The business of adding actuarial science to insurance underwriting goes back as far as the late 17^th century and included the production of life tables, the application of compound interest, as well as calculating the present value of the future liability – the very foundation of life insurance premiums as we know them.

So, what does all of this have to do with gender? Well, in the early days, not very much. Actuaries of the time had their hands quite full wading through individual birth and death records to calculate premiums based on the risk factor that remains of utmost importance even today, the age of the person being insured. At that time, no distinction was made between women and men and, as a result, unisex insurance pricing was the norm.

However, around 1880, the rate of male mortality began to rise causing insurance brokers to reflect those differences in the pricing of life insurance rates (1). This mortality/gender gap is especially evident in those that are older: 57% of all those aged 65 are female and by age 85 women constitute 67% of the population (2). And in Canada, women, on average, live 4 years longer than men (3). So, shouldn’t men be paying more for their life insurance? While in Canada that is typically the case with most life insurance policies, it is not the universal view. For example, since 2012, the European Union has prohibited pricing based on gender for life, health and even auto insurance (4). Perhaps this evokes a question of fairness… should a lower risk group, in this case women, subsidize the higher-risk group, male policyholders?

The question of why women outlive men, at least on average, continues to be a hot topic. Early observations have concluded that smoking and cardiovascular disease are the male culprits, but these days we also possess a deeper understanding of the role of stress, as well as the behavioural and cultural patterns, that may predispose men to take more risks, drink more alcohol and seek medical care less often. The latter point is particularly harmful as although women are often thought to be diagnosed with depression more often, men generally have much higher suicide rates (5).

This was highlighted most recently when United States Senator John Fetterman was hospitalized voluntarily for depression, drawing praise for making his struggle with mental health public (6). Compare this with 1972 United States senator and Vice-Presidential candidate Thomas Eagleton, who dropped from the ticket a week after disclosing his treatment for depression in the past – two very different stories indeed (7).

The fact remains that today’s discussions on gender run deeper than the traditional female-male divide. New perspectives on gender identity, roles and their impact on health bring new understanding and continue to evolve.