COVID-19 Increased Existing Gender Mortality Gaps in High-Income Countries More Than in Middle-Income Countries

Men die at higher rates in nearly all places and at all ages beyond age 45. Using World Health Organization excess mortality estimates by sex and age groups for 75 countries in 2020 and 62 countries in 2021, this paper analyzes how patterns of excess mortality varied by sex and age groups across countries during the COVID-19 pandemic and their association with country income level. In 2020, the pandemic amplified the gender mortality gap for the world, but with variation across countries and by country income level. In high-income countries, rates of excess mortality were much higher for men than women. In contrast, in middle-income countries, the sex ratio of excess mortality was similar to the sex ratio of expected all-cause mortality. The exacerbation of the sex ratio of excess mortality observed in 2020 in high-income countries declined in 2021, likely as a result of the faster rollout of vaccination against COVID-19.