Gender gap in life expectancy widens amid COVID-19, drug overdose crisis

Key takeaways:

• Overall life expectancy in the U.S. decreased from 78.8 years in 2019 to 76.1 years in 2021.
• Life expectancy gap between women and men is the largest it has been since 1996.

The gender gap in life expectancy in the United States has grown in recent years, with women living nearly 6 years longer than men on average, according to the results of a study published in JAMA Internal Medicine.

“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,” Brandon W. Yan, MD, MPH, an internal medicine resident physician at Harvard T.H. Chan School of Public Health, said in a press release.

Yan and colleagues evaluated overall and gender-specific life expectancy, as well as contributors to changes in life expectancy, using data from the National Center for Health Statistics.

They found that overall life expectancy decreased from 78.8 years in 2019 to 77 years in 2020 and to 76.1 years in 2021.

In addition, the life expectancy gap between men and women widened to 5.8 years in that time span, the largest increase since 1996 and up from 4.8 years in 2010. The gender life expectancy gap had previously increased 0.23 years from 2010 to 2019, before rising 0.7 years from 2019 to 2021.

The largest contributors of worsening life expectancy in men compared with women before the COVID-19 pandemic included:

• unintentional injuries (0.23 years);
• diabetes (0.05 years);
• suicide (0.04 years);
• homicide (0.03 years); and
• heart disease (0.03 years).

COVID-19 became the largest contributor to the increased gap in life expectancy in men vs. women (0.33 years) from 2019 to 2021, followed by unintentional injuries (0.27 years).

From 2010 to 2021, unintentional poisonings — typically drug overdoses — and unintentional transport-related injuries contributed to 86.3% and 11.8% of the 0.51-year decline in life expectancy from unintentional deaths, respectively.

“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.

Although increasing rates of maternal deaths among and reductions in cancer and perinatal conditions among men partially mitigated the increasing gender gap, the absolute difference in age-adjusted death rates between men and women ultimately increased from 252 to 315 per 100,000 from 2010 to 2021.

The rises in homicides, overdose deaths and suicide “underscore twin crises of deaths from despair and firearm violence,” while cardiometabolic diseases and mental health are also factors in differential mortality, according to the researchers.

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

References:

• Yan B, et al. JAMA Intern Med. 2023;doi:10.1001/jamainternmed.2023.6041.
• U.S. men die nearly six years before women, as life expectancy gap widens. https://www.hsph.harvard.edu/news/press-releases/u-s-men-die-nearly-six-years-before-women-as-life-expectancy-gap-widens/. Published Nov. 13, 2023. Accessed Nov. 13, 2023.