A number of studies demonstrate the large gender disparities in health status in the United States, with men at a higher risk for mortality and morbidity. One of the mechanisms that has received attention as to why this disparity exist, besides greater engagement in risky behavior, is because men use less preventive healthcare services and do not seek immediate treatment for many health problems. Much of this behavior has been attributed to hegemonic masculinity or commonly-held beliefs about traditional men roles, especially men’s hesitance/reluctance to seek medical care. In addition, social constructionists suggest there is a range of masculine norms that deferentially influence male behavior depending on the situation or that have a differential impact depending on variables such as social class, occupation, racial or ethnic differences, or age. The purpose of this study was to use focus group interviews to explore married men’s avoidance of health care utilization using an ecological approach-something that has been missing in the men’s health research. Five focus group interviews with heterosexual married men (N=44) were conducted and analyzed using grounded theory methods. Several important themes emerged connected to an ecological model of how hegemonic masculinity was associated with healthcare utilization at several levels including organizational (Perceptions of Doctors), interpersonal (Past Family Context and Current Family Context), and individual (Illness Severity, Money Concerns). These themes included sub-themes that interacted with the larger theme of Hegemonic Masculinity at the societal level. Implications for married men’s healthcare utilization and prevention education will be discussed.

Issues: Many males are in silent conflict as normative beliefs surrounding how males should act and react towards people, events, or other societal stimuli quite often contrast with the amount or type of emotions he feels, let alone publicly displays. Research suggests that repressed emotions, and subsequent repressed behaviors and expressions of said emotions, leads to poor mental health outcomes among males. Research links male repression of emotions to suicide, which begs the question whether the way we raise our males to feel and express (or not) emotions are contributing to the rising physical and mental health outcome disparities witnessed among males.

Description: A narrative review offers a synopsis of the current literature, as well as conjecture and anecdotes from popular media sources, on masculinity and emotionality to identify best-practices to help assuage the current disparities witnessed among male populations, most notably, poorer mental health outcomes due to repressed expressions of emotions.

Lessons Learned: This presentation offers insight into the current relationship between normative beliefs of male behavior in society, manifestations of traditional masculinity, emotionality, and possible outcomes associated with the intersections of the current milieu surrounding these concepts. This information is being used to develop outreach programming for the Men’s Health Initiative nonprofit to meet males “where they are” with the most effective information to make the greatest impact possible.

Recommendations: The repression of emotions contributes to disparate health outcomes compared to their female counterparts, such as higher attrition rates from higher education or lack of engagement with offspring.

Building Hope: Suicide Prevention in Construction Companies

Mental health is a growing health problem with a shortage of qualified professionals to address increasing needs among Americans. As a result, suicide is a leading cause of death in the United States, resulting in nearly 45,000 deaths annually. Within the state of Utah, a dramatic 46.5 percent increase in suicide rates between 1999 and 2016 has occurred, and is now recognized as the 4th leading cause of death for all Utahns. Within staggering numbers, construction and extraction workers have the highest occupational risk of suicide, with additional risk among males between the ages of 35-54. Based upon these categoric risks and an existing gap within programs for this target population, our program was created. The program, based upon Social Cognitive theory, implements behavior modifications at both individual and workplace levels within the construction industry. Difficulties surrounding worksite and crew variabilities, and the difficulty of implementing onsite trainings have led to the existing disparities. To overcome these barriers, the program utilizes existing licensure requirements for state licensing of construction contractors to implement awareness and trainings, as well as targeting aspects of workplace culture. The program mandates trainings on the warning signs of suicide, available resources, and seeks to train a population through existing licensing infrastructure. The results of this program uptake have potential for broad impact to reduce suicide rates as it is implemented on both state and national levels. The program could be further altered for applicability within various occupations for broader impact.

Background: While males have better health outcomes than females on many quality measures, striking disparities still exist among males. Poor outcomes are linked to multiple factors such as environmental, socio-cultural, behavioral and biological factors.^{1, 2}

Methods: This analysis examines 19 care coordination measures from the core set of the 2017-2018 QDR. The data show trends and disparities by race/ethnicity for males, 18 years or older.

Significant differences require a minimum relative difference of 10%, and statistical significance with p-value < 0.05. Trends were assessed using weighted least squares regression of change where average annual rate of change is at least 1 percent per year and statistically significant (p-value < 0.05).

Findings:

• A trends analysis shows that eight measures improved (7/8 were related to hospital admissions for conditions including heart disease, pneumonia, COPD and diabetes), six did not change and five worsened (two concerned hospital admissions for chronic diseases and three regarded ED behavioral health visits) from 2000 – 2015/2016.
• In 2015, the disparities analysis shows hospital admissions for hypertension per 100,000 population are worsening over time but not synchronously: Hispanics (32.3), Non-Hispanic (N-H) Whites (31.2), Asian-Pacific Islander (API) (18.0) and Blacks (146.7).
• A similar pattern was observed for hospital admissions for uncontrolled diabetes without complications per 100,000 population: N-H Whites (38.2) and Hispanics (39.7), API (18.9) and Blacks (118.0).

Conclusion: Improving health equity for all communities requires examining disparities for males by sub-populations and the factors that may impact their health to better design interventions to improve male health outcomes.