SAN FRANCISCO — For over a century, studies have shown that women tend to outlive men. Now, however, a new report from scientists at UC San Francisco and the Harvard T.H. Chan School of Public Health indicates the life expectancy gap has been widening between the genders for over a decade and shows no signs of slowing — at least in the United States.
Among other factors, study authors point to both the COVID-19 pandemic and the opioid overdose epidemic as two of the biggest recent driving factors behind this trend. More specifically, the study reports the difference between how long American men and women live increased to 5.8 years in 2021, which is the largest gap seen since 1996. In 2010, the gap was at its smallest point in recent years (4.8 years).
Researchers explain the pandemic took a disproportionate toll on men and was the biggest contributor to the widening gender death gap seen from 2019 to 2021. After COVID-19, unintentional injuries and poisonings (mostly drug overdoses), accidents, and suicide all ranked among the top contributors.
“There’s been a lot of research into the decline in life expectancy in recent years, but no one has systematically analyzed why the gap between men and women has been widening since 2010,” says the paper’s first author, Brandon Yan, MD, MPH, a UCSF internal medicine resident physician and research collaborator at Harvard Chan School, in a university release.
Overall life expectancy in the United States dropped in 2021 to 76.1 years, falling from 78.8 years in 2019 and 77 years in 2020. This observed decline in the lifespan of many Americans has been attributed in part to so-called “deaths of despair,” which refers to increases in deaths attributed to suicide, drug use disorders, and alcoholic liver disease. All of those causes are often associated with stress, depression, and economic hardship.
“While rates of death from drug overdose and homicide have climbed for both men and women, it is clear that men constitute an increasingly disproportionate share of these deaths,” Yan adds.
Thanks to data provided by the National Center for Health Statistics, Yan and fellow researchers from all over the country searched for causes of death that appeared to be lowering life expectancy the most. Then, they estimated the impact on both men and women in an effort to see just how much each of the causes was contributing to the gap.
Trends changed during the pandemic, though, as men were more likely to die of the coronavirus. This was likely caused by a number of reasons, such as differences in health behaviors, as well as social factors like the risk of exposure at work, reluctance to seek medical care, incarceration, and housing instability. Chronic metabolic disorders, mental illness, and gun violence were all also found to have contributed.
Yan adds the results raise questions regarding whether more specialized care for men, specifically in mental health, should be developed to address this growing gender disparity in life expectancy.
“We have brought insights to a worrisome trend,” Yan comments. “Future research ought to help focus public health interventions towards helping reverse this decline in life expectancy.”
Yan and co-authors, including senior author Howard Koh, MD, MPH, professor of the practice of public health leadership at Harvard Chan School, conclude further analysis is warranted in order to see if these trends change post-2021.
“We need to track these trends closely as the pandemic recedes,” Koh concludes. “And we must make significant investments in prevention and care to ensure that this widening disparity, among many others, do not become entrenched.”
The study is published in JAMA Internal Medicine.
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