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Men’s health: Empowering change for a silent crisis


By Bipin Mistry, MD, Chief Medical Officer, Alight Solutions
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As I reflect on Men’s Health month, it’s clear men aren’t pacing ahead by all metrics. Currently, the male life expectancy falls around six years short of women, and that longevity gap is the result of a quiet and complex crisis — failing equity in men’s health. Now more than ever, the data indicates that men need better support for their mental and physical wellbeing. But what’s required to get there and how can the system acknowledge differences to illuminate good health across genders?

The hidden dangers of gender disparities in health

When we think about problems hiding in plain sight, men’s health should be top of mind. While some of the legacy issues impacting men’s health have policy drivers for improvement, emerging threats such as unattended stress and depression are not yet supported by comprehensive strategies for advancement.

According to data from The Washington Post, mortality rates are higher in men than women across all stages of life, with cultural norms and socioeconomic factors further widening that disparity:

  • More men die of diabetes than women. The death rates for men are 31.2 per 100,000 people vs. 19.5 per 100,000 for women.
  • The cancer mortality rate is higher among men — 189.5 per 100,000 — compared with 135.7 per 100,000 for women. Black men have the highest cancer death rate at 227.3 per 100,000. Among Black women, the cancer mortality rate is 149 per 100,000.
  • Death rates for boys and teens ages 10 to 19 (44.5 per 100,000) far outpace that for girls (21.3 per 100,000). Even among infants, the mortality rate is higher for boys (5.87 per 1,000 live births) vs. girls (4.95 per 1,000).
  • Men die by suicide nearly four times more often than women, based on 2020 data from the Centers for Disease Control and Prevention. The rate of suicide is highest in middle-aged White men, but teen boys also face a high risk.
  • In 2020, 72 percent of all motor vehicle crash death victims were male. Men also accounted for 71 percent of pedestrian deaths, 87 percent of bicyclist deaths and 92 percent of motorcyclist deaths.
31.2
The death rates for men are 31.2 per 100,000 people vs. 19.5 per 100,000 for women.
189.5
The cancer mortality rate is higher among men — 189.5 per 100,000 — compared with 135.7 per 100,000 for women.
4x
Men die by suicide nearly four times more often than women, based on 2020 data from the Centers for Disease Control and Prevention.
72%
In 2020, 72 percent of all motor vehicle crash death victims were male. 

Shorter lives, longer reasons: the longevity gap in men

Historically, men have underutilized healthcare. Where women engage in preventative care and tend to be responsive toward metrics (e.g., weight, blood glucose, cholesterol levels, resting heart rate and blood pressure), men tend to neglect preventative care and are more interested in knowing what they can do with their bodies than static measurements or benchmarks.

Underlying men’s lack of attention toward health is the age-old notion of masculinity. Not only are men socially programmed to project strength and hide weakness, but they also take greater risks than women in the areas of recreation and pleasure.

These socially conditioned challenges are compounded by how men cope with things such as anxiety and depression. Where women may feel more comfortable talking about how they feel and seeking support for mental health conditions, men are more apt to redirect toward alcohol, smoking, illicit drug use and even aggression.

In an interview with NPR, Richard G. Reeves, a Brookings Institution scholar, suggests that economic, social and cultural shifts are some of the reasons for a decline in male mental health. He goes on to tell of the diminishing need for men as primary family providers and points out the lesser-told side of the gender pay gap story — a decline in male wages in the middle and at the bottom ­— as ­a major contributor to male unwellness.

Most men in the U.S. today earn less than most men did in 1979, which is an extraordinary economic retreat.

Richard V. Reeves
Brookings Institution

Biology, however, may still play the larger role in male health disparities. We know, for example, that high levels of testosterone can decrease overall immunity, and that estrogen can be more protective of cardiac, bone density and brain functions. This means that men need to pay more attention to things such as cardiovascular risk factors and not wait for symptoms to surface.

While young boys and girls tend to visit their pediatricians at the same rate, the trend changes toward adulthood. CDC data show that the physician visit rate in 2018 among females was almost 40 percent higher — 3.08 visits per woman vs. 2.24 per man. Could it be because of the existing pathway for females to seek gynecological care in their reproductive years? Steven Nissen, Chief Academic Officer for the Cleveland Clinic believes so, but he also shares research showing that women are still twice as likely to visit the doctor for preventative care and regular annual exams, even when pregnancy is excluded.

40%
CDC data show that the physician visit rate in 2018 among females was almost 40 percent higher — 3.08 visits per woman vs. 2.24 per man.

Reframing health to better resonate with men

There are two health conditions that men pay more attention to than others: erectile dysfunction and musculoskeletal issues — both tied to performance and self-worth. Knowing this provides a point of entry for employers, human health services and health systems alike to have larger conversations around prevention and to promote the primary care for men that’s been lacking for decades.

In a recent GUMC article, founder and director of the Center for Men’s Health Equity, Derek Griffith, PhD said, “Policymakers developing interventions to increase life expectancy among men should consider how men see themselves or why they feel they are seen as important to their communities and families.”

Currently, the healthcare journey can be lonely for men. At Alight, we provide support to employers looking for ways to help men discuss mental and physical health and become better consumers of healthcare.

Here are four actions employers can take to enable important healthcare conversations around men’s health:

  1. Reevaluate your benefits to include telehealth services. Consider how men view the structural nature of clinics and constraints of time. Not only do telehealth services appeal to male views on convenience and privacy, many healthcare companies like Ro, are expanding telehealth services beyond treatment for ED. This provides a gateway to broader services in prevention and primary care, and anonymous accessibility to behavioral health counseling.  
  1. Hold incentivized forums, either in-person or through webinars, where men can get information that might otherwise be inaccessible. Consider first, the nature of your employee population. Think how you can package information to best serve those in operational or production roles vs. those in administration, technology or finance roles. Part of the population may respond better to data and statistics (e.g., average sodium intake for American men is 3,400 mg per day, far exceeding the federal recommendations of 2,300 mg per day), where the other part responds better to shared experiences and examples (eating 3 hot dogs per day exceeds the federal recommendations on sodium intake and increases the risk of high blood pressure, heart attack and stroke). The information in your forum should be palatable and easy to understand, and your event timing and incentives might need to vary by audience. It’s all about connecting the dots in a meaningful way for each segment of your employee base.
  1. Create primary care models that increase accessibility, whether through benefit design (where primary care and urgent care have no out-of-pocket expense), or through on-site/near-site clinics. Important to this endeavor is an increase in awareness and, ultimately, engagement. The key is in shifting away from one-size-fits-all plans to more dynamic plan structures — those that eliminate obstacles to care and address the needs of those experiencing equity gaps in care.
  1. Consider targeting partners and spouses in your campaigns to reach different segments of your employee base. It’s not uncommon for them to be the primary decision-makers around benefits or be an influential force behind preventative healthcare and wellness visits.  

Though the topic of men’s health hasn’t been prioritized to the same level as women’s, men haven’t slowed in their prioritization of money, time with their children and relationship intimacy. This means that to help men live healthier, happier and longer lives, we must change the narrative on healthcare and remove stigmas that prevent men from asking questions they deem embarrassing or too time-consuming.

With the right plan benefits and wellbeing solutions in place, you can provide the same personalized touchpoints to healthcare that you can for retirement, payroll or professional services. And it doesn’t hurt to use male priorities as conversation starters for better health and improved outcomes.

Though the topic of men’s health hasn’t been prioritized to the same level as women’s, men haven’t slowed in their prioritization of money, time with their children and relationship intimacy. This means that to help men live healthier, happier and longer lives, we must change the narrative on healthcare and remove stigmas that prevent men from asking questions they deem embarrassing or too time-consuming.

With the right plan benefits and wellbeing solutions in place, you can provide the same personalized touchpoints to healthcare that you can for retirement, payroll or professional services. And it doesn’t hurt to use male priorities as conversation starters for better health and improved outcomes.

Bipin Mistry, MD
Bipin Mistry, MD
By Bipin Mistry, MD

Bipin Mistry, MD is Chief Medical Officer at Alight Solutions. He is board-certified in Internal Medicine and obtained his medical degree at Kings College School of Medicine and Dentistry, University of London and an MBA from Babson College. He is passionate about value-based care and issues connected to the advancement of health equity.

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