In Latin America, men’s health care represents multiple challenges. Unhealthy lifestyles (smoking, excessive alcohol consumption, sedentary lifestyle), rigid gender stereotypes, lack of information from both users and health services about men’s health, cultural and economic barriers that translate into little use of preventive and curative health services, paucity of gender-focused programs, and the increasing prevalence of chronic diseases are some of the problems that health systems must face to meet men’s health needs.
Risk factors and behaviors in men
Frequently, men incorporate risky behaviors into their lifestyle, which has consequences for their health and even increases the risk of mortality. The gender norms and stereotypes on which the notion of masculinity is based (for example: strength, independence, self-sufficiency, power, virility, among others), not only influence the epidemiological profile of men, but also have repercussions for social level.
It is estimated that in Latin America and the Caribbean, there are 32.1 million men smokers and 15.7 million women who smoke. Tobacco use is one of the main risk factors for cardiovascular diseases, which are the main cause of death in Latin America, with higher mortality for men than for women.
In our region, men have weekly episodes of excessive alcohol consumption in a ratio of 4 to 1 compared to women. As a result, the mortality and disability rates associated with alcohol consumption are higher in men , mainly, between the ages of 15 and 49. At a social level, this problem directly affects the economically active population, creates conditions of dependency in young adults and increases health demand. It should be noted that these deaths and injuries are 100% preventable, avoiding the harmful consumption of alcohol. Similarly, according to a report from the Pan American Health Organization, the consumption of alcohol by men increases the possibility that they use violence against women.
In Latin America there is a serious problem of violence against women , mainly by their partners. According to the evidence collected by ONUMUJERES , existing gender attitudes in the region tend to socially “justify” the use of physical and sexual violence against women by men, in addition to the fact that there are rigid models that legitimize the use of intimate partner violence, as a way of “disciplining” women. Therefore, it is essential to involve men in policies and programs for the prevention of gender violence. However, men are also victims of interpersonal violence. In a study carried out by the IDB, it was found that young men are the main victims of homicides in several Latin American countries (48% were between 15 and 29 years old), and in six of the 17 countries in the study, more than 90% of homicide victims were men .
Men make less use of prevention and mental health services.
In Brazil, it has been detected that men make less use of health services, mainly to go to preventive services or to the first level of care; The association between the notion of masculinity and the act of seeking health care has also been explored. Brazil has a National Policy on Men’s Health, in which it is recognized that men are less prone to self-care and seek medical attention in more advanced stages of illness, which implies, on the one hand, negative consequences on their state of health and on the other, an increase in health costs, because their conditions require more technology and specialized personnel for treatment.
Regarding chronic diseases, prostate cancer is the cancer that most affects men, accounting for 13% of all deaths from this disease. The WHO expects the number of cases to double by 2030 . Due to the lack of timely detection (which may be due to the lack of use of preventive services), many cases are only detected in advanced stages .
In the case of depression, the existing norms of masculinity that exalt stoicism, self-sufficiency and strength, represent a social barrier for men to go to mental health services, since vulnerability or weakness are considered “inadequate” . This inhibits the search for professional care, which prevents access to treatment, affects the person’s quality of life and perpetuates stereotypes.
Men must also be included in the sexual and reproductive health agenda.
There is a growing notion that men should be part of the target population within sexual and reproductive health programs and strategies, to increase their effectiveness, given that currently, the global health agenda focuses primarily on the reproductive phase of women. A recent UNFPA study reveals how gender norms put pressure on adolescents, promoting the adoption of unhealthy versions of masculinity. This study found that in many countries, most adolescent men between the ages of 15 and 19 had engaged in sexual behavior. risk in the last year.
Additionally, gaps in both knowledge and policies and care strategies have been detected for some vulnerable and specific communities such as men who have sex with men, or transgender people.
Given this scenario, addressing the health problems that most affect men, understanding the role that stereotypes of masculinity play in the adoption of risky behaviors, and how these affect other social groups, are relevant strategies not only to decrease the burden of disease on men, but also as a mechanism to close health gaps.
Tania Marín Macías is a doctor and has a master’s degree in International Health. He currently collaborates as a fellow in the IDB’s Social Protection and Health Division.