The life expectancy gap between men and women is shrinking worldwide, according to a new report. What are the factors behind this trend and what are the implications for public health?
A new report published in JAMA Internal Medicine has analyzed the mortality data from 194 countries between 1990 and 2010, and found that the life expectancy gap between men and women is narrowing across the globe. The report also examined the causes of death that contributed to this trend, such as COVID-19, drug overdoses, heart disease, and violence.
What is the life expectancy gap?
Life expectancy is the average number of years that a person can expect to live, based on the mortality rates of a population. Traditionally, women have tended to live longer than men, due to various factors such as biology, behavior, and social influences. However, this gender gap in life expectancy is not fixed or universal, and it can change over time and across regions.
According to the report, the average life expectancy gap between men and women in 2010 was 4.8 years, meaning that women lived about five years longer than men on average. By 2021, this gap widened to 5.8 years, the largest disparity since 1996. However, this global average masks significant variations among different countries and groups.
Which countries have the largest and smallest gaps?
The report categorized the 194 countries into five distinct groups based on their life expectancy trends. The group with the highest average life expectancy was made up of the countries with the highest incomes, such as Australia, Japan, the US, the UK, and other parts of western Europe. The group with the lowest life expectancies was comprised of just Rwanda and Uganda.
The researchers found that the largest increase in life expectancy occurred among men in Rwanda and Uganda, who had an average life expectancy of just 30.85 years in 1990, increasing by 14.37 years to 45.22 years in 2010. Among women in these countries, life expectancy increased over this period by just 0.94 years, from 50.37 years to 51.31 years. This means that the gender gap in these countries narrowed dramatically from 19.52 years to 6.09 years.
On the other hand, the smallest increase in life expectancy occurred among men in high-income countries, who had an average life expectancy of 75.64 years in 1990, increasing by only 2.07 years to 77.71 years in 2010. Among women in these countries, life expectancy increased over this period by 1.39 years, from 81.43 years to 82.82 years. This means that the gender gap in these countries remained relatively stable at around five years.
What are the causes of death that affect the gap?
The report also identified the main causes of death that contributed to the changes in life expectancy and gender gap among different countries and groups. The most substantial change occurred between 2019 and 2021, when the COVID-19 pandemic hit the world and caused a significant drop in life expectancy for both men and women.
However, COVID-19 deaths had a greater impact on men than on women, due to a higher burden of comorbidities, differences in health behaviors, and employment in higher-risk industries. According to the report, COVID-19 deaths accounted for 0.42 year of the increase in the gender gap between 2019 and 2021.
Another major cause of death that affected the gender gap was unintentional injuries, mostly drug overdoses but also transport-related injuries such as car accidents. These deaths were more prevalent among men than among women, especially in high-income countries where drug use has been rising. According to the report, unintentional injuries accounted for 0.23 year of the increase in the gender gap between 2010 and 2019.
Other factors that influenced the gender gap included rising rates of diabetes, suicides, homicides, and heart disease among men compared to women. These causes of death were also influenced by biological, behavioral, and social factors that vary across regions and groups.
What are the implications for public health?
The report concluded that the gender gap in life expectancy is not inevitable or immutable, but rather reflects complex interactions between biological, behavioral, social, and environmental factors that can be modified through public health interventions.
The authors suggested that reducing the gender gap in life expectancy requires addressing both the common and specific risk factors that affect men and women differently. For example, promoting healthy lifestyles, preventing and treating chronic diseases, reducing tobacco and alcohol use, improving mental health, preventing violence, and ensuring access to health care are some of the strategies that can benefit both genders.
However, the authors also emphasized the need for gender-specific interventions that target the unique needs and challenges of men and women. For example, improving reproductive health, screening for breast and cervical cancer, and empowering women socially and economically are some of the interventions that can improve women’s health and longevity. Similarly, raising awareness of men’s health issues, encouraging men to seek help for mental and physical problems, and addressing the stigma and stereotypes that affect men’s behavior and well-being are some of the interventions that can improve men’s health and longevity.
The authors also called for more research and data collection on the gender differences in health outcomes and determinants, as well as the evaluation of the effectiveness and cost-effectiveness of gender-specific interventions. They argued that closing the gender gap in life expectancy is not only a matter of fairness and equity, but also a matter of public health and social development.