Research

Are men more likely to die from COVID-19?

The substantial variation across countries of women’s participation in the workforce has largely been ignored. To date, the fact that the percentage of female deaths due to COVID-19 varies considerably across countries has also been overlooked.

Since the start of the pandemic, there has been a widely held belief that the COVID-19 virus is more dangerous for men than women. 

In Europe, the World Health Organization reports that 70% of all intensive care admissions related to COVID-19 were men, with men accounting for 57% of all deaths. Research published in March by the BMJ found that the proportion of COVID-19 deaths is higher in men across China, Iran and South Korea; and data collated by Global Health 50/50 shows that, in the vast majority of countries, men are consistently dying at a higher rate than women.

Various theories have been put forward as to why this is, with arguments focusing on biological or genetic differences between men and women and gender differences in behaviour. Suggestions have ranged from men being more likely to have pre-existing conditions that can make COVID-19 more dangerous (research has indicated that men have higher concentrations of an enzyme which enables the coronavirus to infect healthy cells in their blood) to typical ‘male behaviour’ potentially increasing men’s exposure to the virus.

Going to work has also been associated with increased exposure to the virus, with the closing of non-essential businesses playing a key role in most countries’ efforts to combat the spread. However, in the great COVID gender debate, the substantial variation across countries of women’s participation in the workforce has largely been ignored; To date, the fact that the percentage of female deaths due to COVID-19 varies considerably across countries has also been overlooked.

Could gender difference in COVID-19 deaths be linked to gender differences in work patterns?

My research has shown that the difference in numbers of COVID-19 deaths between men and women across the world is closely related to the split of men and women in the workforce. In Portugal, 50% of deaths were women, and 45% of the country’s workforce is female; In Mexico, where less than 30% of the workforce is female, 35% of deaths were women. Further analysis shows that these results are not driven by differences in age distributions across countries.

There is also a stark difference in the number of female deaths between US states, with the percentage of female deaths due to COVID-19 ranging from 39% in North Carolina to 55.6% in Alaska. Since the argument that biological sex differences vary considerably across countries and US States is presumably indefensible, this variation challenges the idea that the only reason women fare better than men in the coronavirus crisis is because of innate biological or behavioural differences.

Countries with a higher percentage of women in the workforce have more female medical professionals, which in turn correlates with a greater frequency of serious complications among cases of the virus in females. This lends support to the idea that women’s share of COVID-19 deaths increases when they are subject to greater occupational health risks and greater exposure to the virus.

Policy-makers and researchers should be careful to consider social factors when using gender differences in COVID-linked mortality rates as a justification for action.

Future research should be careful to consider social factors when examining gender differences

These findings serve as a starting point for further research into social dimensions related to COVID-19.  Given the rapidly evolving nature of the pandemic and the resulting data, it is possible that further research will uncover factors that moderate the relation between women’s workforce participation and their death rates due to COVID-19; However, it seems unlikely that these would be biological factors.

Policy makers and researchers, therefore, should be careful to consider social factors when using gender differences in COVID-linked mortality rates as a justification for action. On the understanding that men have been dying at higher rates from the virus alone, Italian officials have discussed asking women to return to work earlier than men. Researchers working with the NHS are now investigating hormone therapies and their effect on COVID-19, and are exploring whether administering oestrogen to men will afford them the same alleged immunity to COVID-19 as women.  

Treatment and policies to combat the virus should be gender neutral. In countries with more gender-equal workforces and societies, gender equality in policies can help reduce female deaths. In countries with less gender-equal societies, women often experience a poorer quality of life than men, and it’s crucial that the lower mortality rates for women in such countries are not used as an excuse to discriminate further.