Experts take a critical look at global health policies and say that the issue of gender should be addressed, particularly norms and behaviors that drive up men’s health risks.

Men, in general, have shorter lifespans than women, yet public policy vastly underrates the importance of gender in health outcomes, according to an analysis of the World Health Organization’s annual report on policy and disease.

Sarah Hawkes, a professor of global health at University College London, and Kent Buse, chief of political affairs for UNAIDS, published an opinion paper in The Lancet discussing gender issues and the top 10 global causes of death.

They found that men worldwide lose more years of their lives to death or disability than women do, especially because of higher rates of heart disease, lower respiratory infections, cerebrovascular disease, HIV/AIDS, and road injuries.

Hawkes and Buse say that global efforts from major health institutions focus primarily on women, despite the fact that men ages 25 to 39 have seen the smallest decline in mortality worldwide.

“Evidence shows that gender—a social construct—has a substantial effect on health behaviours, access to health care, and health system responses. Gender norms, whether perpetuated by individuals, communities, commercial interests, or underpinned by legislation and policy, contribute to disparities in the burden of ill health on men and women,” they wrote. “In some settings and for some conditions, women suffer more ill health, but globally males have a higher burden of disease and lower life expectancy than females.”

Major health problems like heart disease, stroke, respiratory infections, COPD, and HIV/AIDS are preventable and are exacerbated by personal health decisions. Doctors should have a gender-specific health conversation about personal choices with men as well as women, the authors argue. Risky behaviors directly at the heart of the issue include tobacco smoking, alcohol consumption, and risky sexual behavior.

“Gender norms drive risk-taking. Drinking alcohol and smoking, in particular, are subject to social pressures which have resulted in men globally running three times the risk of ill-health from these behaviours compared to women,” Hawkes said in a press release. “These norms and customs are clearly perpetuated by all of us, and exploited by commercial interests.”

While the global focus on women’s health is extremely important because girls and women are “universally less powerful, less privileged, and have fewer opportunities than men,” policies and programs addressing men’s health are “notably absent,” the authors argue.

Hawkes and Buse propose a three-step process to bring gender-specific healthcare into the mainstream:

  1. Differentiate by gender and sex in global health research and evaluation efforts.
  2. Shift mindsets to address gender norms and how they affect a person’s health.
  3. Acknowledge that gender in health is a political issue because special interests perpetuate gender norms.

“Achievement of gender equity in health outcomes will need concerted efforts to confront the underlying interests that drive poor health for all, including efforts to better understand and control the effects of commercial interests that exploit and perpetuate gender stereotypes,” the authors wrote.