Men aged 50 years and above may have a significantly higher risk of death than women of the same age group, partly due heavier rates of smoking and heart disease in men, according to a large study of people in 28 countries.
However, the research published in Canadian Medical Association Journal found that the gap in mortality risk among men and women varied across countries.
"Many studies have examined the potential impact of social, behavioural and biological factors on sex differences in mortality, but few have been able to investigate potential variation across countries," said Yu-Tzu Wu, from the King's College London, and Newcastle University in the UK.
"Different cultural traditions, historical contexts, and economic and societal development may influence gender experiences in different countries, and thus variably affect the health status of men and women," said Wu.
The research examined different socioeconomic, lifestyle, health and social factors that might contribute to the mortality gap between men and women aged 50 and older.
The data included over 179,000 people across 28 countries and more than half -- 55 per cent -- were women.
The study found that men aged 50 and over had a 60 per cent greater risk of death than women, partly explained by heavier rates of smoking and heart disease in men.
"The effects of sex on mortality should include not only physiologic variation between men and women but also the social construct of gender, which differs across societies. In particular, the large variation across countries may imply a greater effect of gender than sex," Wu said.
"Although the biology of the sexes is consistent across populations, variation in cultural, societal and historical contexts can lead to different life experiences of men and women and variation in the mortality gap across countries," Wu added.
The researchers noted that the findings are consistent with the literature on life expectancy and death rates.
"The heterogeneity of sex differences in mortality across countries may indicate the substantial impact of gender on healthy aging in addition to biological sex, and the crucial contributions of smoking may also vary across different populations," the authors of the study noted.
The team recommends that public health policies should account for sex- and gender-based differences and the influence of social and cultural factors on health.