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Sex Differences in U.S. Adolescent and Young Adult Mortality
Elizabeth M Lawrence1, Richard G Rogers2, Robert A Hummer3
1University of Nevada, Las Vegas.
Population Research and Policy Review
|October 27, 2025
Summary
Male adolescents and young adults face a significantly higher mortality risk than females. Addressing health behaviors and social factors could reduce these disparities and improve overall U.S. life expectancy.
Area of Science:
- Public Health
- Demography
- Sociology
Background:
- U.S. females exhibit longer life expectancies than males, influenced by social, psychological, behavioral, and health factors.
- Previous research on sex differences in mortality primarily focused on mid- to older-adulthood, overlooking adolescent and young adult populations.
Purpose of the Study:
- To investigate sex differences in mortality among U.S. adolescents and young adults (ages 12-46).
- To identify factors contributing to these sex-based mortality disparities and explore potential interventions.
Main Methods:
- Utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health).
- Linked Add Health data with mortality records through December 2021.
- Employed Cox proportional hazard models to analyze mortality risk by sex.
Main Results:
- Males exhibited a significantly higher hazard of dying (HR=1.69) compared to females in adolescence and young adulthood.
- Mortality disparities were more pronounced for external causes of death than internal causes.
- Controlling for various factors (childhood experiences, health behaviors, social ties) reduced but did not eliminate sex differences in mortality.
- Poorer mental and physical health in young females partially suppressed the observed sex differences in mortality.
Conclusions:
- Significant sex differences in mortality exist in young U.S. populations, with males at higher risk.
- Interventions targeting identified risk factors could decrease mortality for both sexes and narrow the mortality gap.
- Reducing early-life mortality disparities may contribute to increased U.S. life expectancy and reduced sex differences in mortality at older ages.
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