The Brutish and Short Arm of Adolescence: Sex Differences in U.S. Adolescent and Young Adult Mortality

Elizabeth Lawrence , University of Nevada, Las Vegas
Richard G. Rogers, University of Colorado Boulder
Robert Hummer, University of North Carolina at Chapel Hill

U.S. women live longer than men due to a range of social, psychological, behavioral, and health factors. Prior research has largely focused on health behaviors as particularly risky for males and socioeconomic status as a risk factor for females in shaping sex differences in mortality. However, this research has largely focused on mortality during mid- and older-adulthood, with most deaths occurring at older ages. This study focuses on sex differences in mortality among U.S. adolescents and young adults, ages 12-46. We employ Cox proportional hazard models and data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), which was recently linked to mortality records through 2021. The hazard of dying is much greater (HR=1.69; p<.001) for males compared to female adolescents and young adults, with larger disparities for external compared to internal causes of death. Results show that sex differences in mortality are reduced but persist when controlling for childhood experiences, health behaviors, risky behaviors, and social ties. The relatively poor mental and physical health of females suppresses the differences; that is, sex differences in mortality would be even larger were it not for the poorer mental and physical health of young females compared with males. The findings point to adolescent factors that, if changed, could reduce mortality for both U.S. males and females, while reducing sex differences in mortality among younger adults. Such changes could contribute to increased life expectancy of the general U.S. population, and to reductions in mortality and sex differences at older ages.

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 Presented in Session P2. Health, Mortality, Ageing - Aperitivo