Social expectations in terms of masculinity sometimes weigh heavily on men… They could even have a harmful impact on their cardiovascular health.
- The closer the participants were to the masculine stereotype during their adolescence, the less they treated their hypertension and diabetes as adults.
- If this continued when they were young adults, it was associated with lower odds of diagnosis and treatment of hypertension and diabetes in adulthood.
- Hypertension and diabetes are preventable risk factors for cardiovascular disease.
In France, the cardiovascular mortality rate before age 65 is three times higher among men than among women, according to the Ministry of Health. Could this have a link with social expectations in terms of masculinity? According to a new study published in the journal JAMA Network Openmen who adopt behavior close to masculine stereotypes are more at risk of having cardiovascular problems.
Heart: adherence to male stereotypes impact care
“It is well known that male gender and sex are associated with less help-seeking for a range of health problems, particularly mental health and primary care, underlines Nathaniel Glasser, one of the authors, in a press release. In this new paper, we used innovative measurement techniques to examine masculine gender construct and its association with cardiovascular disease prevention”. The objective of this study was to measure the impact of social expectations in terms of masculinity on modifiable cardiovascular risk factors, i.e. hypertension and diabetes.
To do this, scientists followed more than 12,300 people – including 4,230 men, many of whom were adolescents at the start of the study – between 1994 and 2018. They analyzed health data and responses to questionnaires collected during these 24 years. They thus assessed the participants’ masculine gender expression, that is to say the presence of behaviors aligned with stereotypical norms linked to their sex in their social environment. In other words, the researchers looked at how well the male volunteers’ answers to the questions matched those of their same-sex peers.
Result : the closer the participants were to the masculine stereotype during their adolescence, the less they treated their hypertension and diabetes as adults. If adherence to societal expectations continued when they were young adults, it was associated with lower odds of diagnosis and treatment of hypertension and diabetes in adulthood, preventable risk factors for cardiovascular disease.
The researchers also noticed that men who presented a more stereotypical gender expression did not talk about their health problems. For example, when the doctor had already addressed the issue of heart health in consultation with them, they did not specify this in the questionnaires. Worse: when they were diagnosed as having cardiovascular disease, they did not indicate that they were taking treatment to treat it. An oversight that can seriously impact their treatment by doctors.
Take into account the weight of societal expectations in prevention
The authors also note that the risk factors examined in the study such as diabetes and hypertension are conditions that would normally be detected by routine screenings. “It is unclear whether the decrease in reported diagnosis and treatment among people with higher masculine gender expression indicates that men are not getting tested, that they are not paying attention to their diagnoses even when ‘they are screened or simply downplay their diagnoses when questioned. Whatever the underlying reason, the findings highlight a missed opportunity to prevent or mitigate serious cardiovascular disease later in life.”they specify in their press release.
However, researchers put forward a hypothesis for this silence. For them, “Social pressures lead to behavioral differences that impact the desire to limit cardiovascular risks, which is concerning, as this could lead to poorer long-term health outcomes, says Nathaniel Glasser. We see how pressures to convey identity (…) impact health behaviors”.
Thus, for him, it is essential to take into account the weight component of societal expectations concerning masculinity when preventing and raising awareness of cardiovascular risks.
In addition to this societal component, men are also naturally more at risk of cardiovascular problems. Indeed, according to Health Insurance, from the age of 50, they have a greater risk of having a cardiovascular or cardiac accident. In women, this risk increases from the age of 60. Until menopause, these are “more protected than men against cardiovascular diseases”.
