2026 Theses Doctoral

Highlighting The Need to Focus on Men’s Health: A Health Disparity

Punjani, Nahid

There have been increases in life expectancy within the United States since the 19th century, with periods of accelerated improvements that align with key discoveries and achievements (e.g. vaccinations), and certain declines with unexpected world events (e.g. COVID-19 pandemic). One trend that has remained consistent throughout time, is that females have a longer life expectancy than males. While the size of this difference has varied between two to seven years, the current difference remains around five years. This long-standing difference suggests a potential opportunity for both inquiry and intervention, to not only understand why this trend has remained persistent, but how to generate parity and narrow this sex difference.

A focus on men’s health is therefore a timely and important public health issue which warrants attention. Like other important public health problems, it is a complex issue rooted in many domains: biological, social, socioeconomic, behavioral, metabolic, cognitive and others. Factors at the individual, healthcare provider, healthcare facility and healthcare system levels all warrant interrogation, and analysis across these various levels may be necessary for intervention development. The goal of this integrative learning experience was to explore men’s health as a public health issue, consider factors at the various system levels (individual, provider, institution and society) and utilize this as a framework to begin exploring possible future interventions.

The first aim examines mortality in the United States using data from the Centers for Disease Control and Prevention National Vital Statistics to better characterize sex-based differences in causes of mortality. The second aim focuses on sex-based differences in healthcare utilization, insurance status and lifestyle behaviors which may be contributory to some of the observed differences in disease outcomes and mortality for men. Finally, the third aim explores one possible solution to address men’s health which includes a review focused on dedicated men’s health programs and/or centers to address men’s health needs.

This study reveals and describes the biological disease processes driving the sex differences in mortality between females and males, importantly demonstrating a greater overall and disease-specific relative risk of death for males compared to females across age, race, ethnicity, and geography. This work, utilizing publicly available survey data, also demonstrates that males have reduced healthcare utilization and may exhibit some higher proportions of high-risk behavior compared to females. Finally, this work highlights data regarding men’s health centers or programs and provides some key insights into possible men’s health specific interventions to address this public health issue.