The gender gap in life expectancy is growing

In 2021, U.S. life expectancy reached the lowest level seen in over 25 years, with an overall life expectancy of 76.4 years. Since 2019, U.S. life expectancy has dropped by 2.4 years — largely due to deaths from the pandemic.

For men, life expectancy decreased by 0.7 years from 2020 to 2021, going from 74.2 years to 73.5 years. Women also saw a similar decline of 0.6 years, going from 79.9 years in 2020 to 79.3 years in 2021.

The gap between men and women's life expectancy in 2021 was 5.8 years, the largest it has been since 1996. Although the gap only grew 0.3 years between 2010 and 2019, it increased by 0.7 years between 2019 and 2021, a date range that include the first two years of the pandemic.

Why?

According to new research published in JAMA Internal Medicine, the COVID-19 pandemic was the biggest contributor to the widening life expectancy gap between men and women in the United States. In 2021, the age-adjusted mortality rate for COVID-19 was 131 deaths per 100,000 men compared to 82 deaths per 100,000 women.

Other significant contributors were unintentional injuries (primarily drug overdoses), diabetes, suicide, homicide, and heart disease.

"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," said Brandon Yan, a resident physician at the UCSF School of Medicine, a research collaborator at the Harvard T.H. Chan School of Public Health, and the study's lead author.

Some potential reasons for the difference in life expectancy between men and women include different rates of comorbidities for men, differing health behaviors, and socioeconomic factors, such as rates of incarceration and homelessness.

"There's a substantial socio-cultural norms component to this data as well in terms of the ways that society views masculinity and the way that men ought to behave," Yan said. "That has profound effects on care-seeking behaviors."

Yan also noted that "a lot of these drivers of worsening life expectancy in particular for men are preventable causes of death." Even COVID-19 could be considered a preventable cause of death after vaccines became available, he said.

"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." According to STAT, public health improvements, such as anti-smoking campaigns and consequent declines in respiratory illness and cancer deaths, helped increase overall life expectancy and decrease the gap between men and women in the years leading to 2010.

In the future, Yan said he and his colleagues plan to explore racial and ethnic differences in life expectancy. "We know that the disparity at baseline between men and women is much higher for Black Americans than it is for white Americans, for instance," he said. "And the interplay between gender and race is an important area for further study." (Merelli, STAT, 11/13; McPhillips, CNN, 11/13; Sobey, Boston Herald, 11/13)

The US healthcare industry has seen relatively few changes in how we deliver end-of-life care over the past several decades. However, the growing number of older adults, the lasting impact of COVID-19, and the shifting dynamics of Medicare enrollment are pressuring the industry to address longstanding challenges in this space. Read on to learn about the three emerging trends that, combined, have the potential to transform the end-of-life landscape.