The gap between the life expectancy of men and women has reached its widest point in over a quarter of a century.
Women in the United States are now outliving men by an average of nearly six years, with COVID-19 and drug overdoses being largely to blame for the difference, according to analysis of mortality data from the National Center for Health Statistics published this month in the journal JAMA Internal Medicine.
“We were surprised to see that a life expectancy gap that had been improving for 30 years was now reexpanding,” says lead author Brandon Yan, MD, a resident physician at the University of California in San Francisco. “It was unsettling to see the degree of mortality difference between men and women with COVID-19 and to see the differences for drug overdose diverge in the way that it has.”
Women Living Longer Than Men Is Nothing New
For more than 100 years, American men have been dying earlier than women, largely due to heart disease and lung cancer.
But the trend had been improving since 1979, when the gap was at nearly eight years, according to data from the Centers for Disease Control and Prevention. In 2010, the gap had sunk to a low of 4.8 years.
By 2021, the gap had climbed to 5.8 years — meaning women were expected to live an average of 79.3 years, while men were expected to reach the age of 73.5.
When looking at U.S. adults overall (both men and women), life expectancy rates have dropped steadily:
- 78.8 years in 2019
- 77 years in 2020
- 76.1 years in 2021
COVID-19 and Drug Overdoses Driving the Trend
For men, the biggest factor to worsening life expectancy has been COVID-19, contributing to almost 40 percent of the difference, followed by unintentional injuries — mostly due to drug overdoses, which contributed to about one-third of the gap.
“For COVID, men have higher rates of comorbidities that put them at higher risk for severe COVID-19 infection and death, such as higher burdens of diabetes, respiratory disease, and obesity,” says Dr. Yan. “Men also constitute disproportionate shares of the homeless and incarcerated populations, which are factors known to be associated with higher COVID mortality from prior research.”
In regard to drug overdoses, Yan draws a connection to higher rates of suicide and homicide as well.
“This points to a picture of deaths from despair, wherein worsening mental health in relation to socioeconomic changes among other factors is driving men especially toward more risky behaviors such as drug use and violence,” he says.
Advances in Cancer Treatment and Prevention Have Kept Gap in Check
On the positive side, reductions in cancer deaths have prevented average life expectancies from dropping even more, thanks to advances in cancer treatment and preventive screening. Study authors indicate that declining rates of smoking — a behavior more common among men than women, according to the National Institute on Drug Abuse — have kept the gap from expanding further.
Another factor that may be keeping the spread from widening further is a reported increase in deaths related to pregnancy and childbirth, according to the research.
Deborah Kado, MD, a professor of medicine and chief of geriatrics research at Stanford University in California, suggests that COVID-19 may have played a role in this trend.
“Pregnant women are more at risk of severe illness due to COVID,” says Dr. Kado, who was not involved in the study. “Also, they might be afraid to go to a hospital for fear they will be exposed to COVID, and this may have led to more complications regarding their health.”
An Alert, Especially for Men, to Take Better Care
The research as whole may serve as a warning signal for everyone to take better care of themselves — but especially men.
“Men may tend to eat more unhealthy diets than women, and drink more than women,” Kado says. “Women seem to embrace more the idea of doing what’s healthy.”
She adds that men may also be more reluctant to go to the doctor, get a checkup, and seek healthcare when needed.
“This is a wake-up call for public health to redouble our efforts in prevention,” says Yan. “COVID deaths are largely preventable now, with excellent vaccines and therapeutics. Diabetes and heart disease at a population level can be better controlled if not prevented. And drug overdose, suicide, and homicide speak to a need for societal interventions to steer people away from harmful behaviors and towards hope and opportunity.”
