The Real Health Gap: Why Men Die Younger and Live Fewer Healthy Years

Over the past few years, the idea of a “women’s health gap” has gained momentum across consulting reports, media, pharma, and policy. The narrative suggests that women are systematically underserved in healthcare, live with more illness, and therefore require urgent targeted investment to correct a structural imbalance.

But when we examine the complete data, a very different picture emerges.

In fact, the most consistent and well-documented health gap is not one harming women, but one harming men.

This is not about minimising the importance of women’s health research. Women’s health has real and legitimate under-addressed clinical needs. But the way the “women’s health gap” story is being told is incomplete. And, in some cases, it is simply based on selective interpretation of the data.

If we are going to improve health outcomes for everyone, we need to start from accuracy, not narrative.

Women Live Longer. And They Live More Healthy Years.

The commonly repeated statistic behind the “women’s health gap” is that women spend about 24 percent more time living with chronic illness or disability than men. This figure comes from a standard global health metric called Years Lived With Disability (YLDs).

But there is a basic problem here - Women live longer.

If you live longer, you naturally accumulate more years experiencing any medical condition. This is a simple effect of lifespan, not neglect.

When we use the correct metric, Healthy Life Expectancy (HALE), the picture changes.

Across the U.S., Canada, and Europe:

• Women live 4 to 6 years longer than men.

• Women live about 2 more years in good health than men. 

• Men lose more life years, not women.

So the idea that women are overall “sicker” is misleading. Women live longer and healthier on average. The difference is that women experience more non-fatal chronic conditions, especially in later life, because they live into later life.

The Research Funding Claim Relies on Flawed Categories

A-peer-reviewed paper in 2021 has been widely cited to argue that diseases affecting women are “underfunded”. But a closer look reveals the conclusion is an artifact of its methodology.

First, the study’s conclusion is not based on the full NIH portfolio of nearly 300 diseases. It is based on a small, selective sample of just 74 diseases where the NIH had successfully aligned funding and burden data. This convenience sample is hardly representative of all biomedical research.

Second, the paper classifies diseases as "male-dominant" or "female-dominant" based on an arbitrary 60% prevalence threshold. The author explicitly states this method "does not consider whether a disease more adversely affects a particular gender".

This methodological choice has massive consequences.

• Coronary Heart Disease, which kills men at a far higher and earlier rate, is classified as "gender-neutral" simply because its prevalence is balanced.

• Prostate cancer is listed as "male-dominant" and breast cancer as "female-dominant". Yet the NIH’s own data shows breast cancer receives $709 million in funding to prostate cancer’s $263 million (based on the 2019 data used in the paper)—a nearly 3-to-1 difference in favor of the female-dominant disease.

The study's final conclusion of a "male-favored" bias is only reached by offsetting this massive funding for breast cancer against a long list of lower-funded, female-prevalent conditions (like migraine and ME/CFS).

The result is not evidence of a structural disadvantage for women.

It is an outcome of how the variables were selected and defined.

The Overlooked Problem: Men’s Health

Here are the most stable, consistent, and globally replicated statistics in public health:

These are not marginal effects. They are structural. Yet:

• There is no NIH or national equivalent “Men’s Health Research” funding category (compare the mandated Office of Research on Women's Health to the lack of a men's office).

• No coordinated men’s health policy framework

• Very limited awareness campaigns

• Very limited clinical engagement until disease is already advanced

So while women’s health has a defined institutional identity, men’s health is largely invisible as a policy category.

This is the real gap.

And it is costing men their lives.

A Better Way to Think About Health Equity

The issue is not whether women or men have it worse.

Both face distinct medical challenges.

The problem is framing health as an identity competition, where one sex must be positioned as disadvantaged to justify investment. That narrative encourages selective evidence use and prevents us from addressing actual clinical needs.

A better approach is simple:

• Recognise sex differences in biology without politicising them

• Fund research based on disease burden and preventability, not messaging

• Expand both women’s health research and men’s health research

• Shift from rhetorical “gaps” to measurable health outcomes

Because the real goal is not to win a narrative.

It is to improve lives.