Men Died From Covid-19 at Much Higher Rate Than Women During the First Year of Pandemic

Men died of complications from Covid-19 at a higher rate than women in both rural and urban parts of the U.S. during the first year of the pandemic, according to a new federal report. 

The report, published Tuesday by the National Center for Health Statistics, examined Covid-19 deaths by sex and age group for 2020, when the virus became the third-leading cause of death in the U.S. and before vaccines against it became widely available.

Data revealed death rates were at least 50% higher for males compared with females. The greatest difference between the genders was found in so-called large central metropolitan areas, where Covid-19 death rates were 78% higher for males, according to the report from the NCHS, part of the Centers for Disease Control and Prevention.

Researchers have previously noted the higher rate of Covid-19 deaths among men compared with those experienced by women. Scientists say there are many reasons for the disparity, including health problems such as high blood pressure and diabetes that men tend to have more often, which could lead to worse Covid-19 outcomes. Researchers have also identified potential biological factors, including women’s more able immune systems. Lastly, research has shown men are more prone to lax mask-wearing habits and delaying medical care.

While the report Tuesday focused on Covid-19 deaths in 2020, there may be similar differences in Covid-19 death rates between the sexes in the years that followed, said Ajay Sethi, an associate professor of population health sciences at the University of Wisconsin-Madison focused on epidemiology and infectious diseases.

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“What continues to be worrisome is that males are on average less likely to be up-to-date on Covid-19 vaccination,” Dr. Sethi said. “Given their greater underlying risk for dying from Covid-19, we can expect to continue to see differences in Covid-19 mortality by sex.”

An art installation last year in Washington, D.C., commemorated those who had died of Covid-19 in America.

Photo: Jose Luis Magana/Associated Press

Since the pandemic began, more than 1.06 million Covid-19 deaths have been recorded in the U.S., according to data compiled by Johns Hopkins University. Deaths from the disease have also disproportionately affected vulnerable seniors and minority populations . Excess deaths—including those resulting from healthcare disruptions—highlight the pandemic’s sweeping toll .  

The study classified U.S. counties in six categories ranging from the most urban—what researchers called large central metropolitan—to the most rural, or noncore. 

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Among people living in large central metropolitan areas, the Covid-19 death rate in 2020 for males under the age of 65 was close to twice that for females, NCHS researchers said in Tuesday’s report. The death rate for males age 65 and older living in large central metropolitan areas was about 50% higher than for females in the same age group and area, they said.

Researchers found a significant rural and urban divide between the two sexes. Men had the highest death rates in urban areas, while women had the highest death rates in rural areas.

Data showed that the highest death rates for men under the age of 65 were in the most urban areas—at 41.5 per 100,000 deaths. For women under 65, those in the most rural areas had the highest Covid-19 death rates, with 24.2 per 100,000 deaths.

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For both men and women, death rates were lowest in smaller urban areas, according to the NCHS researchers. This includes areas they defined as large fringe metropolitan and small or medium metropolitan areas. 

Since 2020, Covid-19 vaccines that prevent severe illness and death have become widely available across the U.S. Federal health regulators recently authorized the use of new Covid-19 vaccines designed to target recent versions of the Omicron variant. White House officials have started to recommend most Americans receive annual Covid-19 booster shots , similar to a yearly flu shot. 

Write to Talal Ansari at [email protected] and Jennifer Calfas at [email protected]