Can social expectations of masculinity be bad for cardiovascular health?

Cardiovascular disease continues to be a leading cause of illness and death, both in the U.S. and globally. What sets it apart is that it's largely modifiable and preventable, unlike many other health conditions. However, early detection and mitigation of risk factors, such as high blood pressure and elevated cholesterol, are crucial to its prevention.

Unfortunately, these efforts are often lacking, with up to 75% of young adults unaware that they even have conditions like hypertension or high cholesterol. This gap in awareness is a significant challenge in the fight against cardiovascular disease.

A recent study from the University of Chicago highlights how social and cultural norms, particularly those surrounding gender, may play a role in this lack of awareness and treatment. Researchers found that boys and men who adhere more closely to stereotypical masculine behaviors are less likely to report being diagnosed or treated for cardiovascular disease risk factors.

The study builds on existing research that shows societal pressures to conform to traditional male gender roles often lead to harmful health behaviors, such as avoiding medical care or disregarding health advice.

“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, who led the study.

He explained that the research team took a novel approach by looking at how male gender identity is constructed in relation to cardiovascular disease prevention.

To conduct the study, Glasser and his colleagues analyzed data from Add Health, a national, longitudinal study that collected health measurements and survey responses from more than 12,300 people between 1994 and 2018. They measured participants’ male gender expressivity by comparing their answers to a subset of survey questions that had been answered differently by male and female participants. This allowed them to see how closely men’s behaviors and attitudes aligned with those of their male peers.

“When we talk about gender expression, we’re not looking at anything physiologic that could be affected by the Y chromosome,” Glasser noted. “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.”

The study focused specifically on cardiovascular disease risk factors, comparing biological measurements with self-reported health data. The researchers found that men who exhibited more stereotypically masculine behaviors were significantly less likely to report having been diagnosed with or treated for cardiovascular disease risk factors, even when they had measurable indicators such as high blood pressure. Even when these men did report a diagnosis, they were still less likely to say they were taking medication for their condition.

This suggests that the gap in diagnosis and treatment might be due to several factors. Men who strongly identify with traditional masculine roles may not seek regular screenings, may not take their diagnoses seriously, or may downplay their health conditions when asked. Regardless of the underlying cause, this pattern points to a missed opportunity for preventing or managing 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.

The study’s implications extend beyond just traditional masculinity. It also highlights how the pressures to conform to various aspects of identity — whether gender, race, or sexuality — can influence health behaviors.

Glasser emphasized the need for increased societal understanding and patience when it comes to the complexities of identity, noting, “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.”

Cardiovascular disease remains a major health concern, and the study sheds light on how gender norms may contribute to the underdiagnosis and undertreatment of key risk factors. By understanding the social pressures that shape health behaviors, there is potential to improve prevention efforts and ultimately reduce the burden of cardiovascular disease.

Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.

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