Do Women Live Longer or Do Men Die Earlier? Reflections on the Causes of Sex Differences in Life Expectancy

Abstract

Background: Although many different factors have been identified to contribute to excess male mortality, it is still unclear which path of the complex cause-effect chain is the decisive driver of the life expectancy gap between women and men. Objective: The question behind this study is whether these sex differences are caused primarily by factors leading to low female mortality or rather by factors causing high male mortality. We hypothesise that they are to a large extent caused by specific subpopulations of men with particularly high mortality levels that decrease the average life expectancy of men. Methods: To test this hypothesis, we investigate in a meta-analysis the variability in mortality (VM) in women and men - defined as the range of death rates prevailing among subpopulations - in empirical studies analysing specific phenomena of mortality differentials. We used the data of 72 empirical studies, including 146 total effects (TE) and 1,718 single effects (SE) for 21 different risk factors. Results: In 85% of TE and three quarters of SE the VM was higher in men than in women, taking into account men's higher overall mortality. The corresponding figures for the direct differences in the VM between women and men are 92 and 82%, respectively. Cases with higher female VM are rare exceptions and appear in particular in the highest age groups. Conclusions: We find support for our hypothesis that the disproportionate high mortality levels of specific male subpopulations are the central cause of the current extent of sex differences in life expectancy. Thus, public health programmes should be targeted toward these disadvantaged subpopulations among men which seem to be related primarily to socioeconomic characteristics.

Gender Differences in Survival in Old Age

“…The majority of research into gender differences in survival has focused upon younger to middle aged populations, with few studies including older people in general (5,6,7), and even fewer studies among the oldest old. (8) Literature that does exist among older people is often contradictory. Findings from some cross-sectional studies have suggested a convergence of differences in comorbidity between the genders in several areas of health, function and disease among the oldest old (9).…”

Household Position, Parenthood, and Self-reported Adult Health. Cross-Sectional and Longitudinal Evidence from the Austrian Generations and Gender Survey

“…The gender gap in life expectancy is a well-known fact in demography, with female life expectancy exceeding that of males (Waldron 2000;Luy and Gast 2014;Caselli et al 2014). Research on gender differences in mortality and morbidity has mainly focused on older people (Bardage et al 2005), but our study provides evidence that women evaluate their health worse than men already in young and middle adulthood.…”

Hair elements and healthy aging: a cross-sectional study in Hainan Island, China

“…According to the previous research, females might live longer as a result of disproportionately high mortality levels in males (Ginter and Simko 2013;Luy and Gast 2014). Sex differences in diet, iron status, and hormone levels can affect the absorption of elements (Kazi et al 2008;Olsson et al 2002).…”