Brittney Vigna, MPH, CHES, CPH
Time: 5 min
The gender gap in health behaviors, outcomes, and decision making is well documented. Heart disease is the leading cause of death for men and women. However men tend to develop heart disease 10-15 years earlier than women, making them more likely to die earlier in life. Men are also disproportionately affected by preventable causes of death, such as disease related to tobacco. These health risks compound for men of color and men in sexual minority groups. Today, we’re diving deeper into the research behind gender disparities and what we can do to close the gap surrounding men’s health.
What do we know about male engagement in healthcare?
When dealing with groups that are disproportionately affected by a health concern, education and engagement are some of the first steps. However, we see overall lower engagement in programs from men, including workplace programs and healthcare utilization. According to a 2016 Gallup poll, female employees are overall more engaged than men in workplace programs. When looking at healthcare utilization, 1 in 4 American men reported not having seen a healthcare provider for the past year. Additionally, a study assessing the utilization of care among participants T2DM with a high PGC showed men to have significantly fewer general practitioner and medical specialist appointments, and longer rehabilitation when compared to women.
But why is engagement is so low?
Despite significant research demonstrating the health disparities between men and women, the research attempting to understand the “why” is still unclear. More research is being published counteracting the idea that men simply do not want to be engaged in their health. However, the assumption that men are disinterested in health can ironically discourage them from engaging. On the whole, the research suggests social context is important, and, in particular, the behaviors and beliefs associated with masculinity. A paper titled “‘Macho Men’ and Preventive Health Care,” found that “men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care”. It’s also worth noting that prevailing male gender stereotypes, such as consuming a “meat and potatoes” diet or binge drinking, are actually health risks.
Another hypothesis is that men generally have less experience than women in regards to healthcare access. Women are encouraged to seek care earlier for things including birth control prescriptions and PAP smears; there isn’t a similar healthcare push for men early in life.
Can digital health change the game?
Digital health coaching provides unique opportunities that can meet men where they’re at health-wise. This can also solve for barriers that you might see in traditional wellness or healthcare settings. Pack Health’s Senior Health Advisor Michael McMorris has found that digital health coaching programs have helped men feel comfortable discussing their health. “I remember one specific male member who thought it would be weird talking to someone he did not know each week about his health. It’s a very personal and private matter. But, after the first call he felt instantly at ease with the rapport we were able to build.”
When we looked at the numbers, we found that our overall number of female members is higher than our overall male numbers (1 in 5 members are male). However our male members are equally as likely to complete our program as our females. This could be related to Pack Health’s one-on-one, personalized approach. We provide private, telephonic engagement with a dedicated Health Advisor, allowing for consistency and comfort across engagement styles. Additionally, our Health Advisors use a Motivational Interviewing approach. This provides a space to speak without the fear of judgement or bias. With either influence, the data shows our digital health coaching program is as engaging for men as it is for women.
Given that men and women show equal engagement once enrolled, but 4 women are opting in for every 1 man who signs up, we can see that the problem is getting men in the door, not keeping them inside once they get there.
So, what can we do?
The next step is tailoring engagement strategies on the front end, in both employee wellness and point-of-care settings. For employers, we recommend balancing feminine, masculine, and gender neutral messages in communications. When it comes to the Pack Health program, we can provide email templates, but this is something to be aware of for other programming as well. At the same time, try to identify men that are considered “thought leaders” and recruit them as champions and collaborators. They can provide insight on reaching other male employees and create more comfort surrounding engagement.
For providers and other healthcare leaders, using continuing education opportunities to educate clinical staff on the nuances of gender as a health disparity. Placing more emphasis on the first interaction with a new patient to help them feel more at ease could be a simple strategy for patient retention. If you’re not sure how to go about this, try a single-question survey asking them what could make that experience better. At Pack Health, for example, we got feedback from some members that they wanted a Health Advisor of the same gender. Now, we give members a choice on Health Advisor gender at the point of enrollment. Small change, big impact. The name of the game is addressing health disparities. Finding easy solutions to provide more options for care access is key.
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