maintain a healthy weight.


Putting health risks into perspective

It's important to understand that this ranking of health risks applies to the entire population of American men, no matter what their age. Although heart disease is the No. 1 lifetime health threat to men, it tops all other causes of death among men in only two age groups: ages 45 to 54, and age 65 and over. From childhood until age 44, accidents are the most significant threat to men's lives. Cancer emerges as the leading killer only in men ages 55 to 64.

Consider, too, what the numbers mean in real terms. For example, it seems staggering to think that nearly half a million men died of heart disease in 2002. But when you consider how many men lived in the United States that year — about 138 million — the number represents just a small fraction of the total male population.

The bottom line: Be concerned about health risks, but don't panic. Do all you can to lead a healthy lifestyle — eat healthy foods, stay physically active, don't smoke, get regular checkups and guard against accidents. By making these preventive measures a way of life, you'll increase your chances of staying vital and active into your 80s and 90s — well beyond the statistical average of 74.5.