The difference in life expectancy between men and women is a globally observed phenomenon. Women tend to outlive men in nearly all countries; in 2021, the global gap was approximately five years (73.8 years for women compared to 68.4 years for men). This difference varies significantly. The complex reasons behind this longevity gap involve fixed biological factors, behavioral patterns, and sociocultural influences that elevate male mortality risk.
Genetic and Hormonal Predispositions
The difference in sex chromosomes provides a biological advantage for females, often called the “female biological advantage.” Females possess two X chromosomes (XX), while males have one X and one Y chromosome (XY). If a mutation occurs on one X chromosome, the second X chromosome can often compensate. Males lack this genetic backup, meaning harmful genetic expressions on their single X chromosome are more likely to be fully expressed, contributing to higher mortality rates.
Sex hormones also play a significant role in this disparity, particularly in cardiovascular health. Testosterone, the primary male sex hormone, has been linked to weakening heart muscles and increasing the risk of hypertension and cardiovascular disease. In contrast, the female hormone estrogen offers a protective effect by helping to reduce circulating levels of harmful cholesterol. Androgens can also suppress the immune system, making men more susceptible to infections and diseases. This hormonal influence suggests a fixed physiological vulnerability that women do not share.
Higher Risk Behavior and Lifestyle Choices
Behavioral patterns contribute substantially to the shorter average lifespan for men, particularly through increased engagement in high-risk activities and substance abuse. Men are significantly more likely to use illicit drugs, often starting younger and consuming higher doses than women. This contributes to a higher rate of substance dependence and increased risk of overdose deaths; two-thirds of opioid-related overdose fatalities in the US occur among men.
Alcohol use follows a similar trend, as men are more likely to drink excessively and engage in binge drinking. These habits are associated with higher rates of alcohol-related hospitalizations, deaths, and impaired driving. Regarding diet, men tend to consume more foods rich in fat and protein. This preference and propensity for visceral fat accumulation are major risk factors for chronic conditions like Type 2 diabetes and cardiovascular disease.
The increased propensity for risk-taking extends to accidents and violent behavior, accounting for a larger share of mortality among young men. Males are involved in over twice the number of fatal motor vehicle crashes annually compared to females, often due to higher rates of speeding or impaired driving. Males also account for 61% of all sports- and recreation-related injury episodes, indicating a higher exposure to physical hazards. These lifestyle choices are reflected in mental health outcomes, where suicide rates are nearly four times higher for men than for women.
Occupational Hazards and Delayed Healthcare Seeking
External and systemic factors further amplify the life expectancy gap, especially concerning career choices and engagement with the healthcare system. Men are disproportionately represented in occupations with the highest rates of fatal injuries, such as logging, fishing, and construction. In the US, men consistently account for over 90% of all fatal occupational injuries, making male workers about 10 times more likely to die on the job than female workers.
This higher exposure is compounded by a widespread reluctance among men to seek medical attention until conditions become advanced. Sociocultural norms often emphasize self-reliance, leading men to perceive seeking help as a sign of weakness and acting as a barrier to preventative care. Around 65% of men, according to one survey, admit to actively avoiding medical appointments for as long as possible.
This delayed engagement has negative consequences for long-term health and survival rates. Men are twice as likely as women to wait at least two years between doctor’s visits, meaning treatable conditions are often diagnosed late. The five-year survival rate for prostate cancer drops sharply from nearly 100% when caught early to under 50% when diagnosed at an advanced stage. By avoiding regular screenings, men miss opportunities for timely intervention.