Many men do not take good care of themselves. COVID-19 vaccination rates are the latest in a problem as old as medicine.

They are less likely to see the doctor. They eat less fruits and vegetables. They are more likely to smoke, die in alcohol-related crashes, and engage in other activities that can lead to traumatic brain injury. By almost all known measures, men are far from women when it comes to taking care of themselves.

And for months now, to the surprise of few in the medical profession, men have consistently fallen behind women when it comes to getting the COVID-19 vaccine. As of mid-November, 57% of men and boys in the United States were fully immunized, compared to 61% of women and girls.

The reluctance of men to seek medical care is so well documented and so exhaustively discussed that it has become a policy. And that can make solutions difficult, said James Leone, professor of health at Bridgewater State University in Massachusetts.

“The reason men often live sicker and die sooner is because we allow it,” he said. “As a society, we don’t go beyond the surface levels and just say, ‘Oh, that’s a shame. What’s wrong with guys? “

But there’s nothing funny about men living sicker and dying earlier than women – especially when the decisions they make about their health can have medical and economic ramifications for their families, as it is. became evident during the COVID-19 pandemic. More than 40,000 children have lost a parent to COVID-19, and many more have experienced food or housing insecurity after their parents lost their jobs or were unable to work.

So what’s going on with men and their health?

Doctors, psychologists, evolutionary theorists seem to agree that it all comes down to the fact that men have a higher tolerance for risk. But unraveling the cause is complicated. Some researchers believe the trait is a genetic holdover from ancient times, when men who exhibited aggressive and risky behavior could compete with their peers for mates and food. Others say that men’s higher risk tolerance is primarily an acquired quality, fostered by social and cultural norms of masculinity.

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While women can also take risks, on average the difference is undeniable, said Daniel J. Kruger, evolutionary psychologist at the Institute for Social Research at the University of Michigan. Regardless of the combination of nature and education at work, these characteristics have been deeply embedded in our society over the centuries. Public health campaigns are exploring new ways to resonate their messages with men, but changing such ingrained behavior will take considerable and concerted effort.

“It goes way back in our evolutionary history,” he said. “It doesn’t determine our behavior, but it certainly influences it.”

During the pandemic, the gender divide was highlighted.

Since 2018, researchers at Indiana University at Bloomington have conducted a long-term study of 250 opposite-sex couples, asking them about a series of what Jessica Calarco, associate professor of sociology at Indiana University , called “sensitive topics” for new parents. – among them breastfeeding, childhood vaccines, co-sleep and when one or the other partner returns to work.

When COVID-19 hit, Calarco and his colleagues added pandemic-themed topics to the mix.

Among the main findings: two-thirds of couples disagreed about the acceptable level of risk for their family. In most cases, when the man and woman disagreed, it was the woman who was the most risk averse and who followed safety instructions the most, such as wearing masks and maintaining social distance.

“Because women were the ones who took the most risk averse positions, they were also the ones who were forced to be the peacekeepers when it turned into conflict,” Calarco said. “Women felt responsible for resolving the conflict or preventing it from escalating.

They did so by taking on the burden of ensuring the safety of the family themselves – and in many cases by taking extra precautions to protect children or elderly parents from their spouse’s riskier behavior, he said. she declared.

“This is not a function of biological differences, but of pressures on women to take care of themselves, to think of themselves and everyone else around them,” said Calarco. “Being pushed into this worrying role within their family or community makes them more aware of the risk than men. “

In other words, women make decisions – including health decisions – based on what they think is best for themselves and for everyone else in their care, which ultimately leads to more conservative choices. Men more often base their decisions on their own personal risk tolerance, which leads to riskier choices, Calarco said.

Leone calls this “normative contentment”.

“It’s kind of a self-fulfilling prophecy,” he said. “Men and boys are going to do things that are bad for their health and we kind of accept that as part of our culture. It’s almost like we’re giving the free social pass to the men and boys so they can just take off and come see us when you have a problem. “

Cultural norms aside, biology ultimately leads the way, Michigan’s Kruger said. While the differences between men and women are not black and white, studies have nevertheless suggested that genetic predisposition plays a role in their varying inclinations for risk.

The phenomenon dates back to our ancestors a long time ago, when men had to fight over partners in a way that women did not. Most women had children, but only the strongest men had partners. They used their physical strength to establish powerful leadership positions within their communities and prevent other men from associating, he said.

“There was a lot of incentive to compete, to get into these powerful, high-level positions where you can attract and retain partners,” Kruger said. “There is a risk of dying without reproducing and a greater motivation to take risks to make it happen.”

Our physical and social environments have, of course, changed dramatically. Back then, no one planned a doctor’s appointment or got a shot, and no modern American’s survival hinges on their ability to physically fend off their competition and hunt down large animals for dinner. But the state of mind born of that genetic inheritance, he said, is still there.

When public health officials sought to encourage public acceptance of vaccines, masks and other pandemic safeguards, few to no messaging initiatives were designed with gender in mind.

But evidence from other health settings shows that it’s possible to get men to be more health conscious, said Leone, who is studying methods to improve health outcomes in underserved communities.

One possibility is terminology.

The term “women’s health” is often linked to issues related to reproductive health and the health of the offspring, while “men’s health”, to the extent that it is only lip service, is isolated. . The more inclusive term “family health” would send a message to men that they too should take care of themselves, Leone said.

But how do you get the message across? It might sound simple, Leone said, but just getting men together in the same room, talking about health topics they might have avoided in the past, can help.

In Australia, for example, men are encouraged to join community organizations called “sheds”, where they discuss healthy behaviors while participating in activities such as woodworking and beekeeping.

In the United States, some healthcare providers have been successful in meeting men wherever they are, such as barber shops or sporting events, Leone said. Blood pressure tests at football games and auto shows are increasingly common in many states, for example. Or community breakfasts associated with cancer screenings, with catchy names like Pancakes & Prostates.

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Much of the strategy is just to get men into new habits, Leone said.

Girls are taught to be proactive about health and, as young women, are encouraged to schedule routine gynecological exams. Young men, on the other hand, may have very little reason to see a doctor, as long as they are healthy, he said. But if they build a relationship with a trusted healthcare provider, men can make lifestyle changes that can reduce the risk of chronic disease for years to come.

Modeling behavior and social influence can also be powerful in shaping health behavior, said Calarco of Indiana – especially for men, who may be less threatened by exposing what they perceive to be. a weakness if someone else does the same.

For example, research has shown that when male executives don’t take advantage of their company’s parental leave policy, new fathers don’t stoop in the organization either.

“The more others do it, the more inclined you are to do it,” she said. “When you have high-ranking men engaging in a behavior, it can send a signal that it’s okay for other men to engage in that behavior as well. “

Will all of this work with the highly politicized subject of COVID-19? Hard to say, although the vaccine mandates can make the question, in many cases, moot.

What is clear is that men and women often have different opinions when it comes to taking care of themselves, yet it is an issue that affects us all.

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