Coming to Canada: the first national health strategy for men and boys, in response to disturbing trends in premature death, mental health disorders, suicide and addiction. A key objective of the strategy is to tackle the barriers that discourage men from seeking care sooner.
Claims data from private health benefits plans bear this out—and present an opportunity for employers to help close the gender gap in self-care.
Men are much less likely to use any paramedical service covered by their health benefits plan, including mental-health counselling, reported Meghan Vallis, Group Sales Vice-President West, and Sofia Colaiacovo, Group Sales Vice-President East, Equitable, at the Benefits Alliance conference in Toronto in April. They are also less likely to hit annual maximums for health spending accounts, use the employee assistance program, use virtual care or go on disability.
Other studies found that more than a quarter of men with symptoms of possible health issues waited more than a month before seeing a physician; 65 per cent waited more than six days. Half reported being overdue to see a family physician for any reason.
The result is higher rates of death, and at younger ages, compared to women due to accidents, cancer and intentional self-harm. “Prostate cancer can have a 100 per cent survival rate if caught early. Screening is critical,” said Vallis.
As well, three chronic physical conditions warrant greater attention due to their impact on men: erectile dysfunction (ED), migraine and fertility.
ED affects about half of men aged 40 to 88 and “is often the canary in the coal mine as it acts as an early warning system” for cardiovascular disease and diabetes, noted Vallis. “Men should not have to ask if it’s covered. We need to normalize ED meds as standard in the benefits plan.”
While women are more likely to experience migraine, its prevalence in men is still comparable to that of diabetes in the general population. Yet self-stigma often prevents men from seeking treatment due to perceptions that this is a “woman’s condition,” said Vallis. In the area of fertility, the cause of infertility can be traced back to men 30 per cent of the time, and in another 30 per cent of the time the cause is unknown or due to both the man and the woman. Self-stigma and the risk of reduced productivity is high for both genders.
Mental health and addiction
While mental health disorders present at similar rates in men and women, more women receive treatment and go on long-term disability. Men are less likely to seek treatment in part because the symptoms for depression and anxiety differ between genders. Since men are more likely to internalize emotions, their symptoms may include anger, irritability and overreaction rather than sadness or lethargy.
Men are three times as likely to die of suicide than females. “While this is quite serious and grim, the good news is we are talking about it,” noted Colaiacovo at the conference. “Proactively helping the younger generation is a great place to start because half of mental-health issues start before age 18.”
Mental-health disorders as well as pain contribute to disproportionately high rates of alcohol and controlled-substance (e.g., opioids) use among men, especially among those working in the trades. Not only is the risk of injury much higher in that sector, but self-stigma more often delays treatment. Claims data from Sun Life reveals that men submit three times as many claims for drugs and services to treat substance use disorders than women.
What employers can do
Employers’ actions fall into three main buckets: raising awareness, improving access to care, and benefits offerings.
Raise awareness
Employers may underestimate their ability to normalize conversations about health care, and to do so in ways that target different populations, including men. A key tactic is to promote trusted resources already available, many at no cost (examples of the latter include podcasts such as “In Good Company” and “Gent’s Talk” and websites such as dontchangemuch.ca and headsupguys.ca).
Employers can also make the connection to programs available from the public system; for example, all provinces offer smoking cessation programs at no cost.
Communicate using direct, factual words, with messages that are brief yet frequent. Leveraging social media is essential for younger employees. Male leaders who share their personal stories can make a significant difference.
Access to care
Men may lack confidence in the traditional public healthcare system—and/or their own ability to navigate it. Make it easy for them to access care through an employer-sponsored virtual care program as well as with on-site clinics for vaccinations and screenings. When promoting screenings, be sure to simply describe what’s involved. Equally important, managers and traditional communication channels can remind employees that they can attend medical appointments during work hours.
Benefits offerings
ED drugs, testosterone replacement therapy and treatments for substance use disorder (including out-patient, third-party support programs) can deliver significant value but may need to be added to benefits plans. Coverage for vaccines, weight-management drugs, smoking cessation and pharmacogenetic testing may also provide outsized benefits for men.