The United States is 25 years into a large‐scale drug overdose epidemic, yet its consequences for gender differences remain largely unexplored. This study finds that drug overdose mortality increased seven‐ and fivefold for men and women, respectively; accounts for 0.8‐year (men) and 0.4‐year (women) deficits in life expectancy at birth in 2017; and has made an increasing contribution (from 1 percent to 17 percent) to women's life expectancy advantage at the prime adult ages between 1990 and 2017. I document a distinctive cyclicality to sex differences in drug overdose. During the epidemic's early stages—the heyday of prescription opioids—gender differences narrowed, but once the epidemic transitioned to illicit drugs in 2010, gender differences widened again. This pattern holds across racial/ethnic groups, and in fact may be even stronger among Hispanics and non‐Hispanic blacks than among non‐Hispanic whites. That we observe this gender dynamic across racial/ethnic groups is surprising since very different trends in drug overdose mortality have been observed for whites versus other groups. The contemporary epidemic is a case of dynamic change in gender differences, and the differential mortality risks experienced by men and women reflect gendered social norms, attitudes toward risk, and patterns of diffusion.

中文翻译：

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药物过量死亡率的性别趋同和差异周期

美国已进入大规模药物过量流行 25 年，但其对性别差异的影响在很大程度上仍未得到探索。该研究发现，男性和女性的药物过量死亡率分别增加了 7 倍和 5 倍；2017 年出生时预期寿命分别为 0.8 年（男性）和 0.4 年（女性）；并在 1990 年至 2017 年期间对成年女性的预期寿命优势做出了越来越大的贡献（从 1% 到 17%）。我记录了药物过量的性别差异的独特周期性。在流行的早期阶段——处方阿片类药物的鼎盛时期——性别差异缩小了，但一旦流行病在 2010 年转变为非法药物，性别差异再次扩大。这种模式适用于所有种族/族裔群体，事实上，在西班牙裔和非西班牙裔黑人中可能比在非西班牙裔白人中更强。我们观察到这种跨种族/族裔群体的性别动态令人惊讶，因为在白人与其他群体中观察到的药物过量死亡率趋势非常不同。当代流行病是性别差异动态变化的案例，男性和女性所经历的不同死亡风险反映了性别化的社会规范、对风险的态度和传播模式。