Tough guys who buy into ideals of masculinity are much less likely to seek preventive healthcare services, such as a prostate exam, compared with other men.
The new finding, based on survey data, reveals that such manly beliefs could help to explain the lower life expectancy of men compared with women.
In the United States in 2005, life expectancy for women averaged about 80 years, while for men it was about 75 years, according to the Centers for Disease Control and Prevention.
"This research strongly suggests that deep-seated masculinity beliefs are one core cause of men's poor health, inasmuch as they reduce compliance with recommended preventative health services," said study researcher Kristen Springer of Rutgers University in New Jersey.
The study will be presented today at the American Sociological Association's annual meeting in San Francisco.
Springer and Rutgers colleague Dawne Mouzon, a sociology graduate student, examined data from 1,000 middle-aged men who participated in the Wisconsin Longitudinal Study in 2004. The researchers looked at participants' masculinity beliefs, socioeconomic status and compliance with three commonly recommended annual healthcare procedures for middle-aged men: a physical exam, flu shot and prostate examination.
To reveal their level of machoness, participants rated eight items on a scale from strongly agree to strongly disagree. These statements included, "When a husband and wife make decisions about buying major things for the home, the husband should have final say;" and "It bothers me when a man does something that I consider 'feminine.'"
Men who strongly endorsed macho ideals were 26 percent less likely than other participants to have received a physical exam in the prior year, nearly 30 percent less likely to have completed a prostate exam and nearly 50 percent less likely to have obtained all three preventive services in the prior year.
While previous research has shown higher socioeconomic status promotes better health, the new research found that wasn't the case for the manly men.
"As job status increases among men who have strong masculinity beliefs, the likelihood that they will obtain preventative healthcare declines significantly," Springer said. "These findings provide some insight into the persistent gender paradox in health whereby men have a lower life expectancy at birth relative to women, despite having higher socioeconomic resources."
(Compared with a woman, a man's life expectancy has been found to be five years shorter and he is expected to have higher rates of 12 of the 15 leading causes of death, the researchers note.)
In fact, men with low-status, stereotypically macho jobs, such as machine operators, truck drivers and construction workers, were more likely than other participants to head to the doctor.
Why they don't go
The researchers suggest several reasons for why macho men would avoid preventive healthcare. For instance, men in high-status jobs "do not want to feel emasculated by placing themselves in the subordinate position of patient," the researchers note. Perhaps, they add, such men avoid the doctor because they have the resources to remedy any resulting health problems.
In addition, men with high-status jobs practice more autonomy and freedom to disagree with authority opinions and so, in the same way, they may just ignore health recommendations, the researchers suggest.
To figure out the cause and to extend the results to a broader population, Springer says the study should be replicated in a sample with more diversity, as the participants in this survey were primarily white, middle-aged men with high-school degrees.
In the meantime, barring a complete removal of masculine norms, in order to increase men's likelihood of seeking preventive care, "we could flip the idea of masculinity on its head," Springer told LiveScience. For instance, a public service announcement by the U.S. Department of Health and Human Services shows men in hospital gowns doing manly activities, such as helping their son fix the car, Springer said.
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