Cover Story

Why women outlive men in Nigeria and elsewhere

By Paul Adepoju

April 04, 2019

In 2019, more than 141 million children will be born: 73 million boys and 68 million girls. Based on recent mortality risks the boys will live, on average, 69.8 years and the girls 74.2 years – a difference of 4.4 years. Life expectancy at age 60 years is also greater for women than men: 21.9 versus 19.0 years.

The World Health Statistics 2019 – disaggregated by sex for the first time —has revealed why women across the world tend to live longer than men. One of the reasons are the different attitudes to healthcare.

“Where men and women face the same disease, men often seek health care less than women,” the new report released today revealed.  

Globally, the sex ratio at birth has been in the range of 105– 110 males to every 100 females; however, mortality rates are higher in males, so the ratio changes as the population ages. Thus, in 2016, there were 100 men for every 100 women in the age group 50–54 years, and 95 for every 100 women in the age group 60–64 years, with the sex ratio falling sharply thereafter.

Because the incidence of different diseases varies with age, and women live longer than men, some diseases can be more common in women; for example, the lifetime risk for Alzheimer’s disease is greater in women than in men, partly because more women survive to ages at which the disease most commonly occurs, although in some locations women also appear to be more susceptible to Alzheimer’s disease

In countries with generalized HIV epidemics, for example, men are less likely than women to take an HIV test, less likely to access antiretroviral therapy and more likely to die of AIDS-related illnesses than women. Similarly, male TB patients appear to be less likely to seek care than female TB patients.The report also highlights the difference in causes of death between men and women – some biological, some influenced by environmental and societal factors, and some impacted by availability of and uptake of health services.

Of the 40 leading causes of death, 33 causes contribute more to reduced life expectancy in men than in women. In 2016, the probability of a 30-year-old dying from a noncommunicable disease before 70 years of age was 44% higher in men than women.

Global suicide mortality rates were 75% higher in men than in women in 2016. Death rates from road injury are more than twice as high in men than in women from age 15, and mortality rates due to homicide are 4 times higher in men than in women.

Published to coincide with World Health Day on 7 April, which this year focuses on primary health care as the foundation of universal health coverage, the new WHO statistics highlight the need to improve access to primary health care worldwide and to increase uptake.

“One of WHO’s triple billion goals is for 1 billion more people to have universal health coverage by 2023,” said Dr. Tedros. “This means improving access to services, especially at community level, and making sure those services are accessible, affordable, and effective for everyone – regardless of their gender.”

“These statistics underscore the need to prioritize primary health care urgently to effectively manage noncommunicable diseases, and to curb risk factors.” said Dr. Samira Asma, WHO Assistant Director General for Data, Analytics and Delivery. “For example, something as simple as controlling blood pressure is just not happening on the scale needed and tobacco use remains a leading cause of premature death.”

Life expectancy has improved since 2000

Between 2000 and 2016, global life-expectancy at birth increased by 5.5 years, from 66.5 to 72.0 years.  Healthy life expectancy at birth – the number of years one can expect to live in full health- increased from 58.5 years in 2000 to 63.3 years in 2016.

Life expectancy remains strongly affected by income. In low-income countries, life expectancy is 18.1 years lower than in high-income countries. One child in every 14 born in a low-income country will die before their fifth birthday.

For the first time, this year, WHO’s Global Health Statistics have been disaggregated by sex. This new analysis has provided insights into the health and needs of people around the world. But many countries still struggle to provide gender disaggregated information.

“Closing data gaps will accelerate and is important to closing the gender gap,” said Dr. Richard Cibulskis, the report’s main author. “Collecting, analyzing, and using good quality, disaggregated data is central to improving people’s health and wellbeing. Health policy and practice must be underpinned by robust and reliable data, generated in countries.”