First-ever men’s health strategy: Why do women live longer than men?
6 May 2025
Posed by models. Credit: Getty Images/sturtiBy Daniel Pye
As the government prepares to launch its first ever men’s health strategy, Doctors.net.uk has looked at the data associated with the long-standing gap in life expectancy between men and women and what male-specific health issues might be addressed in the plan.
The government has launched a call for evidence for its men’s health strategy, with the aim of closing the life expectancy gap of about 4 years.
The Department of Health and Social Care is canvassing the views of men from all backgrounds on what is working and what needs to be done in the NHS to support male health problems. Health secretary Wes Streeting says “every day, men across England are dying early from preventable causes” including suicide – the leading cause of death for men under 50.
The government wants to know how its Plan for Change can improve the health and wellbeing of men through prevention, diagnosis and treatment, and encourage men to to come forward for help.
The life expectancy gap
The Office for National Statistics (ONS) published its updated data set measuring life expectancy for the UK on 18 March. The data uses 3-year periods, with the most recent being 2021 to 2023. Period life expectancy is the average number of additional years a person would expect to live if he or she experienced the mortality rates of the time for the rest of their life.
The figures measuring life expectancy from birth so far this century:
Life expectancy for both genders has increased steadily since the start of the century, with a notable drop-off during the COVID-19 pandemic. The latest period, 2021-23, shows recovery with life expectancy only being 0.47 years lower for men and 0.24 years lower for women than the peak in 2017-19.
This is the life expectancy gap between men and women using the same ONS figures:
Between 2000-02 and 2012-14, the life expectancy gender gap dropped by just over a year. This decrease slowed between 2012-14 and 2014-16, and from 2014-16 until 2017-19 the 3.7-year difference remained largely consistent.
From 2017-19 until 2020-22, during the pandemic, the gap increased to 3.99 years. As of 2021-23, the gap has slightly decreased to 3.95 years. The life expectancy gap is, according to the latest figures, bigger than it was a decade before.
Why is there a historical life expectancy gap?
Veena Raleigh, senior fellow at the think tank The King’s Fund, writes that there has always been a difference between males and females but this was small (only 2 years in the mid-19th century) due to the high prevalence of diseases that killed both sexes indiscriminately.
The gap peaked at 6.4 years by 1969 after widening for around a century. This is at a point where childhood immunisation was eradicating previous widespread diseases. It is no surprise that during the two world wars there were sharp drops in life expectancy for men.
Raleigh says that the gender gap narrowed from the 1970s because of decreases in smoking and mortality from cardiovascular diseases but increased during Covid because mortality rates were higher in males than females.
A JAMA Internal Medicine analysis on the US gender life expectancy gap found that men experienced higher Covid-19 death rates “for likely multifactorial reasons, including higher burden of comorbidities and differences in health behaviours and socioeconomic factors, such as labour force participation, incarceration, and homelessness”.
‘Deaths of despair’
Research published in 2021 in the BioMed Central (BMC) journal, Population Health Metrics analysed how UK health policies shaped the gender gap.
The study looked at the steady decrease in the gender gap between 2001-2003 and 2014-16. It suggests that men seek less healthcare than women, and therefore “any behavioural health policy is likely to be more effective on males who simply have more room for improvement”.
One of the objectives of Streeting’s plan is to encourage more men to come forward for treatment.
While ischaemic heart disease’s contribution to the gap decreased over the study period, the role of drug-related deaths rose. “Deaths of despair”, which drug-related deaths come under, are linked to socio-economic conditions rather than healthcare policies, the study says.
The US JAMA study also cited an increase in deaths of despair for men between 2010-2021.
Finally, the BMC research states that the shrink in gender gap life expectancy possibly reflects the declining gender gap in behavioural risk factors such as smoking, alcohol use and obesity. Women in recent years smoke as much as men, and the gap in alcohol consumption “has been narrowed considerably,” with the risk factors associated with smoking and drinking alcohol disproportionately affecting women more than men.
A pan-European study on life expectancy published in the Lancet Public Health submits that differences in life expectancy between male and female individuals might “reflect broader inequalities in society”.
Unlike other countries, including England, which saw an overall life expectancy slow down in the 2010s, in Sweden and Norway it continued to rise until the pandemic.
The study suggests that in these countries “the gender gaps in labour market participation and employment are among the smallest” and this may have been a contributing factor.
Mortality vs morbidity
The ONS also collects data on average healthy life expectancy for men and women, measured by how long on average people live without a disability.
Between 2011 to 2013 and 2021 to 2023, healthy life expectancy dropped in England and Wales for both genders. However, the drop was larger for women.
Women in England can now expect an average of 61.88 years of disability-free life, which is 3.21% lower than a decade before. In Wales, women have a healthy life expectancy of 59.64 years, 3.63% lower than 2011 to 2013.
“Although females live an average of four years longer than males, they spend a higher proportion and more years of their lives in poor health,” Raleigh writes.
Research analysing the Global Burden of Disease Study in 2021 published in The Lancet Public Health found that males faced a higher disease burden than women. For 13 of the top 20 causes of disease burden including Covid, road injuries and cardiovascular, respiratory and liver diseases, the rates were higher for males than for females.
“Females showed [higher rates of] low back pain, depressive disorders, headache disorders, anxiety, other musculoskeletal disorders, Alzheimer's disease and other dementias, and HIV/AIDS than males,” the study papers state.
Like the King’s Fund research, this study also highlights “the disproportionate toll of morbidity-driven conditions among females”, attributing the greatest observed difference between the genders to mental and musculoskeletal disorders.
‘A more tailored approach’
When it announced the call for evidence for the men’s health strategy, the DHSC said that “with a clearer, more tailored approach for both men and women, their distinct health needs will be met better”.
The Lancet Public Health study supports “the development of specific strategies and national health plans” for men. When it was published, in May 2024, only seven countries had designated national-level policies addressing men’s health, despite 53 World Health Organization member countries ratifying a 2018 strategy on improving the health and well-being of men in Europe.
The study says that any initiative on men’s health should include the social and education sectors to address behavioural risks that are globally more common in males, such as smoking and alcohol use.
“Just as with the differences disadvantaging females, health differences affecting males, such as road injuries and ischaemic heart disease, often have their roots early in life, highlighting the importance of interventions and preventive measures that get implemented from a young age,” it states.
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