Public health
lung cancer, and chronic kidney disease, sex differences tend to be small at young ages and widen over the life course. The exception is the disproportionate toll of road injuries on young males (aged 10-24 years) in all world regions. “Our findings shine a light on the significant and unique health challenges faced by males,” says co-lead author Dr. Vedavati Patwardhan from the University of California, San Diego, US. “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.” The authors stress that progress on health
strategies for men has been slow. Globally, new initiatives for men have started to be rolled out, including the 2018 Strategy on the Health and Well-Being of Men in the WHO European Region, which was ratified by over 50 member countries. But to date only a handful of countries (including Australia, Ireland, Iran, Brazil, Malaysia, Mongolia, and South Africa) have designated national-level policies to address men’s health.
Disproportionate toll of disability-causing conditions among females Among the conditions evaluated, the study suggests that the biggest contributors to health loss globally disadvantaging females 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 largest absolute difference in health loss
disadvantaging females was seen for low back pain, with DALY rates more than a third higher for females than for males in 2021 (1,265 vs 787 DALYs per 100,000). Regionally, this gap was most pronounced in South Asia, where rates were over 50% higher in females (1,292 vs 598 DALYs per 100,000), and in Central Europe, Eastern Europe, and Central Asia, where female rates were about 30% higher (1,807 vs 1,256 DALYs per 100,000). Mental health conditions disproportionately impact females in all world regions. For example, health loss caused by depressive disorders was over a third higher among females than males (1,019 vs 671 DALYs per 100,000) globally in 2021, with the widest differences disadvantaging females seen in high-income countries (1,300 vs 747 DALYs per 100,000) and countries in Latin America and the Caribbean (1,139 vs 624 DALYs per 100,000).
According to Dr. Sorio Flor, “This report clearly
shows that, over the past 30 years, global progress on health has been uneven. 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, especially at older ages. Similarly, males are experiencing a much higher and growing burden of disease with fatal consequences.” She continues, “This kind of critical,
For conditions with the greatest gap
disadvantaging females, such as mental health conditions and musculoskeletal disorders, 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 prioritised to date, such as sexual and reproductive concerns.” She adds, “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.”
Sex- and gender-responsive approaches to health These global differences in health loss between females and males have been largely consistent for the past 30 years, but for some diseases, such as diabetes, the difference in DALY rates between females and males nearly tripled between 1990 (56.1 more DALYs per 100,000 among males) and 2021 (142.7 more DALYs per 100,000 among males). At the same time, there has been a disproportionate rise in global health loss caused by depressive disorders, anxiety, and some musculoskeletal disorders disadvantaging females, highlighting that the burden of chronic conditions experienced by females continues to grow.
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 authors stress 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 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. Ultimately, unravelling the roots of these health
differences by collecting and reporting sex- specific data (and gender identity-specific data when possible) and promoting gender-sensitive research is central to health policy decisions that offer the best opportunities for progress towards an equitable and healthy future for all. But despite repeated commitments from
international and funding agencies, there remain substantial gaps in the availability of sex- disaggregated data. Even for COVID-19, around 60% of countries did not consistently breakdown data by sex, and information on gender identity is even more limited. Dr. Patwardhan adds, “Our analysis also 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.” The authors note some important limitations,
including that while the study uses the best available data, estimates are constrained by the quantity and quality of past data as well as systemic biases present in epidemiological data – such as recall bias from self-reported data and the under-representation of population
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