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Societies make ageing more difficult for women than men, new study finds

A study of 18 high-income countries reveals systematic gender biases in the ageing experience that perpetuate inequalities for women in later life.


Societies make ageing more difficult for women than men, new study finds

A new study has found gender differences in societal ageing favour men over women, and suggests that men have better resources to help them cope with the challenges of ageing.

The international analysis, published in The Lancet Healthy Longevity journal, is the first of its kind to investigate gender differences in the ageing experience of older people across 18 high-income countries.

The study reveals that different gender roles in society not only shape women’s and men’s lifetime opportunities, but also their experience of ageing. Men are especially advantaged in income and wealth, are much more likely to be financially secure, be engaged in paid work, and spend fewer years in ill health than women in later life.

Worldwide, the number of people aged 65 years and older is expected to more than double in the next 30 years, rising from 703 million in 2019 to 1.5 billion in 2050.

While women in high-income Organization for Economic Cooperation and Development (OECD) countries have an average life expectancy that is over three years longer than men, they spend more years in poor health. Although most OECD countries have achieved universal health coverage, the disproportionately greater risk of disability and ill health in women increases their likelihood of needing long-term care. Women also earn less and are more likely to live alone at the end of their lives.

Dr Cynthia Chen from the National University of Singapore in Singapore, and lead author on the report, said ageing societies reinforce the prevailing gender norms in which men continue to be allocated the majority of opportunities, resources, and social support.

“With the world's population ageing at an unprecedented rate, and the ratio of older women to older men expected to increase, there is an urgent need to challenge the structural and policy biases that favour men.”

The countries in the study varied widely in their policies and services to support the wellbeing of older people, but little is known about the differences in the ageing experience for men and women, despite the substantial gender differences in life expectancy and societal roles.

Professor John Rowe from Columbia University, USA, said there was “ample room” for improving women’s standing in paid work, job opportunities, and retirement income.

“Addressing these gender disparities will not only benefit society by increasing women’s long-term savings and old-age security, but may also enable women to live longer independently and in better health. And could have positive knock-on effects for the next generation by reducing the burden of unpaid informal caregiving by younger women.”

To address this, researchers used the latest available data from the OECD and World Bank between 2015 and 2019 for 18 of the 35 OECD countries with sufficient data, to develop a gender-specific ageing index to estimate the degree to which a society enables successful ageing for men and women.

The new index accounts for five domains that capture social and economic factors affecting the quality of ageing: wellbeing (living longer in good health and life satisfaction); productivity and engagement (engaging productively in society either through paid work or volunteering); equity (how equally resources are distributed across the older population, particularly money and education); cohesion (how well older people are integrated in societies, including the provision of social support and not living alone); and security (both financial security and the degree of physical safety perceived by older people).

The researchers calculated the overall index and individual domain scores (from 0 to 100) for men and women, and compared these scores between genders and countries, with a higher score indicating a successfully ageing society.

The findings suggest that gender differences in societal ageing favour men by an average of 9 points over women.

Overall, countries in northern Europe (ie, Denmark, Sweden, Finland, and Norway), the Netherlands, and Japan do well for both genders (overall index score 66 or above for men vs 55 or above for women), whereas countries in much of eastern and southern European are at the bottom of the rankings (eg, Hungary, Poland, and Slovenia, overall score 38 or under vs 31 or under). The USA’s overall performance is average (score 55 for men vs 47 for women), along with other industrialised western European nations, such as the UK (57 vs 47) and Germany (62 vs 51).

Countries with the biggest differences in scores between men and women were the Netherlands (overall index score 70 for men vs 55 for women), Austria (64 vs 51), Italy (51 vs 39), and Denmark (70 vs 59). Poland (overall index score 32 for men vs 29 for women), Spain (55 vs 51), and Ireland (62 vs 56) have the smallest difference between men and women.

The findings reveal that differences between men and women were largest for societal integration, including social support and living with others (the cohesion domain)—favouring men by an average of 21 points. This gender disparity is driven by women often outliving their partners and therefore living on their own towards the end of their lives, despite being more socially connected than men.

In contrast, gender differences in wellbeing and equity revealed a much smaller advantage for men, by an average of 1.5 and 3.5 points respectively. The UK (wellbeing score 74 for men vs 61 for women) and Italy (73 vs 64) had the largest difference in wellbeing scores, with scores favouring men. The largest gaps in equity scores were observed in Austria (equity score 79 for men vs 63 for women) and Germany (77 vs 67). Across countries, men were on average 5% less likely to experience poverty in later life than women. Western and northern Europe (ie, Norway, Denmark, Finland, the Netherlands, and Belgium) ranked highest for equity for both genders, reflecting strong welfare support, while the USA and the UK performed more poorly, indicating growing inequality in the distribution of income and wealth in these countries.

The authors propose four measures to help address gender bias and inequality in societal ageing, including assessing minimum income requirements for healthy living in older people and minimum pensions and income standards to remove barriers to health care. They also recommend addressing older adults’ social isolation to improve emotional and mental wellbeing, and introducing national policies to tackle the lower economic standing of older women (for example, by increasing pension benefits and providing tax incentives for older workers and their employers). Lastly, they suggest societies should tailor policies to different gendered experiences to improve societal welfare and reduce labour market inefficiencies (for example, by adopting flexible working hours to make it easier for women to work).

“Our findings underscore the importance of considering gender-specific needs when developing policies and programmes for ageing societies. Even the top-performing countries have considerable room for improvement,” says Dr Chen.

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