Deadly distribution: Why are men more likely to die of Covid?

But a new study analysing sex differences in COVID-19 deaths over time in the United States suggests that the picture is much more complicated. While men overall died at a higher rate than women, the trends varied widely over time and by state, the study found. That suggests that social factors like job types, behavioural patterns and underlying health issues played a big role in the apparent sex differences, researchers said.

“There is no single story to tell about sex disparities during this pandemic, even within the United States,” said Sarah Richardson, director of the GenderSci Lab at Harvard University, which studies how biological sex interacts with cultural influences in society.

Dr. Richardson’s team began collecting sex data on COVID cases and deaths early in the pandemic, before the Centers for Disease Control and Prevention began collecting and sharing this information. Her research group logged on every Monday morning and checked each state’s data, maintaining it on a tracker on the lab’s website. The tracker, which stretches from April 2020 through December 2021, is the only source of sex-based weekly COVID-19 data by state. That data enabled the researchers to analyse COVID case rates and deaths across all 50 states and Washington, D.C. over a period of 55 weeks.

Nationally, they found no significant differences in case rates between men and women. But the death rates the number of deaths among men or women divided by the state’s total population of each sex  were often higher among men than women. Just how much higher depended on the state and the date. In Texas, for example, men died at a notably higher rate in every week the research group analysed. In New York, men died at a higher rate than women although the gap was not quite as large as in Texas  during all but three weeks. But in Connecticut, women died more than men in 22 of the weeks analysed. “You can have states right next door to each other, like Connecticut and New York, that have a different pattern but yet experienced the same wave,” Dr. Richardson said.

Cumulatively over 55 weeks, mortality rates were slightly higher for women in two states, Rhode Island and Massachusetts. In nine states, including Connecticut, the rates were roughly equal. And in the rest of the country, death rates were higher for men.

Sex differences in genes, hormones or immune responses are not likely to explain these differences, the researchers said. “There would be no reason for biology to be that variable across time and space,” said Katharine Lee, a biological anthropologist and engineer at Washington University in St. Louis and an author of the new study.

But social and behavioural factors, the researchers said, could help explain many of these patterns. For example, men are more likely to have jobs in transportation, factories, meatpacking plants, agriculture and construction  occupations with higher rates of COVID-19 exposure and fatalities. Men are also more likely to be incarcerated and to experience homelessness, increasing their risk of virus exposure.

Women are more likely than men to report hand washing, mask wearing and complying with social distancing restrictions, all of which may lower their risk of contracting the virus. And women are more likely to be vaccinated. Still, independent experts said the new findings should not lead researchers to entirely discount the role of biology.

The writer is a journalist with NYT©2022

The New York Times