Opinion: Men and COVID-19: the hidden story

By Dr. John Izzo

Vancouver Sun, April 11, 2020

In a time filled with new realities, people are asking many questions about the public health concerns of this pandemic. One of these is: Why are more men dying of COVID-19? A second, less-explored question is: How might this crisis impact men socially?

According to international data gathered by BMJ Global Health, while the COVID-19 virus infects men and women equally, it appears men are 50 per cent more likely to die from it than women of the same age. There are two potential hypotheses: First, men are more likely to engage in unhealthy behaviour such as smoking and alcohol abuse, thereby driving higher levels of underlying conditions. Secondly, men have certain biological factors, such as receptors controlled by a gene on the X chromosome, hormonal differences and different immune responses that make them more vulnerable.

We believe that it’s not just men’s physical immune system that makes COVID-19 particularly dangerous for them. It is quite likely that the emotional and social “immune” system of men, and that of dominant male culture, pose a significant risk to public health.

At The Men’s Initiative, affiliated with the Faculty of Medicine at the University of B.C., we have several decades of experience working with groups of men, including military, protective services, university athletes and business executives. Our experience suggests that men are often less able to talk about emotional challenges, and because of this, are often less resilient in the face of various life stressors. Their resilience is further compromised by the fact that men have been shown to have fewer intimate friendships, weaker social support systems, and are much less likely to ask for help when they need it, especially on matters of mental health. This is particularly true of men in mid-life and older.

Men are also more likely than women to translate emotional suffering into violent acts, substance abuse, and are more likely to die from suicide. Put these men under the acute pressure of lost jobs, economic hardship, social isolation and loss of meaning and identity, and this could have dramatically negative consequences for men, families and communities. Across the country, we are seeing the harmful effects of this crisis with a rise in domestic violence calls, an increase in liquor sales, and higher incidence of calls to crisis phone lines. Vancouver Battered Women’s Support Services says their staff have seen a 300-per-cent increase in calls over the last three weeks. The organization reports that 40 per cent are first-time callers reaching out. Even the United Nations has recognized a global rise in domestic violence and called for urgent measures to address what UN Chief Antonio Guterres called a “horrifying global surge” in domestic violence. We rightly need to take immediate steps to protect women and vulnerable families, but we must also recognize the dangers for men who are not abusers in the form of addiction, depression and potential suicide.

To be sure, women and those who identify with other genders also find this time equally challenging, but men in our society may be less able to adapt to the present crisis. Men are often not as intentional about “checking in” to see how each other are doing. Men need to be encouraged to talk about what is happening to them emotionally, and we all need to not accept a stoic “I’m fine” answer. Since men may be more likely to “suck it up,” we need to reach out and dig deeper to find out how the men in our lives are really doing. In our society, men are often socialized in a way that makes anger a more acceptable emotion than sadness, which is often associated with being weak. To build resilience in men during this time of crisis, we need to encourage men to speak out about their experiences, and in so doing, give other men the courage to share their own stories.

The team at The Men’s Initiative has decades of experience working with predominantly male work cultures, such as the military and firefighting, getting people to tell their stories and to be heard by others has proven to improve resiliency under ongoing stress. Our work with firefighters and men with prostate cancer has shown that rates of depression and suicide are greatly reduced by having men talk about their experiences.

There is a time and place for men to be stoic, but this is not it. We all have a vital role to play in creating the conditions for men to break their silence, standing beside them as they speak courageously about their experiences and struggles. As one veteran put it: “Anyone can go get drunk, but sitting down sober and talking about what’s really going on takes real courage.” Many of the men in our programs have said, “This is the first time I have told anyone about this.” The price of such silence in a time like this may be devastating.

The longer the present situation extends, the greater pressure the COVID-19 crisis will put on men and families. While we are all rightly focused on stopping the spread of this virus, we may well need to look deeper at the serious emotional, psychological and relationship toll that these measures are taking and will continue to take for the coming months. In Canada, surveys show men are not as concerned about the pandemic as women are. This should be a source of public concern since it may turn out that men are not only more vulnerable to the virus but also to the impacts of the imposed public health measures.

John Izzo is an adjunct professor at the University of B.C. and co-founder of The Men’s Initiative.