The literature has long demonstrated that men die earlier and at higher rates from the vast majority of the leading causes of death.^1,2 Specifically in the United States, life expectancy in 2020 was 74.2 years for males vs 79.9 years for females—a gap which only widened during the COVID-19 pandemic.^3,4 Moreover, men face higher rates of several chronic conditions including cardiovascular, metabolic, and psychiatric diseases.⁵ These patterns are present throughout the world, exacting significant emotional and financial costs on patients, families, and broader society.

This disparity is not well addressed. It’s understood that communities holding unfair social advantages—whether based on race, gender, sexual orientation, or economics—experience better health outcomes. Interestingly, however, men typically suffer from poorer health regardless of the advantages afforded to them. Men who belong to a racial minority or the LGBTQ+ community face even greater disparities. Yet because of the paradoxical nature of this trend, awareness surrounding men’s health is lacking.

Medicine has slowly begun appreciating the social determinants of health and systemic factors that modulate outcomes. Recent events including the COVID-19 pandemic demonstrated the massive disconnect between medical experts and the lay public. Flaws in science communication exacerbated the pandemic by reducing trust and adherence to recommendations.⁶ The paradox of men’s health demonstrates many parallels to this trend, and we must work on better communicating and connecting with our male patients to improve outcomes.

Although studies have demonstrated that innate factors such as hormonal and genetic differences affect longevity, differences also often arise from the gender roles assigned by society. Poorer men’s health is often attributed to the phenomenon of toxic masculinity, where men feel pressure to appear self-sufficient and strong. Studies repeatedly demonstrate that men less frequently seek out preventive care, undergo recommended screenings, and adhere to medical advice. Additionally, men demonstrate higher rates of risky activities, violence, illicit drug use, alcohol overuse, and poor nutrition. Most recently with COVID-19, men experienced higher disease burdens given reduced adherence to recommendations including masking and social distancing.⁴ These are all preventable factors which harm men’s well-being.

Ultimately, men are less likely to perceive risk of harm or seek out care. How can these deep-rooted beliefs be targeted?

I believe that urology holds the answer. Urologists can embrace the opportunity to become thought leaders and trusted advocates for men’s health. Granted, urology certainly isn’t limited to men, and the field provides important care for all patients. Nonetheless, urology is the closest thing to a specialty devoted to prototypical male issues. Moreover, urologists have a unique relationship with their patients, considering that they often address highly sensitive medical concerns. As a result, urologists have the opportunity to actively engage men on an array of physical and mental health topics—regardless of whether these topics fall within the traditional domains of the genitourinary system.⁷ Much like the women’s clinic model, which has become profoundly popular and demonstrably beneficial, urologists can lead interdisciplinary work to improve men’s health outcomes.⁸

Accordingly, science communication is decidedly relevant to men’s health. As trusted providers, urologists must increase their presence in the community via engagement with media experts, promotion of government policy rooted in scientific knowledge, and design of social infrastructure to support health-promoting behaviors. They can lead public awareness campaigns, develop educational resources, and directly communicate with patients to normalize healthy decision-making. Ultimately, this visibility can help fight toxic masculinity and risky behaviors.

One well-known example of direct patient engagement is the barbershop initiative, where trusted community members such as barbers perform outreach in concert with providers. One study demonstrated the benefits of this initiative in improving hypertension metrics.⁹ This model demonstrates that collaborating with patients in a personable manner can be highly effective. Similar work can be replicated with urology-specific concerns such as prostate cancer screenings or testicular cancer self-examinations. However, urologists can also utilize their unique position to positively affect seemingly unrelated conditions that disproportionately affect men, such as cardiovascular disease or unhealthy lifestyle choices. Given the evolving holistic and multifactorial view of disease, these initiatives will certainly return benefits to urology itself. For instance, erectile dysfunction has deep associations with cardiovascular or mental health.

Social media also offers great promise. As patients increasingly seek medical advice online, urologists must expand their online presence using evidence-based strategies to effectively share information. Countless studies have demonstrated high rates of internet misinformation, demonstrating that work is necessary to expand physicians’ online presence in a manner that counteracts anti-science materials while also providing actionable, effective advice to patient audiences.^10-13 We also need to support rigorous research into effective social media and science communication strategies.¹⁴ Offering a trusted voice online can further raise awareness to counter common male misconceptions.

Science communication is difficult yet important. It takes skill to effectively develop trust, demonstrate the value of specific advice, and contextualize nuanced topics for a lay audience.⁶ Accordingly, we must start by educating physicians in this realm. Although medical education has rapidly evolved, shifting from a science-heavy focus toward clinical skills and application-based learning, there remains a need for progress. Although future physicians will need far more than a basic science education to effectively serve patients, contemporary medical education paradigms still lack adequate education surrounding social determinants of health, science communication, and the humanities.⁶

Considering this challenge, I am excited to introduce a new initiative—the AUANews Medical Student Column. We hope that this platform will encourage trainees to deepen their involvement in urology while contributing to the discourse surrounding the issues affecting our patients, advances in urological research, and general topics in medical education. Concurrently, we hope that this opportunity will help medical students develop their writing and communication skills—hopefully allowing them to better lead their communities in the near future.