Time to change the outdated narrative that masculinity is the principle cause of men’s health problems

CommentaryHealth

Apr 7

It’s obvious that behaviours can impact health, and some health behaviours show sex differences. However the idea that masculinity is to predominantly to blame for men’s health problems is woefully reductionist when other factors that impact men’s health are not taken into account.

“As of today, around 65% of coronavirus deaths are male yet very often the narrative in the media and in politics seems to be that although more men die, the main crisis is the inconvenience to women.”

The term ‘victim-blaming’ refers to the tendency to focus on the individual as the source of their problems, without due consideration of other contributory factors, and approaches to men’s health that pathologise masculinity can be seen as victim blaming. This view of men can be seen as creating, or exacerbating, the gender empathy gap, and part of a wider unconscious bias regarding men called gamma bias. In contrast, approaches to women’s health are generally conducted with more sensitivity to the social factors that impact their health behaviour.

As of today, around 65% of coronavirus deaths are male yet very often the narrative in the media and in politics seems to be that although more men die, the main crisis is the inconvenience to women.

Disappointingly, but not surprisingly, the response from academics and health agencies tends to be to presume masculinity and male-typical behaviour is a problem when it comes to men’s health and the coronavirus pandemic. This week men’s greater cigarette consumption in China was given as an example of how men’s health behaviour contributes to their greater risk of death from coronavirus: over 50% of men in China smoke tobacco compared to only around 5% of women, and smokers are more vulnerable to respiratory conditions. However men are more likely than women to die from coronavirus in countries where there is little sex difference in smoking. For example, in Denmark around 35% of both men and women smoke, yet the death rate from coronavirus is around 65% higher in men (as of 30th March 2020). This suggests that in many countries, men’s health behaviour isn’t a good explanation for men’s susceptibility to coronavirus.

Given this prevailing narrative, it was not unexpected that one of the first peer-reviewed publications on sex differences in coronavirus risk restated the mantra that masculinity is bad for men’s health due to increased risk-taking and reduced help-seeking. However the authors, Allessandra Buja et al (2020) from the University of Padua, Italy, went on to make three important points:

1/ “…men have a weaker immune response and have also been shown to have more chronic mucus hypersecretion, which may worsen their prognosis and increase the likelihood of death”

2/ “The association of sex with post-hospitalization risk is complex, and likely to be influenced by multiple factors”.

3/ “…there are few studies that evaluate the effectiveness of interventions that promote the access of men to primary care. A recent review found that physical activity, education, peer support-based interventions improve quality of life in men with long-term conditions. More studies are needed to understand what is successful in improving elderly men’s health and reducing the risk of readmission”.

“This article does not assert that men should take no responsibility for their health behaviours, but that it is time to investigate the ways in which male psychology can be beneficial to health.”

Buja and colleagues are to be congratulated for breaking with the popular narrative by highlighting these points, which I predict will be far more successful in reducing men’s deaths than health promotion campaigns that run the risk of patronising and alienating men. Perhaps these three points will inspire other to think of how male-typical behaviour might be useful, not least in the emergency services, populated mainly by men, where risk-taking is to the benefit of other people’s health. It might also inspire others to seek out existing research demonstrating that harnessing traditional masculinity can improve health.

Of course there are examples of where men engage in risky behaviours that harm their health, but casting a negative light on masculinity doesn’t appear to improve these behaviours very much.

This article does not assert that men should take no responsibility for their health behaviours, but that it is time to investigate the ways in which male psychology can be beneficial to health. In the meantime I urge influential players such as the World Health Organisation (WHO) to be careful not to perpetuate a narrative that stigmatises masculinity, promotes victim blaming and the alienation of men.

I don’t think men’s health is going to benefit from another policy document taking a doubtful view of masculinity. We should take heed of the points raised by Buja et al (2020), and take the hard road of immunological research and meaningful research into how we can harness male psychology in order to promote better health behaviour in men. In the meantime I would like to encourage health professionals, media pundits, and anyone else with an opinion to please consider retiring the tired old narrative that masculinity is the principle cause of men’s health problems.

This article was first published on the Male Psychology Network website in 2020

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