Men’s health in the United States: a national health paradox

Abstract

A health paradox exists in the United States. Men have worse health outcomes than women, but national offices exist for promoting women's but not men's health. Two factors that might contribute to this paradox are: underappreciation for the number of health issues that affect men more than women and unawareness that men’s health receives less attention than women’s health. Therefore, the aim of this article was to summarize the data related to these two factors. First, using mostly government data, an inventory of health issues that are more common in males than females was generated, with prevalence rates listed. Second, results from two new scientometric analyses are presented: (a) number of times “men’s health” and “women’s health” appeared in titles or abstracts of papers in PubMed from 1970 to 2018; and (b) number of journals currently indexed in MEDLINE that specialize in men’s or women’s health. The epidemiological data illustrate numerous health issues are more prevalent in men than women, and scientometric data reveal men’s health has been given less attention as a distinct field of biomedical research than women’s health. This information can help to educate legislators, health officials, journalists, and the general public about the current paradox surrounding men’s health in the United States.

Keywords:

• Health promotion
• epidemiology
• life expectancy
• men’s health
• women’s health

Introduction

In 1990, the National Institutes of Health created the Office for Research on Women’s Health (ORWH) in response to the claim women were inadequately represented in biomedical research trials. Multiple sources later confirmed this claim was unsubstantiated [1,2], yet the ORWH still operates and no equivalent office for men’s health has ever been created. Moreover, the Centers for Disease Control and Prevention (CDC) and The Food and Drug Administration have offices dedicated to the study and promotion of women’s health. Neither agency has an office for men’s health (Table 1).

Table 1. List of men’s and women’s offices in national health agencies within the United States government.

Government agency	Women’s office	Men’s office*
National Institutes of Health	Office for Research on Women’s Health (est. 1990)	None
Department of Health and Human Services	Office on Women’s Health (est. 1991)	None
Centers for Disease Control and Prevention	Office of Women’s Health (est. 1994)	None
Food and Drug Administration	Office of Women’s Health (est. 1994)	None

*An attempt was made to establish an Office for Research on Men’s Health within the National Institutes of Health in 2009, but the relevant bill, the Men’s and Families Health Care Act of 2009, died in subcommittee.

The absence of national offices dedicated to men’s health is perplexing and paradoxical given that men, on average, have worse health outcomes than women. For example, life expectancy for males in the United States is 4.8 years less than that for females [3]. Notably, this difference is greater than the life expectancy difference between Blacks and Whites (3.4 years) [3]—a statistic which additional offices have been created to address (e.g. NIH Institute on Minority Health and Health Disparities Research; NIH Office on Minority Health Research Coordination; CDC Office of Minority Health and Health Equity).

One factor that might contribute to the lack of advancement on men’s health issues in the United States is a general underappreciation for the number of issues that affect men more than women. Recognition of these issues might be enhanced if the relevant epidemiological data were collated into one source, something that has rarely been done. Another factor that might underlie the lack of progress on men’s health issues in the United States is that few attempts have been made to quantify the different amounts of attention given to the fields of men’s and women’s health. The greater number of national offices dedicated to women’s health than men’s health lends initial support to this (Table 1), as does data showing the number of women’s health centers in the United States far exceeds the number of men’s health centers [4]. Different degrees of attention to men’s and women’s health may also manifest in differences in the amount of scholarly output published under the purviews of “men’s health” and “women’s health.”

Therefore, this article had two aims. The first was to summarize the health issues that are prevalent in males than in females. In most cases, data from the CDC and other agencies within the United States government were reported. The second aim was to examine the different levels of recognition given to the concepts of men’s health and women’s health over the past 50 years. This was done by first quantifying the number of times the terms “men’s health” and “women’s health” have appeared in the titles or abstracts of papers in PubMed from 1970 to 2018. Then, a list of journals currently indexed in MEDLINE and specializing in either men’s health or women’s health was generated. Together, the epidemiological data from the first aim and the scientometric data from the second aim can be used to educate legislators, health officials, journalists, and the general public about the current paradox surrounding men’s health in the United States.

Health issues that are more prevalent in males than females

Table 2 lists and describes the substantial number of health and health-related issues that are more prevalent in males than in females. Examples include life expectancy, accidental injuries and deaths, cardiovascular disease, sexually transmitted diseases (HIV, syphilis), most types of cancer, amyotrophic lateral sclerosis, cerebral palsy, muscular dystrophy, spinal cord injury, traumatic brain injury, amputations, gout, kidney stones, inguinal hernia, sleep-disordered breathing, hearing loss, attention deficit hyperactivity disorder, antisocial personality disorder, autism spectrum disorder, communication disorders, conduct disorder, Tourette syndrome, educational attainment, pathological gambling, substance abuse (alcohol, tobacco, cocaine, hallucinogens, heroin, opioids), criminal activity and bullying (perpetrator and victim), imprisonment, homelessness, and suicide.

Table 2. Health issues (A–Z) that are more prevalent in males than in females in the United States.^a

A
Accidents
Bicycle injury, death In 2015, 85% (n = 697) of cyclists killed and 80% (n = 158,229) of cyclists injured were males [5]. Deaths from unintentional injuries In 2016, unintentional injuries were the third leading cause of death in males (7.4% of all deaths, n = 103,864). They were the sixth leading cause of death in females (4.3% of all deaths, n = 57,510) [6]. Drowning The death rate from drowning is four times higher in males than in females (2.07 vs. 0.54 per 100,000 population) [7]. Motor vehicle injury, death In 2012, the number of males killed in motor vehicle accidents was more than double that of females (23,808 vs. 9733). The number of males who had experienced incapacitating injuries from motor vehicle accidents was also higher than that of females (104,000 vs. 78,000) [7]. Occupational injury, death In 2017, 12 times as many males (n = 4761) than females (n = 386) died from occupational injury (5.7 vs. 0.6 per 100,000 full-time equivalent workers) [8]. Sports injuries 61.3% of sports- and recreation-related injuries occur in males [9].
Amputation
65% of individuals living with limb amputations are male [10].
Amyotrophic lateral sclerosis (ALS)
In 2014, ∼63% (n = 9821) of ALS patients were male and 37% were in female (n = 5584) [11].
Androgenic alopecia (balding, patterned hair loss)
Prevalence of patterned hair loss is higher in males than females [12,13].^b
Antisocial personality disorder
Prevalence of antisocial personality disorder is 5.5% in males and 1.9% in females [14].
Asthma
Asthma is more prevalent in boys (9.2%) than girls (7.4%) [15].
Attention-deficit hyperactivity disorder
The male:female ratio for attention deficit hyperactivity disorder is 1.9–3.2:1 [16].
Autism spectrum disorder
Males are four times as likely as females to have autism spectrum disorder (26.6/1000 vs. 6.6/1000) [17].
B
Bullying
In grades 6–10, males are more likely than females to be both the perpetrators and targets of bullying. 12.9% of males and 5.2% of females say they bully someone weekly. 10.8% of males and 6.4% of females say they are bullied weekly [18].
C
Cancer
Brain and other nervous system In 2013, the number of deaths from cancers of the nervous system was 8491 for males (5.2 per 100,000 persons) and 6852 for females (3.6 per 100,000 persons) [19]. Deaths from all types Cancer is the second leading cause of death in both males and females. In 2016, the number of males (n = 314,571) who died from cancer was more than the number of females (n = 283,467) [6]. The only forms of cancer in which mortality rates are higher in women than men are gallbladder and thyroid cancer [19]. Digestive system In 2013, the number of deaths from cancers of the digestive system was 85,255 for males (52.9 per 100,000 persons) and 63,528 for females (31.4 per 100,000 persons) [19]. Death rates were higher in males in each subcategory (e.g. esophagus, stomach, small intestine, colon and rectum, liver, pancreas). Leukemias In 2013, the number of deaths from leukemias was 13,625 for males (9.1 per 100,000 persons) and 9924 for females (5 per 100,000 persons) [19]. Lymphomas In 2013, the number of deaths from lymphomas was 11,801 for males (7.8 per 100,000 persons) and 9402 for females (4.7 per 100,000 persons) [19]. Mesothelioma In 2013, the number of deaths from mesothelioma was 1911 for males (1.3 per 100,000 persons) and 586 for females (0.3 per 100,000 persons) [19]. Miscellaneous In 2013, the number of deaths from “miscellaneous” forms of cancer was 21,647 for males (13.8 per 100,000 persons) and 18,583 for females (9.1 per 100,000 persons) [19]. Myeloma In 2013, the number of deaths from myeloma was 6,407 for males (4.2 per 100,000 persons) and 5,394 for females (2.7 per 100,000 persons) [19]. Respiratory system In 2013, the number of deaths from cancers of the respiratory system was 89,108 for males (56 per 100,000 persons) and 71,536 for females (35.9 per 100,000 persons) [19]. For lung and bronchus cancer, the number of deaths was 85,658 for males (53.9 per 100,000 persons) and 70,158 for females (35.4 per 100,000 persons) [20]. Skin (excluding basal and squamous) In 2013, the number of deaths from skin cancer was 8723 for males (5.6 per 100,000 persons) and 4025 for females (2 per 100,000 persons) [19].
Cardiovascular issues
All Prevalence of cardiovascular disease (coronary heart disease, heart failure, stroke, and hypertension) is greater in males than females in every age bracket up to the age of 80 [21]. Congenital heart defects From 1999 to 2006, the number of deaths from congenital heart defects was 21,848 in males (1.89 per 100,000 population) and 19,646 in females (1.67 per 100,000 population) [22]. Coronary heart disease Prevalence of coronary heart disease (includes myocardial infarction and angina pectoris) in males (7.4%) is higher than in females (5.3%) [21]. Age-adjusted death rates for coronary heart disease are 266.1 per 100,000 for men and 182.1 per 100,000 for women [21]. Deaths from diseases of the heart Diseases of the heart are the leading cause of death in both males and females. In 2016, the number of males (n = 339,265) who died from diseases of the heart was greater than the number females (n = 295,995) [6]. Hypertension Prevalence of hypertension is higher in males than females in every age bracket up to the age of 65 [21]. Sudden cardiac arrest during exercise In all studies that have quantified sudden cardiac arrest during exercise, males have been found to be at greater risk than females [23].^b
Cerebral palsy
In 2008, the point prevalence ratio for cerebral palsy in males to females was 1.5:1 [24].
Communication disorders (voice, speech, language)
All Boys (9.6%) are more likely than girls (5.7%) to have a voice, speech, language, or swallowing disorder during the past 12 months [25], although the trend is switched in adulthood [26]. Speech delay Speech delay is 1.5 times more prevalent in boys (4.5%) than girls (3.1%) [27].
Conduct disorder
Estimated lifetime prevalence of conduct disorder is 12% in males and 7.1% in females [28].
Crime
Perpetrator In 2017, 73% of persons arrested were males (n = 6,016,739); 79.5% of persons arrested for violent crimes were males; 87.5% of persons arrested for murder or non-negligent manslaughter were males; and 75.7% of persons arrested for drug abuse violations were males [29]. Males were more likely than women to commit every type of crime listed in the FBI’s dataset [29]. In 2013, the estimated number of males supervised by the adult correctional system (i.e. probation, parole, local jail, prison) was 5.6 million. The number of females was 1.2 million [30]. Victim In 2017, 11,862 males were murdered, accounting for 78.4% of all murder victims [29].
D
Drugs
Alcohol Lifetime prevalence of any alcohol-use disorder is 36% in male and 23% females [31]. Lifetime prevalence of severe alcohol-use disorder is 18.3% in males and 9.7% in females [31]. Also, males account for 76.4% of deaths from alcohol poisoning [32] and 81% of all episodes of alcohol-impaired driving [33]. Anabolic steroids The male:female ratio for anabolic steroid use has been estimated to be 50:1 [34]. Cocaine Prevalence of past-year cocaine use is higher in males (1.37%) than females (0.7%) [35]. Prevalence of cocaine use disorder is higher in males (0.47%) than females (0.25%) [35]. Hallucinogens Prevalence of lifetime use of hallucinogens is two times greater in males (12.6%) than in females (6.3%) [36]. Heroin Lifetime prevalence of heroin use is 2.4% in males and 0.9% in females [37]. Prevalence of heroin use disorder is 1% in males and 0.4% in females [37]. General Lifetime prevalence of any drug-use disorder is 12.3% in males and 7.7% in females [38]. Lifetime prevalence of moderate to severe drug use disorder is 8.1% in males and 5.2% in females [38]. Marijuana Prevalence of past-year marijuana use disorder (abuse or dependence) is higher in males (4.2%) than in females (1.7%) [39]. Opioids Prevalence of past-year non-prescription opioid use is higher in males (4.4%) than in females (3.9%). Lifetime prevalence of non-prescription opioid use is higher in males (13%) than in females (9.8%) [40]. Tobacco In 2017, 24.8% of adult males reported using a tobacco product every day or some days compared to 14.2% of females [41]. The annual number of cases of tobacco-related cancer in males is higher (n = 383,201) than in females (n = 275,380) [42]. The annual age-adjusted rate of tobacco-related cancer is higher in males (249.7 per 100,000) than in females (148.4 per 100,000) [42].
E
Educational attainment
In 2015, the percentage of males 16–24 years old who were not enrolled in school and did not have a high-school diploma or alternative credential was 6.3% (i.e. status dropout rates) [43]. The status dropout rate for females was 5.4%. Males have had higher status dropout rates since 1977, although rates have steadily improved for both sexes [43]. In the 2013 school year, the percentage of males in grades 10–12 who dropped out of high school (i.e. event dropout rate) was slightly higher than the percentage of females who dropped out (5.4% vs. 5%) [44]. However, this small difference is fairly consistent since 1973 [44]. In 2015, 88% of men aged 25 and older were high-school graduates compared to 88.8% of women [45].
Employment status
Males have higher rates of unemployment than females. In 2014, the unemployment rates for males and females were 11.4% versus 10.3%, respectively [46]. In 2017, the unemployment rates for males and females were 9% and 8.3%, respectively [47].
G
Gambling
In 2013, rates of any gambling (82.4% vs. 76.5%), frequent gambling (13.5% vs. 6.8%), problem gambling (5.6% vs. 2.7%), and pathological gambling (4.1–6.8% vs. 2.5–2.9%) are all higher in males than females [48].
Gender dysphoria and nonconformity
The prevalence of gender dysphoria in male-to-female transgender individuals (5–14 per 1,000 adult males) is higher than the prevalence of gender dysphoria in female-to-male transgender individuals (2 and 3 per 1000 adult females) [49]. The proportion of transgender male-to-females in the population is 0.28% compared to 0.16% for females-to-males [50].
Gout
Prevalence of gout is higher in males (5.2%, n = 5.9 million) than in females (2.7%, n = 3.3 million) [51].
H
Hearing loss
Prevalence rates for speech-frequency hearing loss (18.6% vs. 9.6%) and high-frequency hearing loss (42.2% vs. 14.6%) are greater in males than females [52].
Human immunodeficiency virus (HIV)
In 2010, the estimated number of male adolescents and adults living with HIV (diagnosed and undiagnosed) was 868,700 (694.7 per 100,000 population) compared to 275,700 for female adolescents and adults (209.9 per 100,000) [53].
Homelessness
Approximately 61% of homeless individuals are males (n = 335,038) [54]. Also, males make up 71% of homeless individuals who reside in unsheltered locations [54].
I
Imprisonment
In 2013, males comprised 92.9% (n = 1,463,500) of the US prison population and 81.8% (n = 5,642,700) of the entire US correctional population (i.e. prison, local jail, parole, and probation) [30].
Inguinal hernia
Cumulative incidence of inguinal hernia is higher in males (13.9%) than in females (2.1%) [55].
K
Kidney stones
Prevalence of kidney stones is 10.6% in males and 7.1% in females [56].
L
Life expectancy
Life expectancy for males is lower than for females in every country in the world [57]. In the US, life expectancy in 2015 was 76.3 years for males and 81.1 years for females, a difference of 4.8 years [3].
M
Marriage
Individuals who never marry tend to die earlier than those who have married [58,59]. In 2009, the estimated percentage of males 15 years and older who have never married was 33% [60]. For females, the number was 27.2% [60].
Muscular dystrophy
Duchenne and Becker muscular dystrophy are conditions that affect males almost exclusively. Prevalence of Duchenne/Becker muscular dystrophy is 1.3–2.05 per 10,000 males aged 5–24 [61,62].
P
Parkinson’s disease The age-standardized male-to-female ratio for incidence of Parkinson’s disease is 1.46:1 [63].
S
Sleep-disordered breathing
The estimated prevalence of sleep-disordered breathing is 24% in males and 9% in females [64]. Also, the odds of a male with sleep apnea getting into a motor vehicle accident are higher than same odds for a female [65].
Spinal cord injury
Approximately 71% of all traumatic spinal cord injuries occur in males [66].
Suicide
Males have higher rates of death from suicide than females in every geographic region in the world [67]. In the US, the rate of suicide is 3.5 times higher in males (21.2 per 100,000 population) than females (6.2 per 100,000 population) [68]. In 2016, 34,727 males in the US committed suicides (2.5% of all deaths in males). It was the eighth leading cause of death in males but it was not in the top 10 leadings causes of death in females [6].
Syphilis
In 2013, 92% of primary and secondary syphilis cases occurred in males, with a rate of 9.8 per 100,000 population in males and a rate of 0.9 per 100,000 population in females [69].
T
Tourette syndrome
The prevalence of ever receiving a diagnosis of Tourette syndrome in male youth is ∼3 times higher than in female youth (4.4 vs. 1.5 per 1000) [70].
Traumatic brain injury
Deaths from traumatic brain injury are three times higher in males than in females (28.8 vs. 9.1 per 100,000 population [71].
U
Use of health services
Males are less likely than females to seek healthcare. In one survey, 33% of males, compared to 19% of females, said they did not have a regular doctor [72]. Also, 24% of males, compared to 8% of females, said they had not visited a physician in the past year. Sex differences on these two outcomes were observed in most age categories.

^a Not reported in this table are health issues specific to the male reproductive system and those in which males and females demonstrate similar rates.

^b Data not specific to the United States.

Notably, Table 2 has two large omissions. First, outcomes specific to the male reproductive system are not reported (e.g. prostate cancer, erectile dysfunction). Second, outcomes in which prevalence rates are similar between males and females are also not reported. Both sets of outcomes affect millions of males and provide further rationale for more attention to men’s health issues. Nevertheless, the goal of Table 2 was to represent only those health behaviors and outcomes that are biologically possible for both sexes and are noticeably worse in males.

Attention given to men’s health as a distinct area of biomedical research

Figure 1 illustrates the number of times the terms “men’s health” and “women’s health” appeared in the titles or abstracts of papers in PubMed from 1970 to 2018. The term “men’s health” has been used 1555 times over that 48-year period, whereas the term “women’s health” has been used 14,501 times (nearly a 10-fold difference). From the figure, it is also evident that “women’s health” was conceptualized as a field of research and practice much earlier than “men’s health.” In 2018, the term “men’s health” was used 199 times. The term “women’s health” had already exceeded 200 uses in a single year by 1993, roughly the same time the national offices on women’s health were established.

Figure 1. The number of times the terms “men’s health” and “women’s health” appeared in the titles or abstracts of papers in PubMed from 1970 to 2018. The search was performed by typing “men’s health” [TIAB] into the PubMed search field. The same search was performed for “women’s health.” The count for “men’s health” in a given year is illustrated by the white bar. The count for “women’s health” during a given year is the black bar plus the white bar (e.g. the term “women’s health” appeared in the titles or abstracts of 1090 papers in 2018). These data reflect the degree to which men’s health and women’s health have been conceptualized as distinct areas of inquiry. This is not to say men’s health has not been considered in other ways; for example, journals on substance abuse might have a heightened focus on men. Nevertheless, this does not deter from the fact that men’s health, as an abstract concept, has not been recognized and promoted in the same way as women’s health.

Table 3 lists the journals currently indexed in MEDLINE and dedicated to either men’s or women’s health issues. A total of 6 journals were identified as dedicated to men’s health issues, whereas a total of 62 journals were identified as dedicated to women’s health issues. Notably, if journals dedicated to obstetrics and genecology are removed from the list, the number of journals dedicated to women’s health issues still exceeds the number dedicated to men’s health issues. Another interesting observation from Table 3 is that there are five journals dedicated to breast disease and cancer and one dedicated to prostate disease and cancer, even though death rates from breast cancer (20.7 per 100,000 persons) and prostate cancer (19.2 per 100,000 persons) are similar [19].

Table 3. List of journals that focus on men’s health and women’s health and are currently indexed in MEDLINE.

Tally	Journal name	Publication start year^a	MEDLINE start year^b
Men’s health
1	American Journal of Men’s Health	2007	2007
2	Andrology	2013	2013
3	Asian Journal of Andrology	1999	1999
4	Prostate Cancer and Prostatic Diseases	1997	2002
5	The Aging Male: the Official Journal of the International Society for the Study of the Aging Male	1998	2002
6	The Prostate	1980	1980
Women’s health
1	American Journal of Obstetrics and Gynecology	1920	1965
2	Archives of Gynecology and Obstetrics	1987	1987
3	Archives of Women’s Mental Health	1998	2002
4	Best Practice & Research: Clinical Obstetrics & Gynecology (continued from Baillière's Best Practice & Research: Clinical obstetrics & Gynecology)	1999	1999
5	BJOG: an International Journal of Obstetrics and Gynecology (continued from British Journal of Obstetrics and Gynecology)	1975	1975
6	BMC Pregnancy and Childbirth	2001	2001
7	BMC Women’s Health	2001	2007
8	Breast Cancer: the Journal of the Japanese Breast Cancer Society	1994	2000
9	Breast Cancer Research: BCR	1999	1999
10	Breast Cancer Research and Treatment	1981	1981
11	Breast Disease	1987	2004
12	Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine	2006	2006
13	Climacteric: the Journal of the International Menopause Society	1998	1998
14	Clinical Breast Cancer	2000	2000
15	Clinical Obstetrics and Gynecology	1958	1965
16	Current Opinion in Obstetrics & Gynecology	1989	1989
17	European Journal of Obstetrics, Gynecology, & Reproductive Biology	1973	1974
18	Female Pelvic Medicine & Reconstructive Surgery	2010	2012
19	Gynecologic and Obstetric Investigation	1978	1978
20	Gynecological Endocrinology: the Official Journal of the International Society of Gynecology Endocrinology	1987	1987
21	Gynecological Oncology	1972	1972
22	Health Care for Women International	1984	1984
23	Hypertension in Pregnancy	1993	1999
24	Infectious Diseases in Obstetrics and Gynecology	1993	1998
25	International Journal of Gynecology and Obstetrics: the Official Organ of the International Federation of Gynecology and Obstetrics	1969	1973
26	International Journal of Gynecology Pathology: Official Journal of the International Society of Gynecological Pathologists	1982	1982
27	International Journal of Women’s Health	2009	2009
28	International Journal of Gynecological Cancer: Official Journal of the International Gynecological Cancer Society	1991	2001
29	International Urogynecology Journal	2010	2010
30	Journal of Gynecology, Obstetrics, and Human Reproduction	2017	2017
31	Journal of Gynecologic Oncology	2008	2014
32	Journal of Lesbian Studies	1997	2005
33	Journal of Human Lactation: the Official Journal of the International Lactation Consultant Association	1985	1988
34	Journal of Midwifery & Women’s Health (continued from Journal of Nurse-Midwifery)	1973	1973
35	Journal of Minimally Invasive Gynecology (continued from Journal of the American Association of Gynecologic Laparoscopists)	1993	1993
36	Journal of Obstetrics and Gynecology: the Journal of the Institute of Obstetrics and Gynecology	1980	2002
37	Journal of Obstetrics and Gynecology Canada	2001	2002
38	Journal of Obstetric, Gynecologic, and Neonatal Nursing (continued from JOGN Nursing: Journal of Obstetric, Gynecologic, and Neonatal Nursing)	1972	1972
39	Journal of Ovarian Research	2008	2014
40	Journal of Pediatric and Adolescent Gynecology	1996	1996
41	Journal of Psychosomatic Obstetrics and Gynecology	1982	1993
42	Journal of Pregnancy	2010	2010
43	Journal of Women & Aging	1988	1998
44	Journal of Women’s Health (continued from Journal of Women’s Health & Gender-Based Medicine / continued from Journal of Women’s Health: the Official Publication of the Society for the Advancement of Women’s Health Research)	1992	1997
45	Menopause: the Journal of the North American Menopause Society	1994	1998
46	Nursing for Women’s Health (continued from AWHONN Lifelines: Association of Women’s Health, Obstetric and Neonatal Nurses)	1997	1997
47	Obstetrical & Gynecological Survey	1946	1965
48	Obstetrics and Gynecology	1953	1965
49	Obstetrics and Gynecology Clinics of North America	1987	1987
50	Post Reproductive Health	2014	2014
51	Pregnancy Hypertension	2011	2015
52	Taiwanese Journal of Obstetrics & Gynecology	1985	2006
53	The Australian & New Zealand Journal of Obstetrics & Gynecology	1961	1965
54	The Breast: Official Journal of the European Society of Mastology	1992	2002
55	The Breast Journal	1995	2001
56	The Journal of Obstetrics and Gynecology Research	1996	1996
57	Ultrasound in Obstetrics & Gynecology: the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology	1991	1995
58	Violence Against Women	1995	2005
59	Women and Birth: the Journal of the Australian College of Midwives	2006	2006
60	Women & Health	1976	1977
61	Women’s Health	2005	2008
62	Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health	1990	1990

^a The publication start year is the year the journal was founded (according to MEDLINE).

^b The MEDLINE start year is the year the journal was first indexed in MEDLINE. MEDLINE was established in 1964.

Discussion

In this article, two types of data were presented and summarized. The first were epidemiological data, illustrating the large number of health issues that are more prevalent in males than females. The second were scientometric data, confirming men’s health does not have widespread recognition as a distinct field in biomedical research. The potential for a causal relationship between the lack of recognition of men’s health as a distinct field of research and practice, and the relatively poor health outcomes in males, should be considered in future work and discussions.

Women’s health

The frequent use of the term “women’s health” in biomedical research (Figure 1) and the large number of journals dedicated to studying women’s health (Table 3) are further evidence that women’s health has been given a good deal of attention over the past 50 years [1,2]. Such evidence contradicts the notion women have been discriminated against in health research. In fact, the scientometrics in Figure 1 and Table 3 illustrate women’s health, as a distinct field, has received more attention than men’s health. Moreover, this finding is consistent with the finding that in clinical practice, there are more opportunities for females to seek specialized care than there are for males. Of the top 50 urology hospitals in the United States, 49 (98%) have a women’s health center, whereas 16 (32%) have a men’s health center [4].

There are health issues that are more prevalent in women than men (e.g. eating disorders). Those issues deserve of attention. However, this article is not the place to discuss these issues. Multiple offices in national health agencies already exist for the purpose of increasing awareness of women’s health issues.

Men’s health

Progress on men’s health issues in the United States has been slow compared to other developed countries, where reports on men’s health issues have been generated [73–80]. A similar report will likely be necessary to increase awareness of men’s health issues in the United States. Given the current academic climate focused on “health disparities” and “health inequalities,” it is perplexing that men’s health has not garnered more attention. In fact, discussions on “gender equity” in health tend to focus almost exclusively on women [81,82]. Moreover, notions of “patriarchy” and “male privilege” are rampant in the media and in academic journals. These concepts, and the ethos surrounding them, are not only misguided, but they are likely detrimental to the health of men. They direct attention away from men’s health issues, and as generalizations, they do not accurately reflect the lives of many males. For example, what power does a homeless man hold? What aspects of performing manual labor or collecting garbage are privilege? Moreover, readers should consider how the health issues that are more prevalent in men would be recognized differently if they were more prevalent in women. For example, how many additional national offices or action plans would be created if a study found women were the sex more likely to commit suicide, be homeless, or abuse alcohol?

Finally, if one day evidence arises that men are more frequently represented in research trials than women, this does necessitate a conclusion of discrimination. It might simply reflect the differences in health conditions between the sexes. Given that health outcomes are not equal between men and women, it seems odd that representation is equal.

Conclusion

The epidemiological data summarized in this article illustrate that men have worse health outcomes than women, and the scientometric data reveal men’s health has been given less attention as a distinct field of biomedical research than women’s health. These data should be considered within the appropriate historical context. For the past 25–30 years, national offices have been studying and promoting women’s health issues; yet, over this time, men have been the sex exhibiting the worse health outcomes. This paradox should be acknowledged, and men’s health in the United States should be given more attention. Both men and women will benefit from efforts to improve health outcomes in boys and men.

Disclosure statement

The author declares no conflict of interest.