Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

Abstract

Males are at higher risk relative to females of severe outcomes following COVID-19 infection. Focusing on COVID-19-attributable mortality in the United States (U.S.), we quantify and contrast years of potential life lost (YPLL) attributable to COVID-19 by sex based on data from the U.S. National Center for Health Statistics as of 31 March 2021, specifically by contrasting male and female percentages of total YPLL with their respective percent population shares and calculating age-adjusted male-to-female YPLL rate ratios both nationally and for each of the 50 states and the District of Columbia. Using YPLL before age 75 to anchor comparisons between males and females and a novel Monte Carlo simulation procedure to perform estimation and uncertainty quantification, our results reveal a near-universal pattern across states of higher COVID-19-attributable YPLL among males compared to females. Furthermore, the disproportionately high COVID-19 mortality burden among males is generally more pronounced when measuring mortality in terms of YPLL compared to age-irrespective death counts, reflecting dual phenomena of males dying from COVID-19 at higher rates and at systematically younger ages relative to females. The U.S. COVID-19 epidemic also offers lessons underscoring the importance of a public health environment that recognizes sex-specific needs as well as different patterns in risk factors, health behaviors, and responses to interventions between men and women. Public health strategies incorporating focused efforts to increase COVID-19 vaccinations among men are particularly urged.

A Comprehensive 16-Year Analysis of National Center for Health Statistics Data on the Top Three Causes of Death Before Age 75 by Sex, Race, and Hispanic Origin

“…The sex disparities in YPLL rates align with earlier studies highlighting that males generally experience higher premature mortality rates than females. This phenomenon is attributed to differences in health behaviors, healthcare utilization, and the prevalence of specific diseases [5,[10][11]. Our study reinforces the need for sex-specific health promotion strategies and interventions tailored to address the unique health challenges faced by men.…”

Assessing sex differential in COVID-19 mortality rate by age and polymerase chain reaction test results: an Iranian multi-center study

“…In a study by Griffith et al, the role of these factors on men’s health was reported [ 49 ]. In other studies, the effect of behavioral and social differences between men and women as contributing to the disparities in COVID-19 mortality by sex was investigated [ 50 , 51 ]. However, due to insufficient available data in our study, the effect of these factors on the difference in mortality between men and women was not investigated.…”