Did Men Benefit More from Medical Progress in Recent Decades? Cause-of-Death Contributions to the Decreasing Sex-Gap in Life Expectancy in the United States

BACKGROUND The narrowing of the sex gap in life-expectancy since the mid-1970s in the United States has been explained by women’s growing involvement in previously male-dominated risky behaviours, and in particular tobacco consumption. We argue that the narrowing sex-gap could additionally have resulted from greater benefits to men than women from new medical technologies due to differential access and the fact that many medical solutions result from studies based entirely on men. METHODS We decompose the sex gap in the mean duration of life between ages 0 and 75 into four large cause of death groups according to the index of amenable mortality. FINDINGS In the studied years, with the exception of 1985-1995, the sex gap decreased due to causes amenable to public policy interventions. An important contributor to this change was increased smoking among women. The observed narrowing of the sex gap due to medically amenable causes is limited to age 0. When a new group of causes amenable to medical interventions was formed by including half of the contribution of IHD, it had a positive contribution to the narrowing sex gap, and in particular at ages 1-75 years. CONCLUSIONS We demonstrate that when the group of medically amenable causes of death includes half of the contribution of IHD, the narrowing-sex gap in life-expectancy results from the two sexes benefiting to a different degree from medical developments due to differential access or from the fact that treatments are better fitted to male physiological needs than those of women.