Scientists May Have Finally Figured Out Why Women Live Longer Than Men
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New research names potential reasons that U.S. women continue to live longer than men on average.
The sex age gap has widened, with women living an average of six years longer than men.
Several factors seem to be involved in the difference.
For more than a century, research has found that women in the U.S. live longer than men. But the latest data show that women outlive men now by nearly six years—and life expectancies overall have dropped. Scientists may have figured out some contributing factors to this life expectancy gap between the sexes.
The study, which was published in the journal JAMA Internal Medicine, analyzed mortality data from the National Center for Health Statistics to look at changes in life expectancy at birth between those assigned male at birth and those assigned female at birth from 2010 to 2021, divided by pre– and post–COVID–19 years. Overall, researchers found that life expectancy at birth in the U.S. dropped for the second year in a row, from 78.8 years (2019) to 77 years (2020) and 76.1 years (2021).
But there was also a difference between those assigned male at birth, with those assigned female expected to live 5.8 years longer—the largest lifespan difference between the two sexes since 1996. The smallest gap in recent history was 4.8 years, which was determined back in 2010.
“We are always very interested in disparities in health outcomes by race, ethnicity, and [sex] and we were monitoring the [sex] disparity data overall before embarking on this study,” says study co-author Alan Geller, M.P.H., senior lecturer at the Harvard TH Chan School of Public Health. “Most importantly—and this is the theme throughout—we are looking to intervene and educate so that we can work to modify one’s health behavior and practice.”
The researchers didn’t just find that there was a life expectancy gap—they also determined why this exists. Here’s what you need to know.
So, why do U.S. women live longer than men?
It’s important to note that life span is a highly individualized thing, and these findings are simply averages based on data. Meaning, factors like diet, exercise routine, underlying health conditions, habits, and genetics all influence how long you’ll actually live. Still, women’s health expert Jennifer Wider, M.D., calls the findings “concerning,” adding, “Women have consistently outlived men, but the widening of the gap is more than most people would expect.”
There have been a few trends that researchers detected. In the latest study, the researchers noted that those assigned female at birth have typically outlived those assigned male due to lower cardiovascular disease death rates and lung cancer death rates, which they linked to differences in smoking behaviors.
But the study also found that COVID-19 was a big factor in the latest data. During the height of the pandemic, men were more likely to die of the virus: The researchers found that, in 2021, the age-adjusted mortality rate for COVID-19 was 131 deaths per 100,000 men vs. 82 deaths per 100,00 women.
“From the beginning of the pandemic, it’s been clear that the mortality rate in men is higher when it comes to COVID,” says Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. This, he says, is likely due to those assigned male at birth being more likely to have comorbidities like type 2 diabetes, lung disease, and heart disease—these raise the risk of developing severe forms of COVID-19, he says.
There are a few other elements that may be involved, although they’re hypotheses, says Thomas Russo, M.D., chief of infectious diseases at the University at Buffalo in New York. “We know that the X chromosome is important for the immune response, and women have two of them—there’s a belief that women will have a better immune response when faced with an infection,” he says. Dr. Russo also notes that some data find that those assigned female at birth have a lower concentration of ACE2 receptors in their lungs, which is where the spike protein of SARS-CoV-2 (the virus that causes COVID-19) binds to cells and makes you sick.
Drug overdoses have been a notable cause of death for years, says Lewis Nelson, M.D., chair of emergency medicine at Rutgers New Jersey Medical School. “It’s only getting worse and the number of drug poisonings continues to rise,” he says.
As for why those assigned male at birth are more likely to die of drug overdoses than those assigned female at birth, Dr. Nelson hypothesizes that it could be due to elements like a greater likelihood of risk-taking behaviors and having more underlying health conditions at a younger age. “Fatalities are a reflection of the prevalence of the health problem,” Geller says. “While there are many women with a past and current history of substance use, the problem of substance use, particularly use of heroin and fentanyl is greater among men.”
Those assigned male at birth are also more likely to experience substance use issues, says Henry Kranzler, M.D., a professor of Psychiatry and the director of the Center for Studies of Addiction at the University of Pennsylvania Perelman School of Medicine. “Men have higher rates of other substance use—13.1% of men smoke, while 10.1% of women do; 12.1% of males ages 12 and older have current alcohol use disorder compared to 9.1% of women,” he says. He also notes that suicide rates “have always been much higher in men than women and that trend is increasing.”
But those assigned female at birth who have substance use disorder may be using drugs in a way that poses less of a risk for overdose, suggests Samantha Lookatch, Ph.D., a psychologist at NewYork-Presbyterian/Columbia University Irving Medical Center. “This may be related to using with others who can administer life-saving medications—Naloxone/Narcan—and/or call for help if needed, using smaller doses of opioids or using less frequently,” she says. “Women are also more likely to engage in indicated treatment for substance use disorders which may also serve as a protective factor.”
How long does the average woman in America live?
In general, the average person assigned female at birth in the U.S. lives to be about 80 (79.3) years, according to the Centers for Disease Control and Prevention (CDC).
How long does the average man in America live?
The average person assigned male at birth in the U.S. lives 73.5 years, according to data from the CDC.
The bottom line
COVID-19 is still linked with deaths in the U.S., although Dr. Nelson points out that the numbers are much lower than what they were at the peak of the pandemic. To lower the odds you’ll get seriously ill from the virus, Dr. Russo recommends getting your updated COVID-19 vaccine and contacting your doctor if you happen to get sick about getting on an anti-viral medication, particularly if you’re considered high risk for serious disease.
But drug overdoses are more complicated. “The easiest answer to this is to say, ‘Don’t use drugs’ but that’s not practical,” Dr. Nelson says. “We have to direct more people into drug treatments and create better harm reductions for mental and behavioral health issues that don’t drive people into drug addiction.” Geller agrees. “We also need far more community-based drug treatment programs that are situated within areas most beset by drug epidemics,” he says.
Overall, increasing life spans and lessening the sex gap can be helped by investments in public health, Dr. Nelson says. “That just takes money, and a willingness to focus on this,” he says.
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