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Who Chronicle. 1984; 38(5):217-24.As part of its regional strategy for attaining health for all, the World Health Organization (WHO) European Region seeks to reduce sex differentials in mortality. In developing countries, the health consequences of social, economic, and cultural discrimination against females have produced a higher mortality rate among females than males. In contrast, there is a trend toward increasing excess male mortality in the developed countries. The sex differential in mortality arises from 2 broad groups of causes: genetic-biological and enivronmental. In high mortality countries, environmental factors may reduce or cancel out the biological advantages that women enjoy over men. As mortality is reduced through improved nutrition, public health measures, and better health care and education, women's environmental disadvantage is reduced and genetic-biological factors may increase the female life span faster than that of males. In the 3rd phase of this process, life style factors (e.g. alcohol abuse, cigarette smoking) may become increasingly detrimental to male health and survival, leading female mortality to decline at a faster pace than that of males. Although males appear to have adapted less well than women to the stresses of modernization, there has been a trend toward high risk behavior patterns among women too as a result of the changing female role. Prospects for the future trend of sex differentials in developed societies depend largely on developments in 2 areas: the effective treatment of degenerative and chronic diseases, which dominate the cause-of-death structure in these societies; and prevention through health education and encouragement of changes in personal behavior and life style. The challenge for women is to resist pressures to adopt a hazardous life style (e.g. smoking) that might offset the benefits of their improved social status.