Men’s reluctant relationship with healthcare

Or: We have a paternal health crisis. But not the kind you'd think.

During childbirth, the male partner in the delivery room is the last person most people would think to look at. As an obstetrician, I can tell you it’s well worth a glimpse. More often than not, there’s an exact, blink-and-you-miss-it millisecond when someone realizes they’ve just become a dad. 

Parenthood is a period of intense identity reformation. For the person who is pregnant this experience is more immediate and physical. They feel their ligaments stretch as the baby grows. They feel their skin bulge as the baby kicks. 

But for partners, particularly male partners, parenthood and its incumbent reality can be more abstract…right up until the moment it isn’t. Suddenly, their baby appears—present, loud and squirming. 

Before the 1970s and even into the 1980s, fathers were rarely allowed in the room to witness the birth of their child. Fathers today are more of a common presence but it’s not an entirely comfortable one—studies show that men in the delivery room report feeling out of place: helpless (23%); scared (36%); and overwhelmed (14%). 

For many people, the trip to the hospital to have a baby is their first significant encounter with the healthcare system. For male partners, the awkward experience is an unfortunately emblematic one. 

The reluctant relationship men have with healthcare is one that persists throughout their lives. The Commonwealth Fund reported that three times as many men as women had not seen a doctor in the previous year. One in three men had no regular doctor, period, compared with one in five women. 

In general:

• Men are far less likely to access preventative care services. 

• Men are less likely to report having a trusted source of medical advice. 

• Men are less likely to utilize prescription drugs. 

• Men are half as likely to receive mental healthcare treatment.

Also:

• Men live on average 5.8 years fewer than women, the highest gap in a generation that is particularly pronounced for Black, Native American, and Latino men. 

• And in the United States, after centuries of gains, male life expectancy is declining.

Men are suffering and appear adrift. Worse, they don’t quite know how to use our healthcare system to help them. 

We raise men to be less information-seeking when it comes to their own bodies. Meanwhile, “women’s wellness” has become a gargantuan consumer category. Despite having fewer products hawked at them, men remain more susceptible to medical misinformation–particularly when it comes to sex and reproduction. Men engage with inaccurate content about their own virility at concerningly high rates. And well into their elder years, someone is always trying to sell them testosterone. 

Studies have returned to the same kinds of solutions Preprint readers will recognize as apt for women’s health: finding ways to talk about healthcare outside doctors offices; drawing on gender-affirming interests and language; and of course, active listening. Men diagnosed with infertility repeatedly articulated a desire for care that acknowledged their masculinity, treated them holistically, and used language thoughtfully. 

In 2019, Cleveland Clinic unveiled their very first men’s health campaign, “MENtion It.” In practice, that looked like rhetoric that encouraged men to apply their caretaking impulses to their own bodies—using language like “maintenance,” and “pride,” and “not toughing it out.” The world’s most visible men’s public health movement is No Shave November, which seeks to raise awareness of men’s rates of suicide, testicular cancer, and prostate cancer, with guidance like “can you spot a bro who’s feeling low?” 

Men deserve our empathy…and a little empathy can go a long way. 

What my team is reading, considering, and building against: 

• We’re wise to remember that the Ivory Tower is not immune to misinformation. This week, a British scientist used AI to discover manipulated data in cancer research findings at Harvard’s Dana-Farber Cancer Institute. We know AI can accelerate misinformation…but what if it also can decelerate it? 

• As a society, it might be time to bid adieu to gummy vitamins. They have as much sugar as their candied counterparts, and wildly inaccurate concentrations of key ingredients (resulting, among other things, in a concerning corresponding rate of pediatric melatonin overdose). Jacob Stern for The Atlantic makes a convincing case that maybe medicine should never really taste that good.

• This powerful profile of health equity researcher and Maven advisor Dr. Rachel Hardeman should leave you with more questions than answers. Like: what can the Minnesota Paradox teach us about maternal mortality? And: if not within academia, where is the best place for anti-racism work to get done? 

• Researchers at RAND published a JAMA viewpoint on the potential for virtual doulas to advance maternal health equity. They state, “To our knowledge, no research has assessed effects of [virtual doulas] on birth outcomes.” In correspondence with the authors, I learned that our Maven research paper assessing the effects of virtual doulas on birth outcomes and racial equity was published just a day later!