Background: Little is known about men's access to health and social and psychological services, especially in the context of migration and COVID-19. This study compares immigrant male users and non-users of physical health and social and psychological services in Quebec, Canada, concerning (a) their self-assessed physical health and psychological well-being, (b) how those changed during COVID-19, and (c) men's reported use of services during COVID-19. Methods: Participants were 421 immigrant men, with provincial public health insurance. One-way independent t-tests compared differences in participants’ psychological well-being and physical health. Chi-Square analyses explored associations between accessing health services, experiencing physical health problems, psychological well-being, and COVID-19 related worries. Results: Participants who accessed social and psychological services had significantly lower average psychological well-being than those who did not access services. Almost all participants who experienced physical health problems accessed the corresponding service. Conclusion: The challenges involving troubles accessing social and psychological services problems might be affected by cultural norms and put immigrant men in a more vulnerable condition.
Introduction: Alcohol use disorders (AUDs) and related treatment needs are more prevalent among men than women. However, research in South Africa has rarely focused on men's experiences and perceptions of alcohol use and AUD treatment. We explored men's perceptions and experiences of alcohol use and AUD treatment in areas located in four provinces in South Africa. Methods: We recruited men who met criteria for moderate to severe alcohol involvement from treatment and drinking settings. We interviewed 21 men on their experiences and perceptions of alcohol and other drug use as well as AUD treatment seeking, access, and engagement. The data were analyzed thematically. Findings: Four themes were generated from the data. Young, Curious, and Pressured to Drink showed that alcohol use often began in adolescence due to peer pressure and normalization in social settings. Progression to Frequent and Problematic Drinking revealed that drinking evolved from a social activity to a coping mechanism in adulthood. Indicators of Having a Drinking Problem indicated that men recognized excessive drinking and loss of control as signs of an AUD. AUD Treatment Seeking and Engagement highlighted that men often ignored treatment needs due to the normalization of alcohol use within their communities and perceived inaccessibility of treatment centers. Conclusion: Community norms and masculinity ideals contribute to heavy drinking and hinder men's engagement in AUD treatment. Community-based interventions incorporating gender-transformative elements are needed to address the factors driving heavy alcohol use among South African men.
Background: The health and well-being of men raise significant social issues, particularly concerning depression, psychological distress, and suicide, with concern especially pronounced among male farmers. Previous research has primarily focused on risk factors, highlighting the influence of traditional masculinity on the valorization of hard work, excessive autonomy, as well as the stigmatization of mental health issues and the reluctance to seek help. However, the connections between protective and health-promoting factors and masculinity remain largely unknown. This study aimed to better understand the practices of masculinity that contribute to positive mental health among farmers. Methods: This photovoice research used photographs taken by the participants and shared in focus groups to initiate reflection and discussion on their motivations, social support, personal strengths, and environmental factors. Online recruitment in Quebec (Canada) enabled us to reach 31 farmers who were divided into six focus groups that met twice. The focus groups were co-facilitated by a researcher and a retired farmer. The interview transcripts were then inductively analyzed. Results: The results highlight that positive mental health is associated with interpersonal relationships; connection to the land, farm animals, and pets; travel and leisure; and farm activities. The discussion section suggests alignment toward traditional or caring masculinity to overcome the multiple challenges of farming life. Conclusion: This study underscores the value of offering farmers a platform to express their emotions, discuss the impact of traditional masculinity on their well-being, and explore alternative masculine practices. It also facilitates for further discussion on caring masculinity, aiming to better understand and support men in farming while also exploring its potential relevance to other agricultural groups.
Background: The mental health of men is an inadequately addressed issue in India. It is essential to better understand men's mental health needs to inform the development of targeted policies and interventions. This scoping review maps literature relevant to improving the mental health of men in India. Methods: A combined database search was undertaken for 2010 to 2024 with additional searches of gray literature. A broad inclusion criteria was applied to provide a comprehensive picture of men's mental health needs. Results: A total of 35 articles were identified from 2001 records. The review found limited literature specifically focused on the mental health of men in India. However, broader population studies provide valuable data for established men's mental health needs. The literature indicates a high prevalence of mental health issues in men and identifies the role of factors including socio-economic disadvantage, financial instability, loss of employment, restrictive gender roles, stigma, lack of social support, having migrant children, functional limitations, and poor health. The review also identified large treatment gaps and did not identify any programs targeted to addressing men's mental health needs. Conclusions: There is a dearth of literature on this issue. To better support the mental health of men in India, barriers including limited funding, limited health care, societal belief systems including gender roles and norms regarding manhood, and socio-economic disadvantage will need to be addressed. This review underscores the need for more research to explore the mental health challenges faced by men in India and to develop population-level interventions.
Although the issue of access to health and social services in Indigenous communities appears more pressing for men than for women, studies have tended to focus on women's perspectives. Moreover, most studies focus on the barriers preventing access to services rather than on facilitators of help seeking. The objective of this study was to identify factors facilitating help seeking within three Anishnaabe communities in Québec, Canada. Interviews were conducted with 15 Anishnaabe adult men having recently (<5 years) used at least one health or social service. The interviews allowed to identify triggers of Anishnaabe men's help-seeking behaviour (e.g. crisis situation, awakening), motivators of help seeking (e.g. pursuit of well-being for oneself and family), their apprehensions about help seeking (e.g. mistrust towards service providers), as well as facilitators of help seeking (e.g., knowledge of services, ability to express emotions). To foster Anishnaabe men's help seeking, efforts should be made to reach out to them rather than waiting for them to reach out to services. Giving visibility to their engagement and personal development is likely to encourage other men to follow their example. Considering Anishnaabe men's strong sense of self-reliance, procedures of access to services should be simplified, and information sharing about services should be improved.
Engaging young men in mental health interventions remains challenging due to traditional gender norms and social disengagement. Brothers Through Boxing (BTB) is a 24-week program that integrates noncontact boxing with mental health education. This study assesses its appropriateness, effectiveness, and impact on well-being, life satisfaction, social connectedness, and constructions of masculinity. A mixed-methods approach was employed. Between November 2020 and March 2022, pre-, post-, and 3-month follow-up surveys were administered to 29 participants. Validated tools included: the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), Life Satisfaction Scale (LSS), and Duke Social Support Index (DSSI), to assess mental well-being, life satisfaction, and social connectedness, respectively. Qualitative data were collected between November and December 2021 through two focus groups ( n = 4; 43 min and n = 5; 54 min) and one interview ( n = 1; 17 min). There was a significant increase in SWEMWBS (post, p < .001; 3 m follow-up, p < .001), LSS (post, p < .001; 3M follow-up, p < .001) and DSSI (post, p < .001; 3 m follow-up, p < .001) scores. High program satisfaction was reported (mean = 3.76; SD = 0.43; range: 1–4, where 4 = very satisfied). Boxing was the primary engagement driver, with peer-led discussions and the Road to Resurgence toolkit crucial for program success and shifting masculine norms. BTB demonstrates promising potential to improve and maintain mental well-being, life satisfaction, and social connectedness in disengaged young men, a group traditionally difficult to engage through conventional therapeutic approaches.
Numerous studies have confirmed men, their gender norms associated with masculinity, and health are interrelated concepts that influence men's health-seeking behaviours and outcomes. Using the tenets of the Andersen Health care Utilization Model, this study examines predisposing, enabling, and constraining factors along with masculinity as predictors of preventive health care utilization in Black/African American (BAA) men. Public health nurses (PHNs), in knowing the importance of preventive measures, can play a pivotal role in improving BAA men's health outcomes. This nonexperimental correlational cross-sectional design included 176 BAA men aged 26–74 years from the Upper Midwest metropolitan area answering questions on their demographics, current preventive health care utilization using the Older Men's Health Program and Screening Inventory, and conformity to masculine norms using the Conformity to Masculine Norms Inventory-46. Winning, self-reliance, and heterosexual self-presentation were the three norms that significantly contributed to participants’ preventive health care utilization. Higher conformity to heterosexual self-presentation was associated with less preventive measures utilized within the past year, while higher conformity to winning was associated with higher odds of seeing the doctor within the past year. Higher conformity to self-reliance were associated with higher likelihood of visiting an ER within the past year. With improved investigation and closer attention to perceptions and masculine norm conformity, the health care system would have a better grasp on how to approach and improve health disparities among BAA men. From here, PHNs can better determine what it means to be masculine within the BAA community and how BAA men perceive preventive health care to improve health initiatives geared toward BAA men and decrease identified health disparities.
Rigid adherence to traditional masculine norms is associated with mental ill-health. Positive masculinities have been proposed as more flexible, inclusive, and authentic ways of being, whereby boys and men can embody key human strengths essential to their well-being. We interviewed 12 school-aged young men, 11 teachers, and 8 parents and employed thematic analysis to examine how positive masculinity is constructed within an Australian all-boys school. Young men endorsed positive masculine traits, such as acceptance of diversity and emotional disclosure. However, as emerging norms competed with traditional ones, some young men were left without a clear idea of ‘how to be’ masculine in the current social and political climate. Results from the present study support going beyond rhetorical messaging espousing what not to do (ie, a deficit-based approach), in advance of simultaneous education regarding what to do instead (ie, a strengths-based approach) when working with young men.
To report on the impact of a training program for mental health and social service professionals designed to foster gender-sensitive work with at-risk and underserved men. A mixed-method study consisting of qualitative and quantitative components was conducted. A phenomenological thematic method was employed in the qualitative component to identify changes in the participants’ perceptions about men. The quantitative component consisted of an analysis of the impact of the training on the participants’ knowledge, skills, and self-awareness regarding the process of working with men. Qualitative findings revealed a positive shift in the participants’ attitudes about working with men. Quantitative findings indicated significant improvements in the participants’ knowledge ( p < .001), skills ( p < .001), and self-awareness ( p < .001) related to men and their issues. Continuing education about the socialization of men and their needs enhances practitioners’ understanding and empathy for men and efforts to help at-risk and underserved men.
Our study examined the relationship between self-rated health (SRH) and colorectal cancer (CRC) screening intention and behaviors among United States men aged 45 to 75 years. In addition, we assessed whether educational attainment modified these relationships and the presence of an intention–behavior gap. Using data from a 2022 cross-sectional survey ( n = 501), we assessed CRC screening intentions, history, and current status. Multivariable logistic regression models explored associations between SRH and the outcomes of interest, adjusting for confounding. Results were stratified by educational attainment to examine potential effect modification. Cochran's Q test and McNemar's tests evaluated differences and discordance among outcomes. While most participants planned to undergo CRC screening (82.2%) and had been screened before (65.9%), fewer than half (44.9%) were up to date with screening. Good or better SRH was associated with higher odds of planning to get screened (aOR: 1.73; 95% CI: 1.01, 2.97). The relationships between SRH and screening behaviours were not statistically significant. We found limited evidence that educational attainment modified these relationships. There was significant heterogeneity among the outcomes ( p < 0.0001). The only characteristic associated with discordance between intention and participation was age ( p < 0.0001). Men with positive SRH are more likely to intend to undergo CRC screening; however, this intention often does not translate into action. Future research should meticulously investigate barriers preventing men from following through with CRC early-detection screening efforts .
Gender-responsive approaches that have used football have been shown to be effective in both engaging men and improving health in specific male populations. This paper reports on the health impact of participation in an ongoing recreational football initiative (Football Cooperative, [FC]) for all men up to 12M. Findings from this paper will inform the implementation strategy to scale up the FC initiative. Adopting a quasi-experimental, longitudinal design, without control, participants were recruited through purposeful sampling. Self-report, anthropometric, and fitness data were collected at baseline and at 3, 6, and 12 months. Findings show a significant improvement in aerobic fitness at all time points, a positive trend in WC reduction that was significant at 12M (2.5±4.6 cm) and an achievement in the 5% weight-reduction threshold for 17% of those tested at 12M. cardiovascular disease (CVD) risk (≥5 factors) reduced from baseline (52%) to 12M (26%). Loneliness reduced at 6M with a corresponding improvement in sleep quality. However, trends toward improved psychological and health behaviour metrics are evident; the low sample size coupled with high baseline metrics, which may be influenced by gender conditioning, were a challenge to detecting change over time. Participation in the FC initiative reduced CVD risk and improved health metrics ; men should be supported to participate beyond 6M for increased benefit. Future research should use alternative methods to assess psychological and health behaviour metrics and aerobic fitness and should ensure a control group comparison. These findings will inform the implementation of the FC initiative at scale.
Introduction: Despite the social and cultural changes of the recent decades, the tasks associated with childcare continue to be assumed mainly by women, increasing stress and, in some cases, negatively affecting maternal mental health. The “m-What were we thinking” (m-WWWT) intervention seeks to reduce the risk of developing postpartum depression and anxiety symptoms in women by increasing self-efficacy in caring for a newborn and perceived social support, with a special focus on the partner's role. The objective of this study was to describe the mothers’ perception of how this intervention facilitated the father's parenting involvement. Methods: Sixty-four text messages from 25 first-time mothers participating in the m-WWWT program were analyzed using the Grounded Theory open and axial coding criteria. Results: There are four subjective themes linked to fathers and parenthood. The first refers to the loss of the previous balance and increased stress with the arrival of the first child; the second, to the importance of watching the intervention videos together; the third, to the possibility of communicating regarding what is happening; and the fourth, to the shared conceptualization of parenting among the couples. Conclusion: These findings suggest that m-WWWT positively influences paternal involvement in the postpartum period, which is a relevant factor to promote maternal and infant well-being.
Background: Prostate cancer carries a significantly higher burden among Black versus White men in the United States. In Suffolk County, NY, prostate cancer incidence rates are 75% higher among Black individuals with twice the mortality rate. Methods: To address this disparity, a community-based project was implemented. The project used focus groups to assess knowledge, beliefs, attitudes, and health care-seeking practices of Black men. Recruitment was difficult, community members were resistant to participate. Trusted community leaders proved to be the most successful asset for recruitment. Results: In total, three focus groups were held, with a total of 18 participants. Most participants were referred by their school district, pastor, or a community-based organization. Conclusion: A significant lesson learned was the importance of establishing trust, as research done without establishing meaningful connections leads to more mistrust. The downstream effects from the team's initial outreach demonstrate how rich and robust interconnecting relationships may develop within the community.
Introduction: This study proposes an interdiscursive perspective between bioethics and the social and human sciences to understand the phenomenon of unemployment from the male perspective. The objective of the study is to analyse the bioethical principles of autonomy and care for the understanding of masculinity in unemployed men. Method: Qualitative case study from Yin's perspective with a hermeneutic approach, through in-depth interviews with a narrative biographical emphasis. Seven heterosexual men from Bogota, without employment and with family, were recruited through a combined purposive and convenience sampling process. Thematic analysis of the data was carried out after open coding of the narratives, which allowed the construction of families and emerging categories. Results: The main findings revolve around the principles of autonomy and care as macro categories of the social and human sciences and bioethics from a comprehensive perspective. Discussion: The analysis of the bioethical principles of autonomy and care provides key elements to build interdiscursive and interdisciplinary bridges between bioethics and the social and human sciences. It does this by addressing the social phenomenon of unemployment in men and its implications in the rupture of mental and contextual models of men that contribute to the understanding of masculinities.
Introduction: Osteoporosis increases the risk of fragility fracture. Hip fractures are associated with poor outcomes. Men are under-screened and under-treated for osteoporosis, which tends to be secondary, and men have higher mortality and worse outcomes after hip fracture than do women. This study aimed to describe patients admitted with hip fracture following minimal trauma and to explore any gender differences in calcium and vitamin D deficiency and use of osteoporosis medication before admission. Methods: A retrospective cross-sectional study included all patients admitted to Bankstown-Lidcombe Hospital with a fracture of the hip post fall, with or without surgery, from January 1, 2019, to December 31, 2019. Each patient's electronic medical record was reviewed to collect data. The data were extracted and analysed using GraphPad Prism 9.5.1. Unpaired Student's t-tests and Fisher's exact test were used in the analysis. Results: A total of 203 patients were included with a mean age of 83.5 ± 8.8 years and a range of 40 to 103 years, with over half (51.2%) aged 81 to 90 years. Fifty-nine (29.1%) were male. Of 196 patients with vitamin D levels available, 78 (39.8%) had a deficiency, including 30 of 57 (52.6%) males and 48 of 139 (34.5%) females. Males were twice as likely to be vitamin D deficient as were females on admission (OR 2.106; 95% CI 1.143 to 3.939; p = 0.0243). Of 203 patients, 39 (19.2%) were on osteoporosis treatment before admission, including 6 of 59 (10.2%) male and 33 of 144 (22.9%) female patients. Males were 2.6 times more likely to have had no osteoporosis treatment before admission than were females (OR 2.626; 95% CI 1.059 to 6.340; p = 0.0486). Conclusions: Males were more likely to have vitamin D deficiency and not be prescribed osteoporosis medication before admission in a cohort of patients admitted to the hospital with hip fracture post minimal trauma. To prevent hip fracture and resultant hospitalization, increased awareness is needed in diagnosing and managing osteoporosis in men, ideally occurring in the community.
Background: Increasing levels of risky alcohol consumption in older men observed in many countries, combined with trends for increased alcohol-related misuse by men during COVID, indicate a need to examine alcohol use by older men during the pandemic. Aim: To examine the prevalence and predictors of increased and hazardous alcohol consumption in older South Australian men during COVID-19 restrictions. Method: Data collected in the latest (eighth) wave of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) cohort study were interrogated. Participants were 746 community-dwelling older men (mean age 69 years) who completed a self-report survey on mental health, coping, COVID-related worries, and alcohol consumption during pandemic restrictions. Alcohol-related items asked about changes to overall consumption (analysed as increased vs. decreased/same) and number of standard drinks per occasion (analysed as <5 drinks [not hazardous consumption] vs. 5+ drinks [hazardous]). Two hierarchical binary logistic regressions were conducted to explore predictors of increased and hazardous alcohol intake. Results: Eight percent of men reported increased alcohol intake and nine percent reported hazardous alcohol consumption during COVID-19 restrictions. Being in a younger age group (‘younger old’; OR=0.46, 95%CI=1.03, 2.28), having mild to severe depressive symptoms (OR=1.39, 95%CI=1.10, 5.05), and greater concern about becoming sick with COVID-19 (OR=1.52, 95%CI=1.03, 2.28) were predictive of increased alcohol consumption during restrictions. Younger age group (OR=0.46, 95%CI=0.34, 0.62) and greater concern about becoming sick with COVID-19 (OR=1.67, 95%CI=1.13, 2.51) were also predictive of hazardous alcohol consumption during this time. Discussion: Men participating in longitudinal health study follow-ups may be less inclined to engage in unhelpful coping behaviours such as problematic alcohol use. Clinicians should regularly screen older men for risky alcohol consumption; a particular focus on screening ‘younger old’ men, those with more significant concerns around COVID-19, and those with depression symptoms may be warranted.
Background: Australian men are likelier to die younger than women, often from preventable diseases or conditions. Gendered health promotion has improved men’s engagement with health services, with nurses playing a central role in information and healthcare design. The primary aim of this research was to survey senior clinical and executive nurses on their understanding and perception of men’s health. Methods: A cross-sectional quantitative online survey was attended by senior nurses within a single hospital setting in metropolitan Sydney between June 2022 and July 2022. Sampling selection was conducted of nurses who currently hold senior clinical or management roles within the health district (Nurse Manager, Nurse Unit Manager, Director of Nursing, Nurse Practitioner, Transitional Nurse Practitioner, Clinical Nurse Consultant, Clinical Nurse Specialist, Nurse Educator, Clinical Nurse Educator) with descriptive analysis applied to interpret the data sets. Results: A total of 84 responses were received, representing a 33% survey participation rate. A key finding was that 89.1% of senior nurses believed that traditional masculine traits affected health-seeking behaviour. However, 60.2% had not discussed men’s-specific agencies with male patients, and 33.7% of senior nurses believed that gender was not a determinant of health. There was strong endorsement (74.6%) for a men’s health education program to be developed specifically for nurses. Conclusion: The results of this single-site online survey of senior nurses illustrate that while foundational understandings of gender as a determinant of health were divided, there remained strong endorsement for targeted men’s health promotion to patients and the development of men’s health educational programs to support nurses in providing holistic care for their male patients.
