It's a well-known statistic that men don't live as long as women. Life expectancy for an American man is almost 76, versus 81 for a woman. But it's not just older men dying sooner: those numbers are influenced by other deaths that come earlier in the lifespan.
Derek Griffith, a professor of health equity and population health at the University of Pennsylvania, would like to see far more attention paid to men's health.
He's well aware that women's health has been sidelined for years. Right up until the last few decades, most clinical studies were carried out on men.
"Women's health has been understudied," he says. "We don't understand women's health because we haven't invested in it. I'm also saying the only thing we understand with men's health is biology and genetics."
On the other hand, Griffith says, we know very little about how the economy, stress and other factors affect men's health. He says given men's shorter lifespans, we should be invested in finding out more about this.
"It's not a zero-sum game," he says. "We can promote women's equality, equity, opportunities, while actually focusing on the health and well-being of men."
Griffith has been researching men's health for decades, with a special focus on Black and Latino men. He is alarmed that the longevity gap between men and women in the U.S. has widened in the last couple of decades. He says more research is needed into why. Of the 15 leading causes of death — from cancer and heart disease to accidents and suicide — he says men fare worse in 13 out of the 15. And they're not the only ones affected.
"If men struggle with their health, their wellbeing and so forth," he says, "that tends to put not just a burden on those men but on the women in their lives," who have to pick up the economic and emotional slack.
Motivations and judgments
He says to take one example, men are known to eat less healthily than women, which can contribute to chronic disease. Some observers get judgy about this, he says, saying if men won't do the right things, they have to accept some responsibility for the consequences. But Griffith says that view misses a lot about most men's reality.
"We tend to assume from a public health and medical standpoint that people wake up and their goal is to be healthy," says Griffith. "But that's typically not why we wake up." His research has shown that men are focused on their work and their families. Food is a means to an end, particularly for less affluent men.
He says men tell him, "The goal is to get back to work, to contribute to my household and if that meal is going to make me full enough, then I'm going to eat that," regardless of what's in it. He adds that food can also counter feelings of stress.
Griffith says for everyone's sake there should be more emphasis nationally on the many factors that affect men's physical and mental health, and a focus on what can be done to improve health outcomes.
Complications and convenience
There are some men's health centers in the U.S., although several focus solely on sexual health. The Preston Robert Tisch Center for Men's Health in New York City, part of the NYU Langone health system, offers comprehensive care. Dr. Steven Lamm directs the center. He says they aim to make things convenient for men, who generally don't want to spend a lot of time at the doctor. The center has specialists in multiple fields and lets patients get most things done then and there.
"You've got to remove the obstacles for men's care," says Lamm. "That's just the way it is."
He says traditionally men haven't gone to the doctor as often as women. Societal pressures meant many men associated paying attention to their health with weakness. But Lamm says that's changing. Plenty of men, especially younger ones, now use apps and smart watches to track steps and sleep patterns and are eager to stay fit.
"If you see a man in his 20s as opposed to seeing him in his 50s, it's an opportunity for preventive care and early diagnosis, or preventing certain diagnoses," he says.
Today he's seeing more young men for checkups than he ever has, which gives him hope for their futures. Still, he says, for many guys under economic stress, health is not their priority.
"They don't have time to take care of themselves," he says. "They're not going to address their weight. They're just struggling to pay the bills."
Lamm tells his patients that if they can take care of their health in their youth and middle age — keep an eye on their blood pressure, watch their weight, drink less alcohol — they have an excellent chance of living well later in life, thanks to advances in medicine.
He says medical research and advances are moving much more quickly than when he started his career. Lamm says he tells his patients, "If you can just hang on and don't mess up when you're younger, we have a chance of keeping you youthful and vital and alive as you get older, because we're going to be able to prevent the Alzheimer's, treat the Parkinson's, and do much better with diabetes and kidney failure, strokes, and heart attacks."
Lamm says these improvements could happen as soon as the next five years.
Reckoning with "Superman"
But for a lot of men, thinking about their health, especially if something is wrong, is uncomfortable.
Jack Rainer of Tryon, North Carolina, is 70 now. He says when he was a kid, he devoured Superman comic books. "And we learned how the man of steel could do all things, and so that is in many ways how I learned psychologically about what it meant to be masculine," he says.
Rainer, a semi-retired psychologist, has treated older men who are struggling to come to terms with serious health issues. So it was a shock to discover a couple of years ago that he was now one of them. He found out that he had an aggressive form of prostate cancer. Part of the treatment involved removing testosterone from his body, and the effects caught him off guard.
"Removal of the sense of masculinity left me without what I called gumption," he says.
He felt vulnerable in a way he never had before, unmoored and unmanned. A widower, Rainer says friends helped him get through the treatment.
Today, he's cancer free. But he says he has to accept that he's not as vibrant as he was at 40. And that's hard.
"I am very much in the process of considering what it means to be 70, reasonably healthy, and how I want to be living into the next iteration of the journey," he says.
He says being at this stage of life feels like stepping into the unknown.
This story was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The John A. Hartford Foundation.
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