Women live longer than men but experience more years in poor health, a global gender health gap analysis has shown, underscoring the need for gender-responsive approaches to health.
The study, published in the Lancet Public Health journal, found that globally, there are substantial differences between men and women when it comes to health, with limited progress in bridging these health gaps over the past 30 years.
Non-fatal conditions that lead to health loss through illness and disability, including musculoskeletal conditions, mental health conditions and headache disorders, particularly affect women globally, the research suggested, while men are disproportionally affected by conditions that cause premature death, such as COVID-19, cardiovascular diseases and respiratory and liver diseases.
The health differences between men and women, however, continue to grow with age, leaving women with higher levels of illness and disability throughout their lives, as they tend to live longer than men.
“This report clearly shows that over the past 30 years global progress on health has been uneven,” said senior author, Dr Luisa Sorio Flor, at the Institute for Health Metrics and Evaluation (IHME), University of Washington.
“Females have longer lives but live more years in poor health, with limited progress made in reducing the burden of conditions leading to illness and disability, underscoring the urgent need for greater attention to non-fatal consequences that limit women’s physical and mental function.
“Similarly, males are experiencing a much higher and growing burden of disease with fatal consequences.
“This kind of critical, comparable and comprehensive research is important, both to understand the magnitude and distribution of the diverse and evolving health needs of females and males around the world and to identify key opportunities for health gain at all stages of life.”
The study is also a call for countries to boost their reporting of sex and gender data, said Sorio Flor.
“The timing is right for this study and call to action – not only because of where the evidence is now, but because COVID-19 has starkly reminded us that sex differences can profoundly impact health outcomes.
“One key point the study highlights is how females and males differ in many biological and social factors that fluctuate and, sometimes, accumulate over time, resulting in them experiencing health and disease differently at each stage of life and across world regions.
“The challenge now is to design, implement and evaluate sex- and gender-informed ways of preventing and treating the major causes of morbidity and premature mortality from an early age and across diverse populations.”
The study looked at the disparities in the 20 leading causes of illness and death between men and women, across ages and regions.
The modelling research used data from the Global Burden of Disease Study 2021, and did not include sex-specific health conditions, such as gynaecological conditions or prostate cancers.
The analysis estimated that for 13 out of the top 20 causes of illness and death, including COVID-19, road injuries and a range of heart, respiratory and liver diseases, the rate was higher in men than women in 2021.
Among the conditions evaluated, the study suggested the biggest contributors to health loss globally disadvantaging women are low back pain, depressive disorders, headache disorders, anxiety disorders, other musculoskeletal disorders, Alzheimer’s disease and other dementias, and HIV/AIDS.
These conditions predominantly contribute to illness and disability throughout life as opposed to leading to premature death, the research found.
For conditions with the greatest gap disadvantaging women, such as mental health conditions and musculoskeletal disorders, the differences in health loss between men and women begin early in life and continue to intensify with age, the findings also showed.
“Large causes of health loss in women, particularly musculoskeletal disorders and mental health conditions, have not received the attention that they deserve”, said co-lead author Gabriela Gil from IHME.
“It’s clear that women’s healthcare needs to extend well beyond areas that health systems and research funding have prioritized to date, such as sexual and reproductive concerns.”
She added: “Conditions that disproportionately impact females in all world regions, such as depressive disorders, are significantly underfunded compared with the massive burden they exert, with only a small proportion of government health expenditure globally earmarked for mental health conditions.
“Future health system planning must encompass the full spectrum of issues affecting females throughout their lives, especially given the higher level of disability they endure and the growing ratio of females to males in ageing populations.”
The global differences in health loss between men and women have been largely consistent for the past 30 years, but for some diseases, such as diabetes, the differences have grown, researchers found.
At the same time, there has been a disproportionate rise in global health loss caused by depressive disorders, anxiety, and some musculoskeletal disorders disadvantaging women.
The authors stressed that the health differences identified begin to emerge in adolescence, coinciding with a critical time when gender norms and attitudes intensify and puberty reshapes self-perceptions.
This pattern, they said, underscores the need for targeted responses from an early age to prevent the onset and exacerbation of health conditions and for adopting a life course approach when planning for health systems so that they are well-equipped to handle the needs of the populations they serve.
Dr Vedavati Patwardhan from the University of California, San Diego, said: “Our analysis highlights the need for targeted policies and planning to address the health needs of diverse populations.
“Without granular insights on risk behaviours, social dynamics, economic conditions and access to health care for all people in various parts of the world, the systemic barriers that sustain health inequities will remain.”
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