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Leading health experts are calling on countries around the world to increase their reporting of sex and gender data and to use these data to overhaul their approach to health.
The calls come following a new study published in The Lancet Public Health which has identified “substantial” health differences between females and males.
The study found that while health loss is higher in males, mainly driven by premature deaths, females endure higher levels of illness over their lives.
Indeed, females live longer than males and are therefore disproportionately affected by illness and disability including musculoskeletal conditions, mental health conditions, and headache disorders. Male ill health is primarily driven by conditions that lead to more premature death, such as Covid-19 and road injuries, as well as cardiovascular, respiratory and liver diseases.
Senior author Dr Luisa Sorio Flor at the Institute for Health Metrics and Evaluation (IHME), University of Washington, says the study clearly highlights that global progress on health over the past 30 years has been “uneven”.
“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,” she said.
Study looked at sex-related health differences across global population
To conduct the research, the authors used data from the Global Burden of Disease Study 2021 to measure the number of disability-adjusted life years (DALYs) for the 20 leading causes of disease in females and males.
All participants were aged 10 years and older and data was assessed at a global level across seven world regions between 1990 and 2021. The authors note that sex-specific health conditions (e.g. gynaecological conditions or prostate cancers) were not examined.
Covid-19 the leading cause of health loss in males in 2021
The analysis found that 13 out of the top 20 causes of disease burden were higher in males than in females in 2021. Overall, Covid-19 was the leading cause of health loss in 2021, with males experiencing 45% more health loss from Covid than females, closely followed by ischaemic heart disease.
Conditions which disproportionately affected males tended to have a small sex difference at young ages, with this gap widening over the life course. The only leading cause of health loss that was higher at younger ages was road injuries, with this trend seen in all world regions.
Dr Vedavati Patwardhan from the University of California said the findings shine a light on the significant and unique health challenges faced by males.
“Among these challenges are conditions that lead to premature deaths, notably in the form of road injuries, cancers, and heart disease. We need national health plans and strategies to address the health needs of men throughout their lives, including interventions targeting behavioural risks such as alcohol use and smoking that typically begin at a young age,” he said.
Dr Patwardhan added that progress on health strategies for men has been slow, with only a handful of countries having created national-level policies to address men’s health.
Females more likely to have poor mental health and musculoskeletal disorders
Contrastingly, the biggest contributors to health loss affecting females were lower back pain, depressive and anxiety disorders, headache disorders, musculoskeletal disorders, certain types of dementia, and HIV/AIDS.
Females were a third more likely to experience both lower back pain and depressive disorders. As with males, the differences in health loss between females and males begin early in life and continue to intensify with age.
“Large causes of health loss in women, particularly musculoskeletal disorders and mental health conditions, have not received the attention that they deserve”, says 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.”
Ms Gil adds that conditions disproportionately impacting females in all world regions 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,” she said.
Targeted early age responses needed to prevent onset of health conditions
These global differences in health loss between females and males have been largely consistent for the past 30 years, stressing the need for more sex- and gender-related data to inform national ill-health prevention policies.
As these health differences begin to emerge in adolescence, the authors say government should develop targeted responses from an early age to prevent the onset and exacerbation of health conditions. They add that health leaders should also adopt a life course approach when planning for health systems so that they are well-equipped to handle the needs of the ageing populations.
The authors also highlight some important limitations to the study, including that it could not produce estimates for gender-diverse or sex-diverse groups, and that they were unable to include sex-specific conditions.
Even so, Dr Patwardhan says: “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 healthcare for all people in various parts of the world, the systemic barriers that sustain health inequities will remain.”
