Statistics show that for more than a century women outlive men. But new research led by Harvard T.H. Chan School of Public Health and UC San Francisco shows that, at least in the United States, the gap has been widening for more than a decade. The COVID-19 pandemic and the opioid overdose crisis, among other things, are driving the trend.
In a research paper, that was published online in November 13, 2023 in JAMA Internal Medicine, the authors found the difference between how long American men and women live increased to 5.8 years in 2021, the largest it’s been since 1996. This is an increase from 4.8 years in 2010, when the gap was at its smallest in recent history.
The pandemic, which took a disproportionate toll on men, was the biggest contributor to the widening gap from 2019-2021, followed by unintentional injuries and poisonings (mostly drug overdoses), accidents, and suicide.
“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,” said first author Brandon Yan, a UCSF internal medicine resident physician and research collaborator at Harvard Chan School.
In the United States, life expectancy fell to 76.1 years in 2021, down from 78.8 years in 2019 and 77 years in 2020.
The shortening life expectancy of Americans has been ascribed to a limited extent to supposed “deaths of depression.” The term refers to the increase in deaths from such causes as suicide, drug use disorders, and alcoholic liver disease, which are often connected with economic hardship, depression, and stress.
While both men’s and women’s rates of homicide and drug overdose deaths have increased, it is evident that men account for an increasingly disproportionate number of these deaths.
Using data from the National Center for Health Statistics, Yan and fellow researchers from around the country identified the causes of death that were lowering life expectancy the most. Then they estimated the effects on men and women to see how much different causes were contributing to the gap.
Prior to the COVID pandemic, the largest contributors were unintentional injuries, diabetes, suicide, homicide, and heart disease.
But during the pandemic, men were more likely to die of the virus. That was likely due to a number of reasons, including differences in health behaviors, as well as social factors, such as the risk of exposure at work, reluctance to seek medical care, incarceration, and housing instability. Chronic metabolic disorders, mental illness, and gun violence also contributed.
The records raise questions about whether more specialized care for men, such as in mental health, should be developed to address the growing disparity in life expectancy.
Yan and co-authors, including senior author Howard Koh, professor of the practice of public health leadership at Harvard Chan School, also noted that further analysis is needed to see if these trends change after 2021.
credit: Harvard University