According to a new study published in JAMA Internal Medicine, women in the U.S. are now projected to live about six years longer than U.S. men. TIME reports: [T]he 2021 data represent the largest gender-based life expectancy gap in the U.S. since 1996. The gulf began to widen before the COVID-19 pandemic, the authors note, but the trend accelerated from 2019 to 2021. Deaths from COVID-19 and unintentional injuries, a category that includes accidental drug overdoses, were the largest contributors to the widening of the gap, but differential rates of homicide, heart disease, and suicide deaths also played a role, according to the report. It’s well-established that men die of these causes more frequently than women, and in recent years, they have been some of the most common causes of death overall. Heart disease, COVID-19, and unintentional injuries accounted for three of the top five in 2021.

The gender gap would have been even wider, the authors note, but for factors including increases in maternal mortality and decreases in cancer deaths among men. Overall, the data underscore the continued importance of limiting COVID-19’s spread, and of finding better ways to improve national mental health and prevent drug overdoses and suicides — fatalities sometimes labeled by experts as “deaths of despair.”