The life expectancy of men in the U.S. is nearly six years shorter than that of women, according to new research published on Monday in JAMA Internal Medicine.
At least partially as a consequence of over 1 million Covid-19 deaths, life expectancy in the U.S. has declined significantly over the past few years, falling from 78.8 years in 2019 to 77 in 2020 and 76.1 in 2022 — undoing over two decades of progress. This puts the country far behind its wealthy peers: Countries such as Japan, Korea, Portugal, the U.K., and Italy all enjoy a life expectancy of 80 years or more. Countries such as Turkey (78.6) and China (78.2) also fare better. This falloff has become a key issue for the Food and Drug Administration.
The picture is especially concerning for men, whose life expectancy is now 73.2 years, compared with women’s 79.1. This 5.9 year gap is the widest between the two genders since 1996.
“Across the world, women tend to live longer than men,” said Brandon Yan, a resident physician at the UCSF School of Medicine and a research collaborator at the Harvard T.H. Chan School of Public Health, who is the lead author of the study. (Both institutions collaborated in the research.)
But the widening gap should concern the U.S., Yan said, because it shows that baseline factors accounting for men’s lower longevity — genetics, men’s higher vulnerability to chronic disease — aren’t the sole reason for the difference in life expectancies.
“The opioid epidemic, mental health, and chronic metabolic disease are certainly front and center in the data that we see here, explaining why there’s this widening life expectancy gap by gender, as well as the overall drop in life expectancy,” said Yan. Men have higher mortality rates from all three conditions compared to women.
In addition, Yan notes, “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 in the time since vaccines have become available, he said.
The decline in life expectancy in the U.S. suggests that advancements in medical treatment are no longer sufficient to counter ongoing public health crises, Yan said. “We have a health care system that is very advanced in treating illnesses and advanced disease. But for the most part … it is not very good when it comes to preventative care.”
In the years leading to 2010, it was public health improvements — such as aggressive anti-smoking campaigns and the consequent reduction of deaths from respiratory illnesses and cancer — that led to the increased longevity and a reduced male-female gap in life expectancy.
The reasons that issues such as suicide or opioid overdose affect men more than women are complex. “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,” said Yan. “That has profound effects on care-seeking behaviors,” he said. Whether a man seeks care for mental health issues, for instance, or even goes to routine primary care visits and takes medications, may be impacted by ideas about masculinity.
The analysis doesn’t provide insight into racial and ethnic differences. Yan says it is an area he and his colleagues plan to explore further. “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. And the interplay between gender and race is an important area for further study,” he said. As of 2022, the life expectancy for African American men was 61.5, nearly eight years shorter than for African American women.