Public Health’s Historical Prejudice Against Men and Boys

“Shorter life expectancy among men in general, if likely avoidable, would clearly be an issue of public health importance based on the magnitude of potential population impact. However, men as a group have more wealth, influence, and prestige, so this difference would not be a social injustice and, therefore, not a health disparity or equity issue.”

That statement was written in a paper published in the American Journal of Public Health in 2011. The title of the paper is “Health Disparities and Health Equity: The Issue Is Justice,” and it has been downloaded over 97,000 times according to the publisher’s website and cited over 1,400 times according to Google Scholar. The lead author of the paper is Paula Braveman, who is currently a professor emeritus at the University of California – San Francisco. In writing the paper, Braveman was accompanied by six co-authors, all of whom have doctoral letters after their names. Remarkably, none of those letters created immunity from the anti-male prejudice expressed in the statement that the authors signed off on.

Putting aside all the nasty and inaccurate things said about boys and men in humanities journals, Braveman’s statement is one of the most irresponsible things that I have ever read about men’s well-being in a health or medical journal. Her statement is shocking in its dismissiveness, its irrationality, and its inhumanity. It was published 15 years ago, but it is still relevant, because it helps to explain how we arrived at our current situation in which group identities are prioritized over individual flesh-and-blood human beings. It helps to make sense of why substantially more funds and initiatives have been dedicated to women’s than men’s well-being, even though male life expectancy has been significantly shorter than female life expectancy for many years.

The misguided ideas expressed in Braveman’s statement come from critical theory, critical race theory, and intersectionality. The injection of these ideas into the public health domain can be traced back to the founding of the Commission on Social Determinants of Health within the World Health Organization in 2005, including the Commission’s 2008 report titled, “Closing the gap in a generation: health equity through action on social determinants of health.” The report included a section on “gender equity,” which only discussed women’s health.

In the past year, men’s health has received increased attention in the public policy sphere, and continued progress seems likely. As this progress is made, investigations into how discussions of sex and public health became so historically one-sided ought to also be conducted. The individuals who created the one-sided narrative ought to be known, and their ideas ought to be dissected.

Here, my purpose is to identify Paula Braveman and her colleagues as some of the individuals responsible for the years-long denial of boys’ and men’s health issues, and to explain why Braveman’s statement is incorrect, as to ensure a proper defence is readily available the next time that such a statement is made.

So, let us reiterate Braveman’s statement and then dissect it.

Reiterating Braveman’s statement

First, Braveman said that male life expectancy is not an area of public health importance. Second, Braveman said that the reason that male life expectancy is not an area of public health importance is because it is not a social justice, health disparity, or health equity issue. Third, Braveman said that the reason that male life expectancy is not a social justice, health disparity, or health equity issue is because “men as a group have more wealth, influence, and prestige” than women.

Dissecting Braveman’s statement

Braveman’s statement is problematic on many fronts.

First, Braveman incorrectly assumed that for a topic to fall within the purview of public health that it must be a social justice, health disparity, or health equity issue. Yet, the field of public health existed well before Woke concepts