• Posted November 13, 2023

U.S. Men Are Dying Much Earlier Than Women, as Death 'Gender Gap' Widens

The gap in life expectancy between American men and women is now the biggest it has been since the mid-1990s -- almost six years.

The pandemic and opioid overdoses are key factors in the gender difference in longevity, said researchers from the University of California, San Francisco (UCSF) and Harvard University T.H. Chan School of Public Health.

"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 study author Dr. Brandon Yan, a resident in internal medicine at UCSF.

In 2021, the gender gap in life expectancy rose to 5.8 years, its largest since 1996, he and his colleagues report. In 2010, the gap was its smallest in recent history, 4.8 years.

Life expectancy in the United States was 76.1 years in 2021. That's down from 78.8 years in 2019 and 77 years in 2020.

Researchers cited the pandemic as the biggest factor in the widening gender gap; it took a heavier toll on men. Unintentional injuries and poisonings (mostly drug overdoses), accidents and suicide were other contributors.

Another factor in Americans' shrinking lifespan: so-called "deaths of despair." That's a nod to the rise in deaths owing to such causes as suicide, drug use disorders and alcoholic liver disease. These are often linked to economic hardship, depression and stress.

"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 said in a joint news release from UCSF and Harvard.

He and colleagues from around the country used data from the National Center for Health Statistics to zero in on the causes of death that were contributing most to shrinking life expectancy. After that, they examined how much different causes were contributing to the gap.

For a number of reasons, men were more likely to die of COVID during the pandemic. Researchers pointed to differences in health behaviors as well as risk of on-the-job exposure, reticence to seek medical care, being in jail and housing instability. Also factoring in were chronic metabolic disorders, mental illness and gun violence.

The findings were published online Nov. 13 in the journal JAMA Internal Medicine.

"We have brought insights to a worrisome trend," Yan said. "Future research ought to help focus public health interventions towards helping reverse this decline in life expectancy."

He said the findings raise questions about the need to develop specialized care, such as in mental health, for men.

Senior author Dr. Howard Koh, a professor of public health leadership at Harvard, said follow-up will be needed to see if the trends change after 2021.

"We need to track these trends closely as the pandemic recedes," he said. "And we must make significant investments in prevention and care to ensure that this widening disparity, among many others, does not become entrenched."

More information

Peterson-KFF Health System Tracker compares U.S. life expectancy to that in other countries.

SOURCE: University of California, San Francisco/Harvard University, joint news release, Nov. 13, 2023