How Societal Pressures Can Compromise Men's Heart Health

Cardiovascular disease remains one of the leading causes of illness and death in the U.S. and globally. Physicians and researchers closely monitor it, as it’s often more preventable and modifiable compared to other diseases and causes of death(1^✔ ✔Trusted Source
Male Gender Expressivity and Diagnosis and Treatment of Cardiovascular Disease Risks in Men

Go to source). However, successful prevention and management depend on the early identification and control of risk factors like high blood pressure and elevated cholesterol. In the U.S., these risk factors are often under-detected and insufficiently managed, with experts estimating that up to 75% of young adults with conditions like hypertension and high cholesterol are unaware they have them.

Gender Norms Linked to Lower Cardiovascular Risk Detection in Men

A recent study from the University of Chicago revealed that men and boys who conform more closely to traditional gender norms in their social settings are less likely to report receiving diagnoses or treatment for cardiovascular disease risk factors. This finding supports previous research indicating that cultural pressures to adhere to male gender roles are associated with harmful health behaviors, such as substance use and the avoidance of medical therapies and guidance.

“It’s well known that male gender and male sex are associated with lower help-seeking for a range of health conditions — especially mental health and primary care. But previous studies haven’t probed further into the social processes through which male gender is iteratively created through an interplay between the individual and their surroundings,” said Nathaniel Glasser, MD, a general internist and pediatrician at UChicago Medicine and lead author on the paper. “In this new paper, we used innovative measurement techniques to look at the construction of male gender and how it's associated with cardiovascular disease prevention.”

Glasser and his colleagues analyzed data from Add Health, a nationally representative, longitudinal study that collected health measurements and survey responses from more than 12,300 people at multiple points over the course of 24 years (1994-2018). They quantified Add Health participants’ male gender expressivity by identifying a subset of survey questions that were answered most differently by self-identified male versus female participants, then measuring how closely male participants’ answers to those questions matched those of their same-gendered peers.

Men's Cardiovascular Risk Awareness “When we talk about gender expression, we’re not looking at anything physiologic that could be affected by the Y chromosome,” Glasser pointed out. “We’re purely focused on self-reported behaviors, preferences and beliefs, and how closely these reported behaviors and attitudes resemble those of same-gendered peers.”

Zeroing in on cardiovascular disease, the researchers compared the Add Health biological measurements with health-related survey responses to see if men with detectable risk factors like high blood pressure reported receiving diagnosis or treatment for those conditions. They found that men who showed more stereotypical gender expression were significantly less likely to report that a healthcare professional had ever told them about certain cardiovascular disease risk conditions. Even when these men did report having previously received a diagnosis, they were still less likely to report that they were taking medication to treat these conditions.

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Social Pressures Impact on Men

The risk factors examined in the study are all conditions that would normally be detected by screenings that are part of basic primary care. It’s unclear whether the decrease in reported diagnosis and treatment among those with higher male gender expression indicates that men aren’t going in to get screened; that they aren’t paying attention to their diagnoses even when they do get screened; or that they are simply downplaying their diagnoses when asked about them. Whatever the underlying reason, the findings highlight a missed opportunity to prevent or alleviate serious cardiovascular conditions later in life.

“Our hypothesis is that social pressures are leading to behavioral differences that impact cardiovascular risk mitigation efforts, which is concerning because it could be leading to worse long-term health outcomes,” Glasser said.

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Ultimately, the authors see the implications of this research reaching far beyond the topic of traditional masculinity.

“We’re seeing how pressures to convey identity — whether it’s rooted in gender, race, sexuality or something else — impact health behaviors,” Glasser said. “Fitting in and achieving belonging is a complicated task, and we feel strongly that increased societal sympathy, empathy and patience for others undertaking that task would be good for people’s health.”

Reference:

1. Male Gender Expressivity and Diagnosis and Treatment of Cardiovascular Disease Risks in Men - (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825342)

Source-Eurekalert