Women often outlive men but in poorer health

Women tend to suffer more often from lower back pain, depression, and headaches. Men, on the other hand, have shorter lives because they get into road accidents more often and have higher rates of cardiovascular diseases and, in recent years, COVID-19 — both potential causes of premature death.

That's according to an analysis published in The Lancet Public Health journal. Researchers looked at differences between the sexes in the 20 leading causes of illness and death, across all ages and regions of the world.

"Throughout their lives, women will spend more time in poor health, while men suffer from conditions that will kill them sooner," Luisa Sorio Flor, one of the study authors, told DW.

What causes the differences in diseases between women and men?

Most of the differences between the sexes show up in adolescence. That is not only the time when biological differences but also gender norms start to have an impact on people's lives, the researchers write in their paper.

"It's not just about the biological body within which you're born. It's about the gendered experience of the environment in which you live that contributes to those measured differences," Sarah Hawkes told DW. Hawkes is a professor of global public health at University College London and was not involved in the study.

For the purpose of this article, we're using the following definitions of sex and gender:

Sex refers to biological attributes, such as hormone levels and sexual anatomy.

Gender describes socially constructed roles but can also represent an unequal distribution of power in a society.

"We know that there is a bias in health care systems where they will more easily diagnose women with mental disorders," said Luisa Sorio Flor, who is also an assistant professor at the Institute for Health Metrics and Evaluation in the US.

At the same time, men are less likely to get help for mental health conditions due to perceptions of masculine norms that work against their seeking or getting help.

Women in pain are taken less seriously

The high levels of musculoskeletal disorders, such as lower back pain, among women are less easily explained.

Biological factors, such as increased pain sensitivity due to fluctuating hormones, differences in skeletal shapes and the physical stress of pregnancy and childbirth, may all play a role here.

But studies show that women in pain are also often dismissed at the doctor's and undertreated when they seek help.

One recent study showed that health professionals of both sexes were less likely to offer support for lower back pain when the patient was female.

And a review of why women have lower back pain found that women are often in a worse condition than men when they begin a rehabilitation program.

The authors suggested there could be a triple burden at play: They said that work, maintaining a household and care duties may be keeping women from accessing appropriate services.

No improvement in care for women over time

Comparing data from 1990 to 2021, Sorio Flor's team came across an interesting pattern: "For several conditions, we saw decreasing rates over time, but the difference between males and females remains stable."

Conditions that disproportionately affect women, such as lower back pain or depressive disorders, showed far smaller or hardly any decrease since 1990 compared to conditions affecting more men.

"I think there has been a tendency within global health systems to equate women's health with their reproductive capacity. So women's health has all been centered around what their uterus is up to," said Hawkes.

How to close the gap between women and men

A first step to closing the gap is to collect better data, the Lancet researchers said. Because consistently collecting health data that is categorized by sex and gender is still not standard practice.

The COVID-19 pandemic serves as a good example. If we'd had more specific data on sex and gender, health interventions could have been better targeted, said Hawkes. 

"Our results are pretty clear," said Sorio Flor. "The health needs of males and females are simply different."

The researchers want to see governments spend more money on health, especially those conditions that affect females more than males. Things like mental health continue to be underfunded, they said.

Note: The original data used in the Lancet study was collected for the Global Burden of Disease study, which summarized health trends in 204 countries and territories.

Edited by: Zulfikar Abbany

Sources:

Differences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the Global Burden of Disease Study 2021. Journal: The Lancet Public Health. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00053-7/fulltext

The Impact of Sexism and Gender Stereotypes on the Legitimization of Women's Low Back Pain. Journal: Pain Management Nursing. https://www.sciencedirect.com/science/article/pii/S1524904222000972

Gender-Related Issues in the Management of Low-Back Pain: A Current Concepts Review. Journal: Clinic and Practice. https://www.mdpi.com/2039-7283/13/6/122