Impact of Gendered Masculinity in Health Engagement and Decision-making

seX & whY

Show Notes for Episode Seventeen of seX & whY: Impact of Gendered Masculinity in Health Engagement and Decision-making

Host: Jeannette Wolfe

Guests: Dr Fahad Saeed, Nephrologist and Palliative Care Specialist from the University of Rochester

Dr Lauren J. Parker, PhD, Dual PhD in Gerontology and Health Promotion, scientist at the Johns Hopkins Bloomberg School of Public Health

The topic today discussed how masculinity and race can impact access to health and health related decisions.

Take home points

• Overall, men have a shorter life expectancy than women and this is likely influenced by both biologically and sociocultural based factors associated with an individual’s gender identity
• Race based stressors amplify these sociocultural mortality differences
• Men are less likely to access preventative health care services and some of this is likely related to biological sex differences and behavioral patterns that begin in early adulthood as females are more likely to interact with health systems due to pregnancy and child related issues.
• Sociocultural “masculinity norms” may discourage health engagement due to an individual’s desire to be perceived as tough and independent.
• Ways to better engage men with their health (with an emphasis on men of color)

Increase public messaging to normalize the need for men’s preventative health

Increase diversity amongst medical providers

Reach men where they are like sporting events, barber shops and churches

Acknowledge and appreciate the unique roles and challenges that many men face

Target and adjust messaging to engage men at different life points

• Men can get caught in a warrior-like mentality which may impact their end-of-life choices. In cancer patients this may make them less receptive to palliative care due to a concern that it may suggest that they are “giving up”.

Palliative care is a specialty that helps patients, and their families cope with a life shortening illness and to optimize their quality of life. Patients in palliative care can still receive aggressive disease modifying therapy like chemotherapy with the except of patients receiving “hospice care”. Hospice care, although still under the palliative care umbrella, has slightly different rules. Under hospice, it is recognized that a patient is likely in their last 6 months of life and that they would no longer benefit from aggressive treatments, all care is redirected to optimize comfort.

Dr Saeed’s tips surrounding palliative care engagement in men with advanced cancer

• Normalize messaging such that palliative care is considered a natural part of cancer treatment
• Appreciate impact of non-verbal language- be authentic in conversation
• Recognize that most conversations have a logical and emotional component and appreciate that both need to be addressed
• Take time to know the patient’s story, this humanizes the interaction and increases empathy
• Remember goal is to figure out their preferences and then honor them
• Sometimes shifting focus from fighting terminal cancer to fighting for comfort and to ease families suffering can make patients more amenable to palliative care services

Links

- Dr Lauren Parker’s paper that examines ways to more effectively engage men in their health. - List of her other publications- TEDX Rochester talk by Dr Saeed - Links to Dr Saeed’s publications - His specific research that we discussed - 2012 paper that Dr Saeed referenced by Susan Wong