Is the male disadvantage real? Cross-national variations in sex gaps in COVID-19 incidence and mortality

Heeun Kim, Ashley M. Fox, Younhee Kim, Ryung Kim, Green Bae, Minah Kang

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Although the excess male mortality from COVID-19 is well-known, the variations in sex gaps in incidence and mortality across countries and the sources of such variations are not well understood. This study explored the patterns and the sources of variation in the sex gap in COVID-19 incidence and mortality rates across 100 countries where sex-disaggregated cases and deaths were available as of September 2020. Our results show that there is generally a male disadvantage in both incidence and mortality; however, COVID-19 incidence exhibited a lower male disadvantage (1.2 times higher risk for males) than COVID-19 mortality (1.5 times higher risk for males). The extent of male disadvantages in COVID-19 outcomes across countries varied by societal gender inequalities and behavioural factors. Greater gender equality, both socially and behaviourally, was associated with more equal COVID-19 incidence and mortality between men and women. The findings imply that male disadvantages in COVID-19 outcomes, particularly incidence, are socially determined, whereas further investigation is needed to understand behavioural and biological elements yielding a male disadvantage in mortality.

Original languageEnglish
Pages (from-to)1793-1803
Number of pages11
JournalGlobal Public Health
Issue number12
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.


  • COVID-19
  • gender inequalities
  • incidence
  • male disadvantages
  • mortality
  • sex gap


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