In mortality, morbidity, and other traditional indicators of health of men and women, there is a "male disadvantage" in most countries of the Americas, according to a 1998 report by Ruy Laurenti and other reserchers from the School of Public Health of the University of Sao Paulo, Brazil. Their analysis found that men have shorter life spans and higher mortality rates at nearly every age and for almost every cause, due to risk factors related to "sex" (the men's biological status) and also to their "gender" (their roles and behaviors as determined by society). The report's authors compared mortality and morbidity data for men and women for the period of 1981 to 1984 in selected countries of various subregions of the Americas. The researchers found higher mortality for men in all age groups. Among the most common causes of death for men were cardiovascualr illnesses, malignant tumors, and AIDS. The category of external causes, especially motor vehicle accidentes and homicides, was always among the five leading causes of death among males. The only exception were boys under 1 year of age, for whom biological factors were the most important. The risk factors for those external causes are more closely tied to "gender" behaviors than to "sex". For causes of morbidity not determined by the person's sex, women had more hospitalizations because of malignant tumors. Men had more hospitalizations linked to smoking and to drinking alcohol and had more of the related tumors. Men also suffered more often than women from injuries and poisonings. Illnesses connected to lifestyle were more common among men, especially males with lower incomes and less education. Laurenti and the other researchers conclude that in the various regions of the Americas, "machismo" and other gender factors ought to be considered in planning the educational component of health programs that seek to prevent lifestyle-related illnesses. In addition, the authors suggest that reseach designed to describe and analyze some behaviors of men could determine if those actions themselves are harmful to health or if they are damaging when they are associated with biological factors