August 16, 2018 | News | New Publication
The survival advantage of women increases after a hospital stay
Men have a higher risk of death than women at every age. As people become old and sick, the gender gap in mortality doesn’t disappear. Instead, the absolute survival advantage of women actually becomes much larger.
That is the main finding of a new study that Andreas Höhn, demographer at the Max Planck Institute for Demographic Research (MPIDR), together with other researchers at the MPIDR und the University of Southern Denmark, have published in the open access journal BMJ Open.
To investigate whether and, if so, how experiencing a serious illness in the second half of life changes the survival advantage of women, the researchers analyzed the data of Danish women and men between the ages of 50 and 79, looking at whether they had died within a year of an in-patient stay in the hospital.
This happened to the men much more frequently than to the women. The excess mortality observed among these hospitalized men (i.e., their survival disadvantage) was, in absolute terms, even greater than it was in the general population:
Data: Danish Central Population Register linked with the Danish National Patient Register (using a five percent random sample of the Danish population)
Within a year after a stay in the hospital, 43.8 more men than women per 1,000 individuals aged 50 to 79 had died. By comparison, among members of the general population at the same ages, most of whom had not been admitted to the hospital in the past year, only 13.5 more men than women per 1,000 people had died over the same period.
Moreover, among the men in this age group who had not been hospitalized in the past year, the excess mortality amounted to just 6.6 deaths per 1,000 individuals.
The study also found that the survival disadvantage of the men intensified not just over the entire 50 to 79 age span, but at each individual age (see figure). At age 50, the morality risk of the men who had been hospitalized was 5.2 percent, compared to only around three percent for their female counterparts.
In the general population, the gender gap in the risk of death was much smaller, at 0.5 percent for men versus at 0.4 percent for women.
Women have the edge over men at every age
The older the women and men were, the greater the gender differences observed. By age 79 the mortality level had clearly risen for all groups, but so had the survival advantage of the women. The 79-year-old men who had been hospitalized in the previous year had a mortality risk of 26.6 percent, or seven percentage points higher than that of their female counterparts, who had a mortality risk of 19.1 percent. In the general population, the gender gap in mortality remained below four percentage points (9.3 percent for men and 5.6 percent for women).
Overall, Andreas Höhn and his colleagues found that in all population groups and at every age, men experienced higher mortality than women. They also reported that this general pattern applied to each individual cause of death they studied, including cancer and cardiovascular and respiratory diseases.
Men should visit the doctor more often
The reason why men have a greater survival disadvantage after a hospital stay is not related to having spent time in the hospital, study author Andreas Höhn believes. Instead, he argues, men can increase their survival chances not by avoiding hospitals and doctors whenever possible, but by seeking medical treatment earlier and more often.
Höhn speculates that because most men go to the doctor much less frequently than women, it is often too late when they finally decide to seek treatment. In many cases, the diseases men are diagnosed with are possibly at such an advanced stage that medical professionals can no longer do much to help them. As a result, men die more frequently than women.
Original publication: Andreas Höhn, Lisbeth Aagaard Larsen, Daniel Christoph Schneider, Rune Lindahl-Jacobsen, Roland Rau, Kaare Christensen, Anna Oksuzyan: Sex differences in the 1-year risk of dying following all-cause and cause-specific hospital admission after age 50 in comparison with a general and non-hospitalised population: a register-based cohort study of the Danish population, BMJ Open, DOI 10.1136/bmjopen-2018-021813