posts: 20096

{
    "id": "wp-20096",
    "slug": "why-do-women-live-longer-than-men",
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                "value": [
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                        "text": "Our World in Data presents the empirical evidence on global development in entries dedicated to specific topics.\n",
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                        "text": "This blog post draws on data and research discussed in our entry on ",
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                    },
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                            {
                                "url": "https://ourworldindata.org/life-expectancy/",
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                                    {
                                        "text": "Life Expectancy",
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                        "text": " and ",
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                                "url": "https://ourworldindata.org/child-mortality",
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                                        "text": "Child Mortality",
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                                    }
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                        "text": ".",
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                        "text": "An automated translation of this article into Spanish is available here: ",
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                    {
                        "url": "https://ourworldindata.org/por-que-las-mujeres-viven-mas-que-los-hombres",
                        "children": [
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                                "text": "ourworldindata.org/por-que-las-mujeres-viven-mas-que-los-hombres",
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                        "text": "Everywhere in the world ",
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                    {
                        "url": "https://ourworldindata.org/grapher/life-expectancy-of-women-vs-life-expectancy-of-men",
                        "children": [
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                                "text": "women live longer than men",
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                    {
                        "text": " \u2013 but this was not always the case. The available data from rich countries shows that ",
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                    },
                    {
                        "url": "https://ourworldindata.org/grapher/life-expectation-at-birth-by-sex",
                        "children": [
                            {
                                "text": "women didn\u2019t live longer than men in the 19th century",
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                        "text": ". Why do women live so much longer than men today, and why has this advantage increased over time? The evidence is limited and we only have partial answers. We know that biological, behavioral and environmental factors all contribute to the fact that women live longer than men; but we don\u2019t know exactly how strong the relative contribution of each of these factors is.",
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                        "text": "Independently of the exact weight, we know that at least part of the reason why women live so much longer than men today, but not in the past, has to do with the fact that some key non-biological factors have changed. What are these changing factors? Some are well known and relatively straightforward, like the fact that ",
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                    {
                        "url": "https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking",
                        "children": [
                            {
                                "text": "men smoke more often",
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                    {
                        "text": ". Others are more complicated. For example, ",
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                    {
                        "url": "http://www.nber.org/papers/w24716",
                        "children": [
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                                "text": "there is evidence",
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                        ],
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                        "text": " that in rich countries the female advantage increased in part because infectious diseases used to affect women disproportionately a century ago, so advances in medicine that reduced the long-term health burden from infectious diseases, especially for survivors, ended up raising women\u2019s longevity disproportionately.",
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                "text": [
                    {
                        "text": "Everywhere in the world women tend to live longer than men",
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                        "text": "The first chart below shows ",
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                    {
                        "url": "https://ourworldindata.org/life-expectancy",
                        "children": [
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                                "text": "life expectancy at birth",
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                        "text": " for men and women. As we can see, all countries are above the diagonal parity line \u2013 this means in all countries a newborn girl can expect to live longer than a newborn boy.{ref}To be more precise, this chart shows male and female estimates of what is called \u201cperiod life expectancy\u201d. That means these estimates correspond to the average number of years a newborn infant can expect to live, under the assumption that prevailing patterns of mortality at the time of its birth stayed constant throughout its life. You can read more about what life expectancy is and how it is measured ",
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                        "url": "https://ourworldindata.org/life-expectancy-how-is-it-calculated-and-how-should-it-be-interpreted",
                        "children": [
                            {
                                "text": "here",
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                    {
                        "text": ".{/ref}",
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                        "text": "Interestingly, this chart shows that while the female advantage exists everywhere, the cross-country differences are large. In Russia women live 10 years longer than men; in Bhutan the difference is less than half a year.",
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                "text": [
                    {
                        "text": "In rich countries the female advantage in longevity used to be smaller",
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                        "text": "Let\u2019s now look at how the female advantage in longevity has changed over time. The next chart plots male and female life expectancy at birth in the US over the period 1790-2014. Two points stand out.",
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                        "text": "First, there is an upward trend: Men and women in the US live much, much longer today than a century ago. This is in line with ",
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                        "url": "https://ourworldindata.org/life-expectancy#life-expectancy-increased-in-all-countries-of-the-world",
                        "children": [
                            {
                                "text": "historical increases in life expectancy everywhere in the world",
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                    {
                        "text": ".",
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                        "text": "And second, there is a widening gap: The female advantage in life expectancy used to be very small, but it grew substantially over the last century.",
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                        "text": "Using the option \u2018Change country\u2019 on the chart, you can check that these two points also apply to the other countries with available data: Sweden, France and the UK.",
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                        "children": [
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                                "text": "(NB. In case you are curious, the big dip in life expectancy in the US around 1918 corresponds to the ",
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                            },
                            {
                                "url": "https://ourworldindata.org/spanish-flu-largest-influenza-pandemic-in-history",
                                "children": [
                                    {
                                        "text": "Spanish flu pandemic",
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                            {
                                "text": ".)",
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                "text": [
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                        "text": "The female advantage in life expectancy is partly, but not entirely, driven by higher chances of surviving childhood",
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                        "text": "In most countries ",
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                    {
                        "url": "https://ourworldindata.org/grapher/child-mortality-by-sex",
                        "children": [
                            {
                                "text": "child mortality is higher among boys than girls",
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                        "text": ".{ref}The questions of why there are differences in child mortality for boys and girls, and why they have changed over time, are obviously interesting and important in their own right. The male disadvantage in infant mortality in rich countries underwent a surprising rise and fall in the 20th century. ",
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                    {
                        "url": "http://www.pnas.org/content/pnas/105/13/5016.full.pdf",
                        "children": [
                            {
                                "text": "Drevenstedt et al. (2008)",
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                        "text": " write: \u201cAlthough one might expect that innate biological differences between males and females would result in a constant level of the excess vulnerability of males, our analysis shows that biological differences are highly sensitive to both the medical-technical and epidemiological contexts. During the great historical improvements in infant mortality, the rising male disadvantage in infancy revealed a level of unexpected male vulnerability. [\u2026] Changes in obstetrical practice and neonatal medicine that saved all but the weakest babies have benefited boys more than girls because boys were more vulnerable across the entire range of birth weights.\" The full reference is Drevenstedt, G. L., Crimmins, E. M., Vasunilashorn, S., & Finch, C. E. (2008). The rise and fall of excess male infant mortality. Proceedings of the National Academy of Sciences, 105(13), 5016-5021. Available online ",
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                        "url": "http://www.pnas.org/content/pnas/105/13/5016.full.pdf",
                        "children": [
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                                "text": "here",
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                        "text": ".{/ref} How much of the female advantage in longevity is really a story about male disadvantages in infant mortality?",
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                        "text": "In poor countries where ",
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                    {
                        "url": "https://owid.cloud/child-mortality",
                        "children": [
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                                "text": "child mortality",
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                        "text": " is high, these sex differences in mortality are obviously an important factor driving differences in life expectancy. But in rich countries, where fewer children die, and where sex differences in infant mortality are very small, the male disadvantage in infant mortality cannot explain much of the observed differences in life expectancy.",
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                        "url": "http://www.pnas.org/content/pnas/105/13/5016.full.pdf",
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                                "text": "Available evidence",
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                        "text": " shows that child mortality rates in today\u2019s rich countries were higher for male than female infants in the 19th century, and the male disadvantage in child mortality grew through the first half of the 20th century, as health outcomes improved. Similarly, ",
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                        "url": "https://ourworldindata.org/maternal-mortality",
                        "children": [
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                                "text": "maternal mortality",
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                        "text": " in these countries used to be very high, and it ",
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                        "url": "https://ourworldindata.org/grapher/maternal-mortality?country=DEU+JPN+USA+GBR+SWE+FRA",
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                                "text": "decreased dramatically over the 20th century",
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                        "text": ".",
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                        "text": "However, as the chart here shows, in France, Sweden, the US and the UK, the life expectancy of women conditional on reaching age 45, was also higher than that of men, and the difference grew through the first half of the 20th century reaching a peak between 1970 and 1980.",
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                        "text": "Changes in child and maternal mortality do have an impact on life expectancy differences between men and women, but they cannot fully explain the rise in the longevity gap that we\u2019ve observed in rich countries over the last century.",
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                                "text": "(NB. For the same countries plotted in the chart below, you can explore long-run differences in life expectancy at ages 0, 15 and 45 in ",
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                            {
                                "url": "https://ourworldindata.org/grapher/difference-in-male-and-female-life-expectancy",
                                "children": [
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                                        "text": "this interactive chart",
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                                "text": ")",
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                "text": [
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                        "text": "What explains the female advantage and why has it changed over time?",
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                        "text": "The evidence shows that differences in chromosomes and hormones between men and women affect longevity. For example, males tend to have more fat surrounding the organs (they have more \u2018visceral fat\u2019) whereas women tend to have more fat sitting directly under the skin (\u2018subcutaneous fat\u2019). This difference is determined both by estrogen and the presence of the second X chromosome in females; and it matters for longevity because fat surrounding the organs predicts cardiovascular disease.{ref}The evidence regarding the impact that biological differences between men and women can have on longevity is complex and there are many open questions, since it is hard to disentangle genetic, hormonal, behavioral and environmental factors. For this reason, some of the evidence on specific mechanisms comes from lab experiments with animals. For example, studies on mice have been able to establish that the presence of the second X chromosome may have a direct impact on health outcomes keeping hormones and other factors constant (male mice being more likely to suffer from hypertension even in the absence of different hormones).{/ref}",
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                        "text": "But biological differences can only be part of the story \u2013 otherwise we\u2019d not see such large differences across countries and over time. What else could be going on?",
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                        "text": "We do not have a definitive answer, but we do have some clues. For example, we know that changes in ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/comparing-the-share-of-men-and-women-who-are-smoking",
                        "children": [
                            {
                                "text": "smoking habits among men",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " have affected mortality patterns.{ref}Preston, S. H., & Wang, H. (2006). Sex mortality differences in the United States: The role of cohort smoking patterns. Demography, 43(4), 631-646. Available online ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://link.springer.com/article/10.1353%2Fdem.2006.0037",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
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                        "text": ".{/ref} And we know that historical medical advances have affected health outcomes for men and women differently. A ",
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                    {
                        "url": "http://www.nber.org/papers/w24716",
                        "children": [
                            {
                                "text": "2018 study",
                                "spanType": "span-simple-text"
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                        ],
                        "spanType": "span-link"
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                        "text": " by Adriana Lleras-Muney and Claudia Goldin, looking at long-run data on infectious diseases, gives us insights into this mechanism.{ref}The full reference of the study is: Goldin, C., & Lleras-Muney, A. (2018). XX> XY?: The Changing Female Advantage in Life Expectancy (No. w24716). National Bureau of Economic Research. Available online ",
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                    {
                        "url": "http://www.nber.org/papers/w24716",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
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                    {
                        "text": ".{/ref}",
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                        "text": "Lleras-Muney and Goldin show that in the US, infectious diseases disproportionately affected females between the ages of 5 and 25 in the 19th century, so as the burden of infectious disease fell for both men and women, it disproportionately helped women.{ref}The authors point out that it is hard to know exactly why infectious diseases disproportionately affected females between the ages of 5 and 25 in the 19th century. \u201cIt does not seem to have been caused by relative deprivation. Young females must also have had greater exposure to infectious disease than young males, that is a greater morbidity rate, and carried with them, through life, the scarring effects of early illnesses.\u201d{/ref}",
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                "text": [
                    {
                        "text": "What are the open questions?",
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                        "text": "We know that the longer lifespan of females is common in other animals, but it is not universal.{ref}Among wild animals, the female longevity advantage has been observed for example in ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.eva.mpg.de/documents/Elsevier/Hill_Mortality_JHumEvo_2001_1556100.pdf",
                        "children": [
                            {
                                "text": "chimpanzees",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " and ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "http://www.helenemarsh.com/publications/JournalPapers/1984/KasuyaMarshLifeReproPilot1984.pdf",
                        "children": [
                            {
                                "text": "whales",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "; but it has not been observed in ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2293943/",
                        "children": [
                            {
                                "text": "macaques and baboons",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ". Studies with captive animals, giving identical treatment to males and females, have found a female advantage ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.sciencedirect.com/science/article/pii/S1550857906801981",
                        "children": [
                            {
                                "text": "in rats, but not in some types of mice",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ". You can find more references, plus some caveats on how to interpret the evidence, in Austad, S. N., & Fischer, K. E. (2016). Sex differences in lifespan. Cell metabolism, 23(6), 1022-1033. Available online ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.sciencedirect.com/science/article/pii/S1550413116302376",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".{/ref} We also know that biological, behavioral and environmental factors all contribute to the fact that women live longer than men; but we don\u2019t know exactly how strong the relative contribution of each of these factors is.",
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                        "text": "As the chart here shows, in most countries for all the primary causes of death the mortality rates are higher for men. More detailed data shows that this is true at all ages; yet paradoxically, while women have lower mortality rates throughout their life, they also often have higher rates of physical illness, more disability days, more doctor visits, and hospital stays than men do.{ref}Austad, S. N. (2006). Why women live longer than men: sex differences in longevity. Gender medicine, 3(2), 79-92). Available online ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.sciencedirect.com/science/article/pii/S1550857906801981",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
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                        ],
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                        "text": ".{/ref} It seems women do not live longer than men only because they age more slowly, but also because they are more robust when they get sick at any age. This is an interesting point that still needs more research.",
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                "text": [
                    {
                        "text": "A concluding remark",
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                        "text": "An interesting point raised in the study by Adriana Lleras-Muney and Claudia Goldin, is that the disproportionate longevity gain that women enjoyed from reductions in infectious diseases in the 20th century across rich countries, was not about direct benefits from reduced mortality. The direct reduction in deaths due to infectious diseases was important, but it was not the main factor explaining the growth in the life expectancy gap between men and women. In terms of the gap, what seems to have made a difference was the long-run indirect effect for survivors: Those who survive infectious diseases often carry a health burden that affects organs and this makes them more vulnerable later on in life. Rheumatic fever, for example, often damages the valves of the heart and ",
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                    },
                    {
                        "url": "https://en.wikipedia.org/wiki/Rheumatic_fever#Heart_failure",
                        "children": [
                            {
                                "text": "leads to rheumatic heart disease later in life",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
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            {
                "type": "text",
                "value": [
                    {
                        "text": "This relationship between infectious disease in early life and later-life health ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=doi.org%2F10.2307%2F3644718&btnG=",
                        "children": [
                            {
                                "text": "has been recognized in the medical sciences",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    },
                    {
                        "text": "; but there are few estimates of the impact at the population level. So the sizeable impact on life expectancy found by Lleras-Muney and Goldin actually has practical relevance for policy today \u2013 it suggests that in places where ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/infectious-disease-death-rates-per-100000",
                        "children": [
                            {
                                "text": "mortality from infectious diseases remains high",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ", the return from investing in treating these diseases may be much larger than we think, because of the long-run indirect health benefits for survivors.",
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                    }
                ],
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            {
                "text": [
                    {
                        "text": "Further reading",
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                    }
                ],
                "type": "heading",
                "level": 2,
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            },
            {
                "type": "text",
                "value": [
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                        "children": [
                            {
                                "text": "As we were writing this article we reviewed many academic articles, some of which are not directly referenced in the text above. We have compiled them in this ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://owid.cloud/app/uploads/2018/08/Why-women-live-longer-than-men-literature-review.pdf",
                                "children": [
                                    {
                                        "text": "short literature review document",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    }
                ],
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            }
        ],
        "type": "article",
        "title": "Why do women live longer than men?",
        "authors": [
            "Esteban Ortiz-Ospina",
            "Diana Beltekian"
        ],
        "dateline": "August 14, 2018",
        "sidebar-toc": false,
        "featured-image": "life-expectancy-of-women-vs-life-expectancy-of-women.png"
    },
    "createdAt": "2018-08-08T18:45:01.000Z",
    "published": false,
    "updatedAt": "2023-10-23T07:33:31.000Z",
    "revisionId": null,
    "publishedAt": "2018-08-14T06:30:38.000Z",
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    "publicationContext": "listed"
}