Here's what matters most about the health of Clinton and Trump

Between one candidate's pneumonia diagnosis and the other's appearance on a doctor's talk show, Americans now know more about the health of Hillary Clinton and Donald Trump than was available last week.

But the most important predictors of future medical issues for the next president – and for most of the rest of us – have been available all along: age and gender.

"I think that people underestimate the impact of years of living," said Anne B. Newman, a physician who directs the Center for Aging and Population Health at the University of Pittsburgh's Graduate School of Public Health. Patients in their 80s will say, "I just had a checkup and my heart's good and my blood pressure's good," she said, but those measures won't reflect the inevitable damage to arteries, kidneys, and brain "that just haven't surfaced yet."

So, are Trump and Clinton too old to serve effectively?

Newman thinks not. Either could likely serve two terms before age-related health risks really accumulate. With advances in public health and modern medicine, people are living much longer than they used to. On average, a woman of 68 (Clinton's age) will live another 17.95 years, according to Social Security's actuarial life tables. A man of 70 (Trump's age) has, on average, another 14.24 years ahead of him.

Diet and exercise get a lot of attention because you can do something about them. Indeed, they are especially important for people with conditions such as diabetes and heart disease. But as predictors of developing health problems,  their power pales in comparison to what's beyond an individual's control. Gender is huge, statistically speaking.

Rates of nearly all the leading causes of death for whites ages 65 to 74 are significantly higher for men than for women. Heart disease, accidents, influenza/ pneumonia, and Parkinson's are all more than double in men compared with women, according to the National Center for Health Statistics. The death rate from all causes is nearly 50 percent higher for white men in that age group (2,143 per 100,000) than white women (1,433 per 100,000); mortality for blacks is higher and for Asians it is lower, although a female advantage applies in all these groups.

The risk of being male is lifelong, starting with more premature births.

The reasons are varied and not fully understood. For example, research has found that "white men perceive less risk in general than women and all other groups," Newman said.

Many cancers kill more men than women for a whole set of reasons. Men tend to smoke more – a disparity that was much greater in past decades – and cigarettes are known to raise the risk for more than a dozen types of cancer. Men face more occupational hazards, like the melanoma risk of working in the sun and the range of possibilities posed by exposure to hazardous chemicals.

Men also aren't in the habit of getting regular health screenings, like pap smears, that make them have a medical visit where something else might be detected as well. "Guys in their 40s, 50s, and 60s rarely have a reason to go to the doctor the way women do," Otis Brawley, chief medical officer of the American Cancer Society, said in an interview earlier this year.

Of course, statistics for cancer or any other cause of death are averages across huge populations.  What about an individual's medical history?

"What really matters would be major health conditions like diabetes, heart attack, cancer in the past that was removed and could come back," said Newman, whose training is in geriatrics and epidemiology. Lesser-known details about the major presidential candidates – among them Clinton's recent pneumonia diagnosis, and Trump's being overweight – don't rise to that level.

In fact, after Newman learned more about the pneumonia, she followed up on Wednesday's interview with an email that said: "It is pretty awesome that she was sick for more than a week and powered through it."

Both candidates have been harshly criticized for a lack of transparency on health as well as other issues, although Clinton has released far more detail on her medical history. But Newman is not expecting meaningful surprises. Given how long Trump and Clinton have been in the public eye, she said, "I can't believe that if a candidate had had a cancer removed ... or had bypass surgery that people wouldn't know about it," she said.

Americans often misjudge the real sources of risk. Think about people who refuse to fly following news of a plane crash, but still drive, despite evidence that air travel is far safer than driving.

Newman said that her elderly mother was surprised that she had a stroke in the spring despite being physically active (walking a couple of miles regularly), intellectually stimulated (running a website), and socially involved (cooking dinner for others). But it was no surprise to Newman: her mother is 87, an age when strokes are not uncommon.

Trump and Clinton, of course, are far younger. For their age and gender, "they are pretty normal people physically," Newman said. But she added this perspective:

"Would I be surprised if Trump had a heart attack?  No. Would I be surprised if Hillary developed breast cancer? No. But chances are they won't. And [if they do], chances are they will recover and be just fine."