Change of Sex Gaps in Total and Cause-Specific Mortality Over the Life Span in the United States

Abstract

Previous research has led to the expectation that the gap in mortality between sexes narrows in older ages as sex differences in fecundity decrease. However, the patterns and explanations of variations in sex disparities in mortality across the life span and underlying causes of death are not well understood. We conducted a population-based study to further test this hypothesis. By using a nationally representative sample of adults (N = 25,254) with mortality follow-ups for 18 years, we modeled age variations in sex differences in risks of mortality from leading causes of death. Male excesses in mortality decrease at older ages significantly for some but not all causes. Differential exposures to social, physiological, and morbidity risk factors account for the late life reductions of the sex mortality gaps completely in circulatory diseases, partially or minimally in the other causes of death. Social status and relationship are more important risk factors for mortality in younger ages, health behaviors are significant for all ages, and physiological dysregulation is more predictive of mortality in older ages. Sex differences in the risk of mortality have strong age variations and are cause specific. Additional studies of age acceleration of cancer mortality risk are needed.