How gender shapes health: Women live longer but with poorer quality of life

Sex and gender shape health: the simple fact of being male or female interacts with other variables, such as race, socioeconomic status, age, or sexual orientation, and results in a diverse health pathway with a higher risk of one disease or another and different life expectancies. New U.S. research, published last Wednesday in The Lancet Public Health, delves into these differences, and concludes that men experience a greater degree of deteriorating health and have a higher burden of diseases that lead to premature death, such as cancer or heart problems. Women, on the other hand, suffer much more pathologies that lead to poor health and reduce their quality of life: lower back pain, depression, and anxiety, for example, are particularly prevalent among women. The authors of the article warn that these divergences in health outcomes between men and women imply “diverse health needs” and emphasize the “urgent need” for health policies based on age and sex to be implemented.

The researchers drew on data from the 2021 Global Burden of Disease Study (GBD), which quantifies health loss from more than 300 diseases in about 200 countries on a periodic basis. In this specific case, they focused on twenty pathologies: those that generate the greatest loss of health in individuals aged over 10. For example, heart attacks, stroke, lung cancer, cirrhosis, back pain, depression and anxiety, tuberculosis, road traffic injuries, Alzheimer’s, diabetes, and HIV, among others. To gauge the health impact of these ailments, the researchers used disability-adjusted life years (DALYs), an indicator that measures the extent of full, healthy life lost due to disease, associated ill health, or premature death.

“Our research findings reveal substantial differences in overall health between women and men, with little progress in reducing these health differences between 1990 and 2021,″ say the authors of the study. The rates of years of healthy life lost due to disease were higher in men in 13 of the 20 pathologies analyzed: Covid, for example, or ischemic heart disease, affected men much more than women. The seven conditions with higher DALY rates in women were lower back pain, depression, headaches, anxiety, musculoskeletal disorders, dementia, and HIV.

Luisa Sorio Flor, one of the authors of the study and a researcher at the Institute for Health Metrics and Evaluation at the University of Washington emphasizes that “women and men experience health and illness differently across their lifespan.” “Our findings indicate that, in general, men experience a greater degree of health loss. We observed that women suffer disproportionately from conditions leading primarily to morbidity that, while not necessarily fatal, significantly diminish quality of life. In contrast, men show a higher burden of diseases that more often result in premature mortality. Therefore, our study highlights that focusing solely on mortality or morbidity would fail to tell the full story of the health gaps between women and men.”

The influence of gender roles

The authors do not go into the factors that influence these disparities, but Sorio Flor assures that their findings align with the scientific literature reflecting how sex and gender impact health. Evidence suggests, for example, that differences in the prevalence of mental disorders or back pain are due to a combination of biological and gender factors: “From a biological perspective, different physiological responses to pain compared to men and hormonal factors have been linked to variations in musculoskeletal and mood disorders among women. On the gender side, social and cultural factors play an important role: the disproportionate burden of housework, caregiving responsibilities, and social expectations imposed on women may contribute to both physical stress, which causes conditions such as back pain, and psychological stress, which exacerbates mental health problems,” notes Sorio Flor.

Moreover, gender roles and the behaviors linked to them can influence health outcomes, says the researcher. “Specifically, road traffic injuries serve as a pertinent example illustrating how social expectations and gender norms can affect health disparities. Men are more likely to engage in behaviors perceived as risky or aligned with traditional notions of masculinity, such as smoking, heavy drinking, and aggressive driving. These activities are not only culturally reinforced in many contexts, but are also linked to higher rates of accidents and chronic diseases. The gap in the burden of road traffic injuries, which emerges at an early age between genders, highlights the role of risky behaviors,” she explains.

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