Improving the Health & Wellness of Men & Boys!

Guest Blog Feature:

Ansley Chartrand, Spring 2025 Intern with Men’s Health Network

Preventative care is a fundamental piece of the healthcare system in the United States, with its main goal being to reduce the incidence of communicable and non-communicable diseases.

The hallmark of preventative care is its goal to stop diseases from occurring, which in turn reduces the spread if they are communicable. Unfortunately, men do not interact with primary or preventive care to the level they should, and this results in a higher mortality rate for men in most diseases (Baker, 2021). This is not a one-cause issue, the barriers to men interacting with preventive care are multifaceted and appear throughout the United States. Some possible causes for the low utilization of preventive care in men resides largely in social stigma, distrust in healthcare professionals, and the feeling of emasculation.

These issues for men also intersect with widespread barriers such as healthcare access, quality, and costs making men even less likely to seek treatment.

Furthermore, social stigma and traditional gender norms are some of the largest barriers to men seeking preventive and primary care.

Most men are socially pressured into dealing with their issues alone or to avoid seeking help. If they do seek help, they face the fear of being viewed as “weak” by others. Many men avoid facing this fear either consciously or subconsciously by avoiding treatment and/or refusing to disclose symptoms to healthcare professionals. The social stigmas that have been ingrained in most men since they were children, lead to most men dodging care until they cannot. Many of these social pressures come from within and are harder to address. Since many men will seek healthcare when they can no longer ignore their symptoms, the purpose of preventative care is lost.

As a consequence, delaying treatment or being missed by preventive services, the disease or condition will be significantly harder to treat (Powell et al., 2019).

Beyond social stigma, there are systemic barriers in preventive efforts that have impacted men negatively and have only compounded over the recent years.

In an effort to catch women’s health up, there has been an overcompensation of preventative resources dedicated to women resulting in an eventual gap in men’s preventative services (Baker, 2021). With more and more preventative ads as well as interventions targeting non-men, many men are being left behind and ignored. The combination of men interacting with preventive services less and preventive services not focusing on men, an exponential effect of preventive care being underutilized takes place.

Creating spaces where men feel comfortable sharing their experiences and promoting preventions that focus on male health is growing more and more important as these disparities become more pronounced in the eyes of disease statistics.

Doctor-patient trust is evermore important with men, professionals extending empathy must be approached differently when dealing with male patients.

This gendered idiosyncrasy must be addressed in current patient care education.

In addition, African American men experience this medical professional distrust on a heightened level when compared to non-black men (Powell et al., 2019). The American history of black men being lied to by their doctors has deep roots and is ever so present in current African American populations. The intersection of men not seeking preventive care and black individuals distrusting their doctors increased the likelihood of black men avoiding preventive care. A repercussion of this intersection is demonstrated by black men having the lowest life expectancy out of all other populations in the United States (Powell et al., 2019). Systemic issues impact black men twofold from preventive services rejecting men and the healthcare system having years of racism rooted in its foundations. Being aware of this convergence of preventive barriers is necessary for all intervention designs moving forward.

Furthermore, medical mistrust is something that cannot be ignored in order to help reduce the current disparity in life expectancy between men and women. Starting from the educational setting for public health students, medical students, and all other future healthcare professionals is one strategy to address the present mistrust and gap in patient care.

Deeply systemic issues must be uprooted and discussed early in medical professionals career to provide improved care downstream.

One point of insecurity for men resides in sexual health.

The idea that a man will seek treatment for sexual health may present him as less masculine in society’s eyes. Men who are diagnosed with prostate, bladder, or colorectal cancer may experience a heightened sense of self-doubt. Treatment adherence is dependent largely on the patient and if the patient feels uncomfortable with the treatment or prevention testing, there is a smaller chance they will partake in the prevention or treatment (Zhu & Wittmann, 2022). Screening for these cancers and awareness of the impacts has reached most of the American male population. Now the mortality rate is decreasing with incidence rates increasing, this means more men are dealing with psychosocial symptoms relating to their cancer diagnosis (Zhu & Wittmann, 2022). The psychosocial influence can exacerbate physical symptoms such as erectile dysfunction and libido, which can push the patients’ self-confidence further into the negative resulting in more stigmatized fear.

Socially, many men are pressured into being confident about their sex life, and having a disease that correlates to that can seriously impact their recovery and prevention adherence.

In addition, the fear of being perceived as gay or experiencing homophobia will ward off those seeking help for HIV.

To explain, the sexually transmitted disease HIV (human immunodeficiency virus) is paired with the large social association that it only occurs in gay men. This stereotype is present largely due to the HIV and AIDS (acquired immune deficient syndrome) epidemic that occurred in the 1980s. In the 1980s, misinformation about HIV/AIDS only residing in gay men was spread around the country and resulted in many people avoiding treatment due to fear of persecution. The history surrounding HIV has had cascading impacts that still influence patient treatment today. To discuss, current prevention medications are underutilized as a consequence of these social stigmas (Pleuhs et al., 2020). One of these medications is called pre-exposure prophylaxis (PrEP) and it is able to prevent the infection of HIV. Increasing the output of this medication is important for anyone sexually active or is involved in injection drug use.

Men are largely impacted by HIV as a result of low-preventive care usage (Pleuhs et al., 2020).

Increasing awareness around HIV/AIDS is important to undo the years of stigma surrounding this condition and to increase prevention medication usage.

In summary, a large portion of male under-utilization of healthcare and preventive services is due to social barriers.

These social barriers exacerbate all other intersecting barriers present in the U.S. healthcare system, African-American men, and men part of the LGBTQ+ community. Prevention service inactivity among men is generally observed in non-communicable diseases or STIs such as cancers and HIV, but also has a less-discussed influence in infectious diseases. This was exemplified in the 2020 coronavirus pandemic when, “…more men than women have died of COVID-19 in 41 of 47 countries” (Griffith et al., 2020). The causes for the disparity in disease-specific mortality rate are nonsingular and are parallel to other barriers in preventive care in men. These barriers must be addressed by public health and medical professionals and proactivity about systemic biases is necessary to create change. Focus on men with intersecting hurdles to care should be pinpointed in research and intervention development.

Addressing the lack of prevention utilization can be catalyzed by roping in stakeholders, such as Men’s Health Network, to truly work toward change in medical service usage among men.

I believe that these issues have been swept under the metaphorical rug of at-risk populations and men have been left behind as a result.

Sources:

Baker, P. (2021, May 5). Men and Primary Care: Removing the Barriers.

Griffith, D. M., Sharma, G., Holliday, C. S., Enyia, O. K., Valliere, M., Semlow, A. R., Stewart, E. C., & Blumenthal, R. S. (2020). Men and COVID-19: A Biopsychosocial Approach to Understanding Sex Differences in Mortality and Recommendations for Practice and Policy Interventions.

Pleuhs, B., Quinn, K. G., Walsh, J. L., Petroll, A. E., & John, S. A. (2020). Health Care Provider Barriers to HIV Pre-Exposure Prophylaxis in the United States: A Systematic Review. AIDS Patient Care and STDs, 34(3), 111–123.

Powell, W., Richmond, J., Mohottige, D., Yen, I., Joslyn, A., & Corbie-Smith, G. (2019). Medical Mistrust, Racism, and Delays in Preventive Health Screening Among African-American Men. Behavioral Medicine, 45(2), 102–117.

Zhu, A., & Wittmann, D. (2022). Barriers to sexual recovery in men with prostate, bladder and colorectal cancer. Urologic Oncology: Seminars and Original Investigations, 40(9), 395–402.

Ansley Chartrand is currently a Senior studying Public Health Science at the University of Maryland. She plans to follow up her undergraduate education by studying epidemiology in a Master of Public Health program. She also works in the University of Maryland’s Public Health Aerobiology Lab and has experience with germicidal ultraviolet light and operating bioaerosol collection devices. In her free time, she enjoys reading, lifting, and playing basketball.