COVID-19 and men’s health: Time for action

Thursday, July 30th, 2020

Men’s excess burden of mortality from COVID-19 seems clear. In the USA, the CDC’s COVID Data Tracker reported that, by 6 July, 54% of all deaths were male. In some countries, including The Netherlands, Denmark, Dominican Republic and Romania, around twice as many men as women have died. Globally, the WHO has stated that 58% of deaths are male. Applying this proportion to the number of deaths shown on the WHO’s Coronavirus Disease Dashboard suggests that, by 7 July, around 310,500 men had died directly as a result of the pandemic.

This is not to imply that COVID-19 is solely or primarily an issue for men. COVID-19 is a profound and unprecedented human crisis on a global scale; almost every country, every family and every individual has been impacted in some way. The consequences for women have of course been huge, and not just in terms of illness and death. Those on low incomes, with caring responsibilities, at risk of violence or in need of sexual and reproductive health services have been especially affected.

Vulnerability

But men’s particular vulnerability to serious COVID-19 disease and death demands urgent attention. There has been considerable discussion about the role of male biology (chromosomes, hormones and immune systems) as well as their propensity for risk-taking behaviours such as smoking, excessive alcohol consumption, sub-optimal compliance with recommendations on handwashing and mask-wearing, and delayed help-seeking. 

Underlying serious illnesses which affect men disproportionately, including liver disease, ischaemic heart disease and chronic kidney disease, have also been implicated. Research leading to a better understanding the causes of male mortality will help the development of interventions that could help to reduce the risks. But we already know enough to justify the immediate introduction of male-targeted health promotion messaging about the importance of basic infection prevention measures.

Gender-responsiveness

In the longer-term, gender-responsive strategies and programmes to tackle other risk-taking behaviours and the prevalence of serious underlying conditions in men would also help. In fact, the need for such an approach has been called for by men’s health advocates repeatedly over many years pre-COVID-19.

There is an increasing quantity of robust evidence of what programmes work with men in a variety of settings – local communities, digital, sports venues, workplaces, and elsewhere – although policymakers and practitioners may still require practical guidance about their implementation.

Equity lens

A ‘equity lens’ is additionally needed to focus on those groups within the male population most at risk from the pandemic. Men who are most socially and economically disadvantaged have much higher mortality rates, as do men from black and ethnic minority communities. In England, black men are over 3.5 times more likely, and Asian men more than twice as likely, to die as white men. There are also additional risks for prison and homeless populations, most of whom are male. An approach to COVID-19 based on ‘proportionate universalism’ – resourcing and delivering universal services at a scale and intensity proportionate to the degree of need – should be an essential part of the public health response.

Mental health

There are a plethora of COVID-19 spin-off risks for men that also require action. Men’s social support networks, generally smaller than women’s and often linked to the workplace, are likely to be affected by lockdowns and the trend towards home-working. This could have significant mental health and wellbeing impacts for many. It is likely that financial hardship and unemployment will lead directly to increases in male suicide rates. This has certainly been the case in previous recessions. At the same time, many organisations that can help to mitigate these problems are unable to expand their services because of funding problems or to continue to deliver face-to-face activities because of social distancing rules.

The future

So far, gender-responsive actions on COVID-19 by governments have been minimal, not least for men. This is ‘par for the course’ given that most countries have historically overlooked men’s health. Just four countries – Australia, Brazil, Iran and Ireland – have national men’s health policies. An analysis of 35 national health policies in the member states of the WHO European Region found that the term ‘men’s health’ appeared just once.

Global Action on Men’s Health has recently published a report, From the Margins to the Mainstream, that aims to highlight the steps needed for successful advocacy on men’s health policy. It identifies a range of drivers for men’s health policy development. In addition to COVID-19, these include the generally increasing visibility of men’s health, helped by events like Movember, Men’s Health Week and disease-specific awareness-raising campaigns, including on prostate cancer and mental health, the growing acceptance of human rights-based approaches to health which, clearly, apply to each and every person whatever their sex and gender, and the Sustainable Development Goals (SDGs). 

A 30-year old man has a 150 per cent greater risk of dying from any of the four major non-communicable diseases (NCDs) before the age of 70 than women. It follows that the SDG commitment to reduce premature mortality from NCDs would be, if successfully implemented, particularly beneficial to the health of men and boys; equally, it cannot be optimally realized without an approach that takes account of the specific health needs and health behaviours of men and boys.  

The pandemic has shone a cruel but very bright light on health inequities in general and, from a men’s health perspective, revealed the need for systematic action on a problem that has for far too long been hiding in plain sight.  

This blog was first published on 27 July 2020 by the Gender and COVID-19 Working Group.


From the Margins to the Mainstream: Putting Men’s Health on the Gender Policy Agenda

Thursday, July 16th, 2020

COVID-19 has very starkly laid bare the poor state of men’s health. Although men and women have roughly the same rate of infection, men are more likely to die in almost every country for which there is data. In several, men are about twice as likely to die. Read the rest of this entry »


Gender, COVID-19 and NCDs: Illuminating men’s neglected vulnerability

Friday, May 15th, 2020

Men’s risk of death from COVID-19 appears to be much greater than women’s. A major factor could be that men are more likely to be affected by one of the underlying NCDs that are known to increase mortality, such as hypertension, diabetes, cardiovascular disease and chronic obstructive pulmonary disease. Read the rest of this entry »


COVID-19: A men’s health emergency?

Friday, May 15th, 2020

Men are much more likely than women to become seriously ill and to die as a result of COVID-19. The data from about 40 countries is stark: while infection rates are broadly similar between men and women, men are up to twice as likely to die.  Men account for 69% of deaths from COVID-19 in Italy and Ireland, 67% in Denmark, 65% in Germany, and 64% in China. Read the rest of this entry »


Thinking outside the box on men’s health

Thursday, January 16th, 2020

At long last, men’s health has edged on to the global health agenda – and not a moment too soon for those who have spent years calling for more attention to be paid to the health and wellbeing of men and boys. Read the rest of this entry »


When did you last cry? Men, emotions and mental wellbeing.

Monday, September 30th, 2019

Humen, the men’s mental health charity, has recently produced a short but very powerful video. It’s called ’20 Men 1 Question’. In it, 20 men are asked when they last cried. Many had not done so for years. Not talking about or expressing emotions, Humen suggests in the video, is linked to the high rate of suicide in men. Read the rest of this entry »


Men’s Health: The Last Frontier?

Tuesday, April 23rd, 2019

British men have died at a younger age than British women since at least the time of Queen Victoria’s accession and they will continue to do so for the foreseeable future. This is not some strange peculiarity of these islands: the pattern is repeated throughout every region of the world. There is not a single country where men outlive women. In both the UK and globally, there is currently a four-year difference in life expectancy between the sexes. Read the rest of this entry »


The best a man can get?

Monday, February 25th, 2019

The recent furore about Gillette’s new advert and the American Psychological Association’s (APA) guidelines on working with men reveals, yet again, the depth of anxiety felt by some about any perceived challenge to masculinity. Read the rest of this entry »


Men’s Health – an overlooked global health inequality

Thursday, August 16th, 2018

Men’s health – one of the biggest health inequalities but one of the least talked about. Globally, in 2016, average male life expectancy at birth was 70 years, according to WHO data.  Lesotho had the lowest life expectancy for males at 51 years and Switzerland had the highest at 81 years, a difference of 30 years or almost 60%. By comparison, average global life expectancy for females was 74 years. The difference in life expectancy between men and women globally has widened by about 30% since 1970. Read the rest of this entry »


Men’s health: the case for global action

Monday, June 25th, 2018

Men’s health has for too long been a problem hiding in plain sight at both the global and national levels. Men’s poor outcomes, not least in terms of premature mortality, are obvious but have not been addressed effectively by either policymakers or practitioners. There are now, at last, some signs of change – but are they enough to make a difference?

Read the rest of this entry »