Why Mongolian Men Die Younger: A Roadmap to Bridge the Gender Life Expectancy Divide

A World Bank report reveals that Mongolian men live nearly a decade less than women due to high rates of risky behavior, limited health care access, and entrenched gender norms. It recommends targeted, cost-effective interventions to reduce smoking, alcohol use, suicide, and improve male-oriented health services.

A new World Bank report, produced in collaboration with the Centre for Health Development (CHD) and the World Health Organization (WHO), sheds light on one of the starkest gender-based health disparities in the world: men in Mongolia live nearly a decade less than women. Authored by Forest Jarvis, Hillary C. Johnson, and Maude Ruest, the report draws on both national data and international research to provide a comprehensive review of the crisis and a set of targeted interventions. While life expectancy in Mongolia has increased over the past decades, recent stagnation has left men with disproportionately shorter and more hazardous lives. Particularly troubling is the gender gap among working-age adults, with men aged 20 to 69 dying at rates two to three times higher than their female counterparts.

Noncommunicable diseases (NCDs) such as cardiovascular illnesses and cancer are the leading causes of death across both genders, but men experience higher rates of both. Accidental alcohol poisoning, almost entirely from liquor, ranks as the third most common cause of death among men. In 2023, men accounted for 88 percent of suicides in the country, placing Mongolia among the world’s highest in male suicide rates. These statistics not only reflect individual health outcomes but signal deep-seated behavioral and societal drivers that demand systemic change.

Harmful Habits, Social Norms, and Medical Apathy

Risky health behaviors, particularly smoking and heavy alcohol use, are disproportionately common among men in Mongolia. Men are thirteen times more likely than women to smoke and more than three times as likely to engage in chronic heavy drinking. Many of these behaviors are reinforced by social expectations around masculinity, where smoking and drinking are tied to notions of strength, stoicism, and social bonding. Compounding this, Mongolian men are less inclined to seek medical help, often delaying treatment until symptoms become severe. Surveys from four regions reveal that nearly 60 percent of men only consult doctors when sick, and one in five have never visited a medical professional at all.

This reluctance is also shaped by gender norms that frame help-seeking as a sign of weakness. With employment pressures high and income opportunities limited, many men struggle to fulfill traditional roles as providers. This sense of inadequacy feeds into mental health struggles and higher rates of substance abuse. Alcohol, in particular, is widely used as a coping mechanism among unemployed or underemployed men, further exacerbating their risk of illness, injury, and death.

A Policy Toolbox for Saving Lives

The World Bank report outlines a series of evidence-based interventions that Mongolia can deploy, many of which are informed by WHO’s MPOWER package and its list of NCD “best buys.” These include raising excise taxes on tobacco and alcohol, enforcing advertising bans, expanding smoke-free public spaces, and rolling out targeted mass media campaigns. Although Mongolia has made some progress on these fronts, particularly in banning direct tobacco advertising and requiring health warnings, its taxation remains low, and enforcement is uneven.

Fully implementing a package of six recommended tobacco control policies could prevent over 19,200 deaths and save the economy an estimated MNT 2.4 trillion (US$705 million) by 2037. Crucially, these interventions are cost-effective, with many estimated to cost less than a dollar per person per year. Quit lines and counseling services for smoking cessation, when combined with outreach in workplaces and rural communities, offer additional value, especially when tailored specifically to male users.

Transforming Primary Health Care for Men

Improving Mongolia’s primary health care system is essential not just for public health, but for narrowing the gender gap in life expectancy. Men’s underutilization of health services reflects both structural and cultural barriers. The report recommends creating more male-friendly services offering flexible clinic hours, increasing male staff, and delivering services in male-dominated environments such as sports clubs and job sites. International examples, such as Brazil’s men’s health initiative, show that targeted policies can make a significant difference when paired with adequate training, funding, and outreach.

Technology can also play a role. With Mongolia’s dispersed and mobile population, telehealth and mobile health (mHealth) platforms offer promising tools to expand access. Additionally, simple but effective tactics such as sending SMS reminders, involving spouses in health communication, or issuing personalized screening invitations can significantly boost men’s engagement with preventive care.

Mental Health, Masculinity, and the Path Forward

One of the most urgent areas for intervention is suicide prevention. Suicide is the leading cause of death among young Mongolian men aged 15 to 29. The report recommends school-based life skills programs, wider access to mental health services, and training for nonspecialized health workers to provide psychological support. Collaborating with media to ensure responsible reporting and investing in early detection of mental health risks are also emphasized.

However, meaningful change requires tackling the underlying gender norms that shape men’s behavior. The report highlights promising programs that create safe spaces for men to reflect on masculinity and health, such as facilitated workshops, community dialogues, and documentary campaigns. Mongolia has laid the groundwork through its National Gender Equality Program and NGO-led initiatives, but further investment is needed to scale these efforts.

Ultimately, the path forward demands a cross-sectoral approach, coordinated across health, education, media, and labor ministries. Reducing the gender gap in life expectancy is not only a moral imperative it is also economically sound and socially transformative. With political will and targeted funding, Mongolia has a real opportunity to become a regional leader in advancing men’s health and wellbeing.