The ASCOM project was established in the context of the ERC Starting Grant Project HEMOX (“The Male-Female Health Mortality Paradox”, Project No. 262663) and deals in the first years primarily with the gender differences in health and longevity. From the 1960s to the 1980s a common wisdom about differences between males and females in health and mortality emerged which was summarised by the well-known phrase “women are sicker, but men die quicker”. Recently this wisdom has been increasingly questioned. Nevertheless, the general idea of a paradoxical relationship between health and mortality among women and men persists until today. The purpose of this project is to decisively advance the understanding of the paradox by demonstrating that the reverse relationship between sex on the one side and health and mortality on the other is not as paradoxical as it seems. We hypothesise that two factors are mainly responsible for causing this intuitive contradiction. First, the overall reversal in sex morbidity and sex mortality differentials occurs because conditions that figure importantly in morbidity are not very important in mortality, and vice versa. Second, it is very likely that longevity is directly related to the absolute number of life years in ill health. Thus, women show higher morbidity rates not because they are female but because they are the sex with higher life expectancy.
In this ERC (European Research Council) funded project (2011-2016) we will test these hypotheses in a “quasi experiment” by analysing the relationship between health and mortality among Catholic nuns and monks from Austria and Germany in comparison to women and men of the general population by means of a multi-wave health survey. Using demographic, epidemiologic and psychological methods, this study will analyse and explain the differences in health and mortality between (1) nuns and women of the general population, (2) monks and men of the general population, and (3) nuns and monks in comparison to those found between women and men of the general population.
The first wave was carried out between July and December 2012. In total, 1,158 order members participated to the study (response rate: 68.8%), of whom 1,085 lived in 142 communities in Germany and Austria with convent sizes between 2 and 140 persons. The other 69 order members lived in households outside their communities. The figure above illustrates the regional distribution of the study participants with the size of the circles representing the corresponding numbers. The second wave took place between September and October 2014. In this round, 936 order members filled the questionnaire and sent it back to us (response rate: 86.2%). The third wave was carried out in November 2017 with 714 participating nuns and monks (response rate: 76%). First results of this research project have been presented already at several conferences and published in journal articles (see Publications).