in Germany ages 65-74 jumps to 30, whereas it is negative for German adults 45-54 years. For both 45-54 and 55-64 year olds, the sex-ratio is negative in the Dominican Republic, but jumps to over 18 for 75-84 and 85+ age groups. Part of this reflects the sensitivity of ratios for small base value comparisons. For example, in Hungary, the estimate of excess deaths for women 45-54 years old is -3.3 (effectively 0), whereas for men it is 126, resulting in a ratio of -37. Similarly, in the Dominican Republic, there were 14 estimated excess deaths for women 85 and older, compared to 256 for men, resulting in a ratio of 19.

Drawing on our Poisson estimates, Table 2 reports the estimates of four measures: female mortality at age 65, male-female mortality ratio at age 65, and the age slope of female and male morality for an additional 10 years of age. These are estimated for 2020 expected allcause mortality, 2020 excess mortality, and 2021 excess mortality. Table 3 shows the population-weighted results overall and for each of three country-income tercile groupings (population weighted).

In 2020, the average ratio of male-to-female mortality is higher for excess deaths (2.21) than for expected all-cause deaths (1.69) (2020 columns 2 and row 1 of Table 3), and this is also the case for each of the three country-income tercile groups (Table 3). COVID-19 amplified the gender mortality gap, at least at the age point of 65, in 2020. By 2021, the sex-ratio of excess deaths has fallen (to 1.84) but is still above the sex ratio for expected all-cause mortality in 2020 (1.69). However, across income terciles there is variation. In the lowest income grouping, the excess mortality sex ratio in 2021 is slightly lower than for expected all-cause deaths in 2020, whereas in the high-income countries, it remains well above (2.23 in 2021 and 2.3 in 2020 compared to 1.71 for expected all cause deaths in 2020).

The slope of the curve of mortality by age (the change in mortality associated with an additional 10 years of age) goes up sharply from expected all-cause to excess deaths for both women (from 2.95 to 3.46) and for men (2.49 to 2.89) in 2020. And this slope is greater for women than men, as is expected given the higher mortality rates at younger ages for men in excess deaths in 2020. (The sex-ratio of mortality at age 65 is necessarily linked to the ageslope of mortality for women and men.) These patterns in excess mortality patterns shift remarkably by 2021. By 2021, the age slope of mortality shows much less of a gap; it is relatively similar for women (2.40) and for men (2.33).

Notably, this pattern in excess death age-slopes differs across our country-income terciles in 2020. The age slope of mortality is highest for women in high-income countries for 2020 (both expected all-cause deaths and excess deaths), but it falls dramatically by 2021 when it is slightly lower than that of men (2.40 for women and 2.49 for men). On the other hand, in countries in the first and second terciles, in 2021, the age slope in mortality remains slightly higher for women.

A last point of note is that female excess mortality at age 65 increases dramatically (almost doubles) for countries in the first and second terciles from 2020 and 2021 (from 447 to 832 for tercile 1 countries, and from 439 to 824 for tercile 2 countries), whereas it increases much more modestly from 2020 to 2021 for the high-income countries in tercile 3 (from 131 5