It is commonly known that women live longer than men. American women’s life expectancy is 80.2 years versus 74.8 for men, according to the Centers for Disease Control and Prevention.

There are multiple reasons women tend to live longer: Men often take bigger risks, work more dangerous jobs, have a higher suicide rate, experience more social isolation, avoid doctors, and are 50% more likely than women to die of heart disease at a younger age.

But recent research also reflects that men are more likely to get sick with three common diseases—and are less likely to seek care for them.

In a study published in the journal PLOS Medicine, researchers aggregated health data for men and women from 204 countries for three conditions: hypertension, diabetes, and HIV and AIDS. They compared disease rates and differences in diagnosis and treatment, and found that males had higher rates of disease and mortality compared to females—and in some countries, men were less likely to seek out health care and stick to treatment. This presents a double burden for men, who face greater risk for disease and mortality, while also experiencing lower rates of necessary treatment.

“Such data can reveal where the health journeys of men and women diverge, be it in relation to the risk factors they are exposed to, their health care seeking behaviors or their experiences in health care systems,” co-authors Kent Buse and Sarah Hawkes said in a press release. “That is an important first step towards health equity.”

The findings

Researchers found that across the three different diseases, prevalence and mortality rates were often higher among men. In 56% of the countries (114), there was a significantly higher prevalence of HIV among men compared to women, and men were more likely than women to die from AIDS in 131 countries (64%).

In over half of the countries (107), hypertension death rates were higher among men, despite the fact that males and females had similar prevalence of hypertension globally, apart from eight countries.

Similar observations were found for diabetes. Researchers wrote that there were no significant sex differences in most countries for diabetes prevalence, although rates were higher in 30% of the countries. But diabetes mortality was significantly higher for men in nearly half of the countries (100).

Why some rates of disease and death are higher in men

One of the contributing risk factors could be that smoking rates among males are significantly higher than in females in 86% of the countries (176) included, researchers noted. But the study authors believe it goes deeper than that.

“Most of these differences are not explained by sex (biology) alone, but by socially-constructed gender—highlighting the importance of taking a gender justice approach to reducing health inequities,” Buse and Hawkes said.

In exploring the potential contributing factors to their findings, the authors pose questions like:

“Are men subject to the constructions of masculinities that often discourage prevention and care-seeking, presenting later in the disease progression at health facilities compared to women (and hence more at risk of mortality from the diagnosed disease)?”

According to the CDC, men are 50% less likely than women to seek medical attention. One survey from the Cleveland Clinic found that 65% of men stated they avoid seeking medical attention for as long as possible, claiming they were too busy, believed ailments would heal by themselves, and/or felt that it made them appear weak.

Along with the barriers that gender norms present, men appear to be less informed about disease warning signs, according to one study—with awareness of symptoms and the importance of early medical intervention consistently being lower in men compared to women.

Additionally, the authors speculate that some causes of women’s deaths are being underreported or misattributed.

Overall, the authors push for greater gender-specific care, as they ask, “Are there biological reasons why males have a higher mortality rate from diabetes compared to females—and, if so, does this warrant sex-specific clinical guidelines?”

They suggest that public health professionals need to develop methods that encourage men to seek out and adhere to disease prevention and treatment.

“The absence of gender-responsive policies in many areas of health results in gender-based inequities, from risk exposure to care cascades that are not being adequately addressed in many settings,” the authors write. “Acknowledging and addressing the unique health needs of women, men, and gender-diverse people through gender-responsive interventions is needed if we are to reduce health inequities across the whole population.”