What roles do gender, society and culture play in a man’s health? Those are the questions driving the work at the Institute for Research on Men’s Health (IRMH) at Vanderbilt.
The institute opened in 2012 following the arrival of program director Derek Griffith, PhD. “We really wanted to understand the role of gender in men’s health and how to apply it to health promotion efforts, intervention strategy, and ways to communicate messages and motivate men in healthier behaviors,” Griffith explained.
Dispelling Men’s Health Myths
When discussing men’s health, Griffith said a common, knee-jerk reaction is to think of men’s misbehaviors rather than intervention. “We’re very comfortable blaming men’s health problems solely on behavior,” he said. “We have all the opportunities women do, but there’s something about what it means to be male … an attitude … that’s the barrier.”
Griffith continued, “When we talk about things like women’s health, racial disparity, or socioeconomic differences, we have a much broader perspective on what influences health than what’s limited to men. It’s helpful to think about men’s health in a broader context.”
Not unlike women, a man’s health is determined by priorities often set by others – employers, spouses, and kids all demand time and keep men searching for a healthier career/family balance.
“Frankly, we tend to reward men more for taking care of their family and job than their health,” Griffith said. “It’s a real issue.”
Despite their reputation for neglecting medical care, men actually fare similarly to women when it comes to seeking out medical help for symptoms. The glaring gender difference is in the area of preventive care – a gap Griffith hopes to close through research and education.
“We’re trying to understand, are these things true that we treat as normal maxims about men’s health? Often there’s an element of truth, but when you ask men and engage women about men’s health and talk through processes, you get very different results,” he noted.
Another striking gender difference is that men tend to define their health relationally – by looking at what they’re able to do physically and not at medical results. For example, men who can still go to work and play with their kids after work often consider themselves healthy. Griffith hopes to help men translate tests that look at internal functioning and motivate them to engage in healthier behavior.
African American Men & Health
IRMH has been especially busy with studies to better understand and address issues impacting the health of African American men. A recent “Men on the Move” physical activity study looked at the feasibility of using text messaging and wearable devices like Fitbits. Griffith said the technology proved useful in increasing physical activity and self-awareness of activity.
“Whether it’s just competition or having others hold you accountable, those devices and additional features helped participants connect with others and develop a support network,” Griffith said. “Men don’t tend to have as strong or large of social networks as women and don’t utilize them the same way. We’re trying to find strategies to help men engage more and normalize some of the things they’re experiencing.”
An ongoing challenge facing many African American communities is access to healthy foods and safe, affordable places to exercise. “It’s almost like we’re trying to engage in healthy behaviors in potentially unhealthy environments,” Griffith said. To that end, the institute is working with policymakers to increase access to healthy foods and activities. In the meantime, they’re focused on helping people learn to navigate in not-so-healthy environments.
“The most fascinating thing about these studies is that it’s not that men don’t know what to do,” Griffith said. “But the question is – ‘Why do you do things that aren’t in your best interest?’” More often than not, the answer to that question goes back to the priorities of a man and the people in his life. “The challenges we face with men’s messaging and motivating them to be healthier tends to pit health against social priorities and trying to balance the two … to be healthy and also be successful in the rest of life. We don’t want to offer excuses, but we’re trying to figure out ways to honor men while identifying challenges and motivating factors.”
Many men studied turned to their faith for motivation and found the focus also helped with stress reduction and relationship improvement. “You can’t find motivation to be healthy in just health-related things,” said Griffith. “It has to connect to something larger and more important.”
More Questions, More Answers
Currently, the institute is striving to better understand how men think about health: what does it means to be a man, and how do you connect the two?
“We tend to separate men’s health from men’s identity as men, but we want to connect those two to see how being healthy helps men achieve goals,” Griffith said. “They’ll be more motivated to try to overcome time and environmental barriers to be more healthy and active.”
In their search for answers, IRMH has garnered support from Vanderbilt’s Institute for Medicine and Public Health. Griffith’s role also spans the campus as he works with medical school and undergrad programs. Outside Vanderbilt, the Nashville community has embraced opportunities to participate in studies and surveys posted on IRMH’s website. Griffith encourages the local medical community to get involved in health initiatives, advisory boards, surveys and Tennessee’s bi-yearly men’s report card that has become a model for other states. Last released in 2014, the eight-month project was coordinated in conjunction with IRMH, the Tennessee Department of Health and the Tennessee Cancer Coalition. (See findings in sidebar.)
As for the IRMH, their next step is to move beyond the African American community to examine health attitudes among white and Latino men.
“Men’s health and even gender differences are more than biology,” Griffith said. “They have roots in real behavior generated across racial and ethnic groups.”
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Institute for Research on Men’s Health
Grading Men’s Health in Tennessee
The 2014 Tennessee Men’s Health Report Card, the latest edition, highlighted areas of progress for men in our state, areas where Tennessee men still lag far behind national goals, and areas where racial and ethnic disparities in health outcomes persist.
The data in the Report Card was provided by the Tennessee Department of Health, which has been a partner in both the Men's and Women's Health Report cards since 2008. The health outcomes and health behaviors reported were from 2012, the most recent year for which full data was available. Changes in health indicators, both positive and negative, over the years 2007 through 2012 were also reported.
Key Findings
Men in Tennessee lived, on average, five years less than women in 2012.
Over half of the deaths for men in Tennessee in 2012 could be attributed to three conditions – heart disease (24.7 percent), cancer (24.4 percent) and chronic lung disease (5.6 percent). These are conditions where improvements in levels physical activity, diet, tobacco use behaviors and early diagnosis and care could make a difference in outcomes, quality and length of life.
Main causes of death for men vary dramatically by age. Among younger adult men (ages 18-34), 40 percent of deaths were due to unintentional injuries and motor vehicle accidents, and another 30 percent to intentional homicide and suicide.
The rates of deaths examined in the Report Card were not distributed evenly among men in our state by ethnicity, race, or place.
Black men in Tennessee bear an excess burden of heart disease, stroke, diabetes, kidney disease, homicide, pneumonia and influenza, AIDs and cancers of the prostate, colon and rectum, and lung. However, between 2007 and 2012, the rates of each of these conditions showed improvement.
White men bear an excess burden of suicide, unintentional injuries (including drug-related poisonings and overdoses), motor vehicle accidents, lung disease and liver disease. Between 2007 and 2012, the rates for each of these conditions for white men, with the exception of motor vehicle accidents and lung disease, were statistically stagnant or getting worse.
Hispanic men, overall a younger population, have lower rates of death for most chronic conditions and higher grades overall, but received their lowest grades on rates of colorectal cancer, chronic liver disease, motor vehicle accidents and suicides. Death rates from kidney disease among Hispanic men also worsened between 2007-2012.
When data was mapped by Health Department Region, there were often wide variations geographically, and it is not clear whether these are due to differences in environmental factors, in urban vs. rural lifestyles and occupations, or in access to and use of healthcare services.
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