Sliding life expectancy poses gender, inequity questions

Life expectancy gain is slowing in Australia – and figures show these figures are already sliding backwards in both the US and UK – yet little is being done by policy makers to understand specific gender and inequity reasons why this slip is occurring.

Questions about why such affluent western societies are facing a reversal in life expectancy are sounding loud alarm bells for Professor Fran Baum, Matthew Flinders Distinguished Professor and Director of the Southgate Institute for Health, Society and Equity.

Professor Baum is lead author of a study that offers a new perspective on why women live longer than men – noting with concern that while women live longer, many of the recognised social determinants of health are worse for women than men.

The study serves an important reminder of why policy makers need to receive more carefully nuanced research that drills into specific gender data that can best inform public health policy initiatives.

“We need gendered analysis to shape public policy discussion on health inequities – something which is sadly lacking at present in this country,” says Professor Baum.

“Shining a gender lens is vital and contributes to more complex understanding of health inequities and how to reduce them.”

The new paper – “New Perspective on Why Women Live Longer Than Men: An Exploration of Power, Gender, Social Determinants, and Capitals,” by Fran Baum, Connie Musolino, Hailay Abrha Gesesew and Jennie Popay – has been published in International Journal of Environmental Research and Public Health (doi.org/10.3390/ijerph18020661)

The paper highlights that since 2006, in all countries in the world, women have lived longer than men, but paradoxically report more illness than men.

Professor Baum says this situation has been amplified during COVID-19, with such high numbers of women around the world engaged in vulnerable frontline health provision and essential work services.

No existing explanations account fully for these differences in life expectancy, although they do highlight the complexity and interaction of biological, social and health service factors.

“We know that poverty is bad for health, although more women live in poverty than men yet are less likely to die younger than men,” says Professor Baum.

The paper explores a global picture of gendered life expectancy difference (GLED) using a novel combination of epidemiological and sociological methods – highlighting the equally important differences between average life expectancies in different countries and between different groups within countries. This included comparative case analysis offering explanations for GLED in Australia and Ethiopia.

“The Australian and Ethiopian cases demonstrated the complex economic, cultural, symbolic and social factors underpinning this difference, highlighting how similarities and differences are gendered within and between the countries,” says Professor Baum.

The new study sits neatly within a strengthening international women’s equity push, with Professor Baum being part of a Lancet-led global commission investigating gender and health, investigating what impacts the effectiveness of different programs.

“We note that the same answer cannot be effectively applied to both genders – and yet that is not being addressed by public health and equity policy,” says Professor Baum. “This needs to change – now.”

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