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The New Second Sex

Gender inequity kills. However, it is not women who bear the brunt of this affliction (in case you were anticipating where I would go next). Each day, excess mortality from accidents, violence, heart disease, strokes, and cancers takes thousands of lives. Who are these faceless victims? At 57.9 years, life expectancy among black men in Washington DC is equivalent to life expectancies in many developing countries.

It is a well-known though often overlooked fact that women’s life expectancies are considerably longer than men’s and the same holds for African-American women versus African-American men. Though life expectancies in both groups are lower than their white counterparts, black men have the lowest life expectancy in the U.S.

What accounts for black men’s disproportionate mortality and morbidity? Research on the male sex “role” suggests that gender socialization and the endorsement of hegemonic masculine ideals contributes to men’s lower life expectancy vis-à-vis women. For African-American men, these gendered performances of stereotyped sex roles are compounded by race and class.  The resources available in the United States for constructing masculine identities are largely unhealthy, especially among low-income African-Americans.

For instance, some low-income African-American men and boys growing up in disadvantaged neighborhoods face pressures to demonstrate and achieve manhood through acting (or being) tough, such as by joining a gang, selling drugs or generally by demonstrating that they cannot be messed with, exposing them to the risk of violence.  The affectations and attitudes learned from socialization in this environment can negatively influence job prospects, further compounding contradictory social pressures to be a bread-winner but to lack the institutional means of being able to legitimately achieve this status, what Merton referred to as a state of “anomie”.[1]

Demonstrations of masculinity may further compound poor health through the dismissing of health care needs, refusing to take sick leave from work, drinking, smoking, doing drugs, driving fast, having many sex partners and through risk taking behavior in general. These are all forms of gender performances that demonstrate masculinity.

In short, men are put at risk because they do not want to appear feminine. In performing in this manner, their risk of all cause mortality is greatly increased. When these masculine pressures are compounded by race and class based inequalities, the result is even worse health outcomes.

[1] Merton, Robert K. (1968). Social Theory and Social Structure. New York, NY, US: Free Press

Ashley Fox is an Assistant Professor at the Mount Sinai School of Medicine, Department of Health Evidence and Policy.

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About Ashley Fox

Ashley Fox, Ph.D., is an Assistant Professor at the Mount Sinai School of Medicine, Department of Health Evidence and Policy. Learn more about Ashley here.

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