The weaker sex: Why men die before women

Of the 40 leading causes of death, 33 are more common in men. Photo / Getty Images

Women live longer than men everywhere in the world – and the difference is particularly stark in high-income countries like Britain, according to data from the World Health Organisation (WHO).

WHO has applied a gender lens to its yearly analysis of global health statistics and found that in every region of the world men die younger than women and have fewer years of healthy life expectancy.

A baby boy born in Africa in 2016 could expect to live to 60, while a baby girl could expect to live to 63. Healthy life expectancy at birth is 53 for boys and 55 for girls.

But in Europe the difference between boys and girls is much greater - a boy born in 2016 could expect to live to the age of 74 and a girl to the age of 81.

And healthy life expectancy is 66 years for boys and 71 for girls.

Of the 40 leading causes of death, 33 are more common in men. The main causes of death that contribute to a lower life expectancy in men are heart disease, road injuries, lung cancer, chronic obstructive pulmonary disease and stroke.

Global suicide mortality rates were 75 per cent higher in men than in women in 2016. Death rates from road injury were more than twice as high in men than in women from age 15, and mortality rates due to homicide were four times higher in men than in women.

In lower income countries the smaller difference in life expectancy between men and women is mainly due to higher rates of maternal mortality – in low-income countries one in 41 women dies in pregnancy or childbirth, compared to one in 3,300 in high-income countries.

Richard Cibulskis, lead author of the WHO report, said: "Men die from most things more than women and this is true in low and high income countries. But in low income countries women have a greater risk of dying in childbirth so the maternal mortality rates skew the figures."

The reasons for the differences between men and women are three-fold – men have an inbuilt "biological frailty" and poor immune systems which explain why more male foetuses are miscarried and why more boys die in their first year of life.

But the main differences are due to environmental factors – men are more likely to engage in risky behaviour such as smoke and drink – and the fact that men go to the doctor less often than women.

Peter Baker, director of Global Action on Men's Health, said health services needed to be better designed around men.

"You could take the view that men are a bunch of idiots bent on self destruction but that is not true. Most men in the world don't smoke or drink at dangerously high levels," he said.

He said that gender norms placed on men – that is, they are expected to be self sufficient and tough – meant that they were less likely to seek help.

"We all have a responsibility to care for ourselves but you cannot expect people to step out of the way they have been brought up and the social and cultural environment they are in. We need to start thinking about how we respond as a health system," he said.

Mr Baker added that these gender norms were a global issue and pointed to research from UNAIDs which showed that 60 per cent of women with HIV were on treatment compared to less than half of men.

"We need to get services out to where men are and there are lots of examples of this being done through sport," he said.

In Scotland the Football Fans in Training programme invites men to take part in fitness and healthy eating sessions with club coaches. An evaluation of the programme published in the Lancet showed that those on the programme maintained a weight loss of at least five per cent of their original body weight a year later.

Dr Cibulskis said that looking at disease with a gender lens was a vital way of targeting services. Men have much higher rates of TB, for example.

"If we want to bring rates of TB down we need to target people most at risk of spreading it. It's not a question of an equal disease burden," he said.