Why do men still die before women?

The common refrain that the patriarchy is alive and well may not be entirely accurate. Indeed, according to new research, while men on average are still likely to have more wealth, power and status than women, they are also more likely to suffer poor health and die prematurely.

The figures bear this out. In the UK, men die four years earlier than women, and while medical advances have extended the lives of both sexes, men have benefited less. Globally, in 1950, men typically died 3.3 years before women. Today, that figure is 4.8 years, even though global life expectancy has risen at roughly the same rate for both sexes. According to ONS figures, in 2024, UK male life expectancy was 79.1 years. For women, it was 83.

This gender mortality gap forms the basis of three groundbreaking papers published in The Lancet last week. Using global health data from 1990 to 2023, researchers attempted to discover why men die younger than women and suffer disproportionately from heart disease, cancer, suicide and injuries.

The reasons, they discovered, were complex and included not only biology but also societal and cultural factors. Being a “man’s man”, they concluded, comes at a price.

Prof James Catto, of the University of Sheffield, is one of the researchers. As a consultant urologist, Catto, 56, spends much of his working life treating men with prostate concerns. But he began to wonder whether the conditions bringing them into his consulting room were necessarily the greatest threats to their lives.

“I realised that a lot of their other health problems were bigger issues for them. They might have heart disease, another cancer or an infection.”

The male-focused health problems identified in Catto’s research, such as cardiovascular disease, cancer and suicide, are caused by a range of factors, including environment and culture. However, there is one factor men can do very little about.

Biology vs behaviour

Some of the male health disadvantage is built into our genes, although Catto believes it plays a smaller part in the longevity gap than we might imagine.

For example, women typically have two X chromosomes, while men have one X and one Y. A second X can provide some protection against inherited conditions caused by faulty genes. Differences in sex chromosomes can also influence cancer susceptibility, potentially giving women an advantage.

Gender differences in immune response can also put men at greater risk, as Catto explains. “More men die from Covid and tuberculosis. That could be partly to do with our immune system, as there’s some evidence that men have slightly weaker immunity.”

Sex hormones are another factor. But although testosterone, which is important for men’s bone and cardiovascular health, is sometimes associated with risk-taking, it is not considered a significant contributor to the mortality gap.

Indeed, rates of smoking and drinking, alongside economic factors such as employment and healthcare access, are more important in explaining why men die earlier than what’s in our genetic make-up.

Does a stiff upper lip put men’s health at risk?

It is true to say that men are generally less likely to seek medical help and often present later with symptoms. However, it’s too simplistic to blame this entirely on a determination to tough things out. Indeed, the difference in GP attendance between men and women largely disappears among retired people and those with established medical conditions.

Catto also encounters men who avoid seeking help out of embarrassment. He explains: “Men can delay prostate cancer checks because they are worried about having a finger up the bottom, even though the modern way of diagnosing is a blood test and an MRI. And they are embarrassed by urinary or erectile problems. They don’t tend to want to seek help if they’ve got something wrong with their penis.”

Economics can be just as important in predicting life expectancy.

Catto says: “In Sheffield, for example, we have a bus route that goes across town and the life expectancy on that bus route varies by about 20 years between the more affluent and less affluent areas.”

Poverty and unemployment can hit men particularly hard when financial insecurity clashes with traditional expectations that they should be strong, self-reliant providers. These expectations are reinforced from an early age by the male role models men grow up admiring.

When unhealthy habits become part of male culture

Smoking, drinking and gambling are other factors identified in the study. While they have adverse effects for both men and women, they tend to be embedded more deeply in aspects of male social culture.

Catto points out that traditional male heroes are usually portrayed as physically strong, aggressive, hard drinkers. This, he explains, is why conventional representations of manliness can contribute to poor male health outcomes.

In 2013, British researchers analysed all 14 original James Bond books by Ian Fleming and discovered that, if he were a real person, Bond would die aged 56 of liver disease. He would also be at high risk of early-onset dementia and sexually transmitted disease.

“Our role models tend to be aggressive, maybe slightly violent, and their behaviours aren’t necessarily ones we want to transfer through into society,” Catto says.

Similarly, gendered marketing is helping to cut men’s lives short. The research published in The Lancet suggests tobacco and alcohol companies target particular groups of men, including disadvantaged communities. Meanwhile, a University of Cambridge study found that gambling adverts on Facebook and Instagram in Ireland reached 2.3 times as many men as women, with 22 per cent of the advertisements specifically targeting men and none exclusively targeting women.

Catto points to the influence of gambling culture at football matches, where supporters increasingly place bets throughout the game. He says gambling has become part of the sporting experience, with potentially serious consequences including debt, bankruptcy and mental health problems.

The online masculinity trap

Damaging male characteristics are also evident in the digital realm, where podcasters and social media influencers promote particular ideals of male strength, dominance and self-reliance.

These loosely connected online communities, often accompanied by hostility towards feminism and women, are collectively known as the manosphere and are identified in the research as a potentially harmful influence on men’s health.

Catto believes these communities can appeal particularly to boys who leave school without qualifications and subsequently experience unemployment or social exclusion.

“Boys who don’t do so well at school and end up with less well-paid jobs or unemployed, which can lead to more isolation and anger towards society. And that’s where the manosphere comes in offering a solution, saying it’s not your fault, it’s the government, or women, or feminism.”

Why loneliness can be dangerous for men

Social isolation is another factor in early male deaths. A lack of supportive relationships can contribute to poorer mental and physical health and even suicide, which is a significant cause of premature male mortality.

Catto believes men could benefit from becoming more comfortable discussing their problems, particularly when facing serious illness. He contrasts men’s attitudes with the support women often give and receive following a breast cancer diagnosis.

“Someone like Kylie Minogue gets breast cancer and a lot of women empathise and give her a lot of love and outpouring. We don’t always see that in the male population,” he explains.

He believes organisations such as Prostate Cancer UK and football clubs have helped challenge this reluctance by encouraging men to discuss health concerns more openly.

Stable personal relationships and social connections can also have a protective effect on men’s health. A 2025 study involving more than 320,000 British adults found that socially isolated men had a 41 per cent higher risk of premature death, compared with a 25 per cent increase among socially isolated women.

What can men do to live longer?

Catto is taking his own advice. The research has made him think more seriously about his own health. He’s on a statin to manage his cholesterol, has taken up more running and padel, is watching his diet and drinking less.

“There’s nothing like reading about it and realising that you need to act yourself,” he says.

And while he believes governments and employers have a responsibility to improve men’s health, he thinks men can make a start by paying more attention to their own bodies and also encourages men to invest in their friendships, spend less time on social media and become more comfortable talking about their health.

And for fathers wondering how to raise healthier sons, he has some straightforward advice.

“I think it’s being a good communicator,” he says. “And being a good role model, it’s sharing the caring with your wife and demonstrating good traits.”

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