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OKUMU: Levelling the playing field: How social factors impact longevity gap

By understanding social determinants, we can develop targeted strategies to bridge the longevity gap.

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by Josephine Mayuya

Opinion16 April 2024 - 05:30
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In Summary


  • Traditional notions of masculinity discourage men from seeking preventive care or admitting vulnerability, leading to delayed diagnoses and treatment.
  • Education campaigns targeted at all genders can empower individuals to make informed choices about their health.

When women lack control over their lives and bodies, their overall well-being suffers. Here's the twist, despite these societal disadvantages, a paradox emerges: on average, women live longer than men globally. This fact underscores the need to examine the social determinants of health.

The pursuit of a healthy life is a universal human desire. Across the globe, advancements in medicine have dramatically extended lifespans. Yet, a persistent puzzle remains despite these advancements— people's health outcomes vary greatly depending on where they are born and their socioeconomic background.

This disparity, known as health inequality, is a complex issue with profound consequences. It affects not just how long we live, but also the quality of life we experience.

Many disparities exist in the world when we consider many aspects of life in relation to gender, and most of us will agree that the score is largely in favour of the male gender. Liberal theory emphasises the importance of equal rights and freedoms for all individuals, regardless of gender.

Women often experience limitations on their economic and social mobility. They may earn less than men for the same work, have fewer opportunities for education and advancement and face societal pressures that restrict their choices.

Feminist theories further illuminate these inequalities. Concepts like patriarchy, which posits a social system where power rests primarily with men, help explain why women might experience higher stress levels, chronic health problems and even violence.

When women lack control over their lives and bodies, their overall well-being suffers. Here's the twist, despite these societal disadvantages, a paradox emerges: on average, women live longer than men globally. This fact underscores the need to examine the social determinants of health.

Health inequality refers to the unfair and avoidable differences in health outcomes experienced by different groups of people. These disparities can be influenced by a variety of factors, but increasingly, social determinants of health are recognised as playing a major role.

Social determinants encompass everything from socioeconomic status, education level and access to healthcare to factors like neighbourhood safety and social support networks. They shape the conditions in which people live, work and age, ultimately impacting their health and well-being.

One such striking example of health inequality is the gender gap in life expectancy. Globally, according to the World Health Organization (WHO), in 2020, women on average could expect to live 75.6 years, while men lagged behind at 70.2 years [WHO Life Expectancy and Healthy Life Expectancy Data by Country 2020]. This gap persists across continents, with developed countries showing a smaller gap (around five years) compared to low- and middle-income countries (around eight years) [WHO Global Health Observatory data repository].

While biology undoubtedly plays a part, a closer examination reveals a story largely driven by social forces. Let's delve deeper into how these social determinants contribute to the longevity gap and explore ways to bridge this divide.


Beyond Genes: Understanding the social context

While hormonal and genetic factors contribute, social influences have a significant impact. Men are more likely to engage in risky behaviours, such as smoking and excessive alcohol consumption. Additionally, traditional notions of masculinity can discourage men from seeking preventive care or admitting vulnerability, leading to delayed diagnoses and treatment.

Furthermore, socioeconomic disparities often disproportionately affect men. Jobs demanding physically strenuous labour can take a toll on health, and limited access to healthcare further disadvantages those with lower incomes. This complex interplay of socioeconomic factors, like lower income and education levels, can limit access to healthcare and a good understanding of healthy habits.

Furthermore, men employed in physically demanding jobs or facing financial insecurity might prioritise working long hours over preventive healthcare. Unequal access to healthcare creates further disparities, with men less likely to visit doctors for checkups and screenings.

By understanding these social determinants, we can develop targeted strategies to bridge the longevity gap and create a healthcare system that better supports the health of all genders.

Closing the gap: A focus on equity

This is not a competition between genders. Recognising the gender gap in life expectancy allows us to work towards health equity for all.

Here's how:

  • Promoting healthy habits: Education campaigns targeted at all genders can empower individuals to make informed choices about their health.
  • Destigmatising mental health: Openly discussing the importance of mental well-being and encouraging men to seek help is vital.
  • Workplace wellness: Encouraging healthy work practices that prioritise work-life balance and readily available preventive health screenings can significantly benefit men's health.

Towards a healthier future

It’s very rare to find an aspect of life in which women can say they have a clearer advantage over their male counterparts. Life expectancy just happens to be one of them. By understanding the social factors impacting men's health, we can create a healthcare system that is more responsive to their needs.

This isn't about diminishing the biological factors, but rather acknowledging the powerful role social determinants play. Closing the longevity gap isn't a zero-sum game; it's about creating a future where all genders can thrive and reach their full health potential.

The global health landscape is constantly evolving, but one thing remains constant: everyone deserves the opportunity to live a long and healthy life. Addressing health inequality requires a multi-faceted approach that tackles the social determinants impacting health outcomes.

I have focused on gender today, but so many other inequalities exist in the world we live in. By dismantling these barriers and ensuring equitable access to healthcare, we can move towards a future where health is not a privilege, but a right enjoyed by all.

Orthopaedic surgeon and a 2024 Global Surgery Advocacy Fellow 

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