Gender differences in countries' adaptation to societal ageing: an international cross-sectional comparison

Background: Gender differences in life expectancy and societal roles have implications for a country's capacity to support its older population. Specifically, the longevity risk associated with longer life expectancy of women, with greater risk of morbidity entails different needs between genders in older age. We aimed to quantify gender differences in the ageing experience of older people in Organization for Economic Cooperation and Development (OECD) countries as a first step in identifying policy gaps and differences in the allocation of resources and social support for older men and women. Methods: We constructed a multidimensional Ageing Index to account for gender differences in societal ageing, using mostly gender-disaggregated latest available data between 2015 and 2019, for 18 OECD countries. Our Ageing Index is a weighted sum of scores for five domains, which consisted of various measures, that are important for societal ageing: wellbeing, productivity and engagement, equity, security, and cohesion. The construction of the domains and their relative weighting was determined by the Research Network on an Ageing Society, an interdisciplinary group of academics. We computed the overall index and domain scores (from 0 to 100) for each gender and compared these scores between genders and countries. Findings: In every country, gender differences in key domains of societal ageing favour men. Countries in northern Europe (ie, Denmark, Sweden, Finland and Norway), the Netherlands, and Japan had high overall Index scores for both genders, whereas many eastern and southern European countries (eg, Hungary, Poland, and Slovenia) performed less well. Countries with the largest gender difference in Index scores include the Netherlands, Germany, and Italy, whereas Ireland, Spain, and Poland had the smallest difference. Gender differences were present for the domains of productivity and engagement, security, and cohesion. Gender differences favoured men for domain productivity and engagement (mean 10·2, 95% CI 7·8–12·6; p<0·0001), security (10·3, 7·8–12·7; p<0·0001), and cohesion (21·1, 13·9–28·1; p<0·0001). Although the domains of wellbeing and equity showed more mixed results, they nonetheless showed a slight advantage for men. Interpretation: Our multidimensional index helps to identify specific gender differences along key domains of societal ageing in various OECD countries. Furthermore, the inter-country comparisons reveal those countries with more successful societal ageing, which could be instructive for policy makers. Funding: John A Hartford Foundation and the Singapore Ministry of Education.