Which gender is more in nursing homes?: Exploring the demographic disparity

Oct 22, 2025 4 min read •

Demographics long-term care elder care

According to the Centers for Disease Control and Prevention (CDC), women constitute approximately 67% of residents in residential care communities, including nursing homes. The question of which gender is more in nursing homes reveals a stark demographic imbalance, with women consistently outnumbering men, particularly in older age groups. This article explores the statistical evidence and the complex factors contributing to this trend.

Quick Summary

An examination of nursing home resident demographics reveals a clear overrepresentation of women. This disparity is primarily driven by life expectancy differences and varying marital statuses among the elderly. Societal factors, health conditions, and informal caregiving dynamics also play a significant role in determining who receives long-term institutional care.

Key Points

Women Predominate: Women consistently outnumber men in nursing homes and other residential care settings, with some estimates showing they make up around two-thirds of the resident population.
Gap Widens with Age: The gender disparity becomes most pronounced in the oldest age groups; for instance, among residents aged 85 and over, there can be over four times as many women as men.
Life Expectancy is Key: A primary driver is that women typically live longer than men, resulting in a larger population of very elderly women who are most likely to require institutional care.
Role of Marital Status: Older women are more likely to be widowed and living alone, whereas older men are more likely to be married and receiving informal care from their spouses, thereby delaying or preventing nursing home admission.
Impact of Caregiving Norms: Traditional gender roles often mean women are primary family caregivers, which can mean less informal care is available for them in old age, unlike many men who rely on their spouses.
Economic Disparities Play a Part: Lower lifetime earnings and fewer economic resources among women can limit their care options, often making a nursing home covered by Medicaid a necessity.
Health Differences Also Influence Care: While men experience higher mortality rates for many top causes of death, women tend to experience more chronic illnesses and years of disability, increasing their need for long-term care.

The Overwhelming Majority of Women

In residential care communities across the United States, data consistently shows that women are the majority of residents. A 2022 CDC report found that 67% of residential care community residents were female, while only 33% were male. This trend is not confined to residential care; women also make up a disproportionate share of assisted living residents and recipients of home healthcare.

This gender gap becomes even more pronounced with age. For residents aged 85 and older, the ratio can be as high as 425 women for every 100 men. This dramatic increase with age provides a crucial clue to the primary drivers behind the demographic imbalance in long-term care facilities.

Factors Contributing to the Gender Disparity

Several interconnected factors explain why women are more likely to be in nursing homes than men. The disparity is not due to a single cause but a combination of demographic and societal trends.

Life Expectancy and Widowhood

Perhaps the most significant factor is that women, on average, live longer than men. This demographic reality leads to a larger population of elderly women compared to elderly men, especially in the 85+ age bracket where the need for long-term care is highest. This longevity also means women are more likely to be widowed and live alone, losing a primary source of informal, spousal care.

Studies have shown that a spouse is a significant caregiver, especially for men. When a wife passes away, a man may lack the same level of caregiving support from his children, increasing the likelihood of institutionalization. Conversely, because many women outlive their husbands, they may find themselves without a partner to provide care as their health declines.

Caregiving Dynamics

The patterns of caregiving throughout a person's life can also influence who ends up in a nursing home. Historically, women have been the primary informal caregivers for family members. This can have a compounding effect later in life. A woman might spend years caring for her husband, and when she eventually needs care, the burden may fall on institutional care providers rather than family. Additionally, research indicates that men who rely on their wives for care may be more likely to enter a nursing home if their wife becomes unable to provide that care.

Economic and Social Factors

Other social and economic factors also play a part. Older women are more likely to face lower incomes and have fewer financial resources than their male counterparts. This can influence the type of care they can afford, and for many, Medicaid becomes the primary payer for long-term care. Their lower economic status may also limit their ability to hire private, in-home care, making a nursing home a more common and necessary option.

Comparison of Demographic and Social Factors

To better understand the gender differences in nursing home populations, consider the following comparison of key factors:


Factor	Impact on Women	Impact on Men
Life Expectancy	Live longer on average, leading to a larger elderly population that may need care.	Shorter life expectancy means a smaller proportion of the population lives to the age where nursing care is most common.
Marital Status	More likely to be widowed and live alone, potentially without a primary caregiver.	More likely to be married at older ages and receive informal care from a spouse.
Caregiving History	Often the primary informal caregiver for spouses and family, which can result in more complex health needs later in life.	Less likely to have been the primary informal caregiver, leading to a reliance on professional care when health declines.
Economic Status	More likely to have lower lifetime earnings, fewer assets, and rely on Medicaid for long-term care.	Higher average incomes and greater asset ownership, potentially allowing for more in-home care options.
Health	Higher prevalence of chronic conditions and disability-adjusted life years (DALYs) compared to men.	While men die from the top 10 causes more frequently, women tend to have poorer health outcomes overall and more morbidity.

The Broader Context of Long-Term Care

The gender imbalance in nursing homes reflects not only biological differences but also deep-seated social patterns regarding caregiving, gender roles, and economic status. The phenomenon is a complex interplay of personal and structural factors. While the narrowing gap in life expectancy between men and women could theoretically influence future demographics, the current trends remain consistent. Understanding these factors is critical for creating equitable long-term care policies and for supporting aging populations effectively.

For more information on the current landscape of long-term care, the CDC provides detailed reports on the demographic characteristics of residents in various care settings. The CDC's National Post-acute and Long-term Care Study offers recent data that helps inform policy and practice in the healthcare sector.

Conclusion

In conclusion, women are significantly overrepresented in nursing homes compared to men, a reality driven primarily by longer life expectancies that lead to a greater prevalence of widowhood and subsequent lack of informal spousal care. This demographic trend is further exacerbated by long-standing societal roles concerning caregiving and persistent economic disparities that affect older women. The intersection of these biological, social, and economic factors creates distinct pathways toward institutional care for men and women. Recognizing these gender differences is crucial for policymakers and healthcare providers to develop more targeted and effective long-term care strategies for an aging population.

Frequently Asked Questions

There are significantly more women than men in nursing homes. Statistics from the CDC show that approximately 67% of residents in residential care facilities, including nursing homes, are female.

The primary reasons include women's longer life expectancy, a higher likelihood of being widowed and living alone in older age, and different patterns of informal caregiving within marriages.

Because women generally live longer than men, a larger portion of the very elderly population (aged 85 and older), who most often require nursing home care, consists of women.

Marital status is a key factor. A married person, especially a man, is more likely to receive informal care from their spouse, delaying institutionalization. Widowed individuals, a group predominantly comprising women, often lack this spousal support.

Yes. Due to traditional gender roles, women have historically been the primary family caregivers. As a result, many men are cared for by their wives and are more likely to enter a nursing home after their spouse passes away. For women who were the caregivers, their support network is often different.

Yes. Although men may experience higher mortality rates for certain conditions, women generally face more chronic illnesses and years of disability, increasing their need for long-term support and care.

Socioeconomic status plays a role, as women often have lower lifetime earnings and fewer assets, making them more reliant on public assistance like Medicaid to cover long-term care costs.

While the life expectancy gap between men and women has been narrowing over time, the demographic imbalance in nursing home populations has been persistent, driven by a combination of biological, social, and economic factors.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.