The Indian women part is curious. In Japan and America, AFAIK women outnumber men at old age, so one would expect the sex ratio to get worse. Why is this not kicking in for generally treatable heart disease in India? Are the old women severely stressed compared to the old men, such that they drop dead of coronaries? Or is this a matter of women not getting heart care because they're less valuable? In which case Sen's thesis is right in India as well, just not with a selective abortion mechanism.