Despite long-standing evidence of poor health and life expectancy outcomes among men, particularly among men who are socially or structurally marginalised, men's health has generally received little and uneven attention in health policy and practice. Its gendered and intersectional aspects have been especially overlooked. This third paper in the Lancet Men's Health Series examines why men's health has received so little policy attention and proposes strategies to raise men's health on national and global agendas. We applied a gender lens to the 3-i theory-based framework and analysed how ideas, interests, and institutions shape the prioritisation of men's health within national and global policy agendas. We review the modest development of men's health policies and assess how power and politics, including the roles of a range of stakeholders from global and national health spaces, commercial actors, and civil society organisations, have shaped the construction of the problem as well as policy attention and framing, resource allocation, and interventions. The scarcity of attention paid to men's health on global and national agendas reflects how power operates through ideas and institutions which contribute to the conflation of gender with women, institutional inertia, and contested constructions of individual versus structural drivers of ill health. We highlight how this has created a space in which commercial actors, including the manosphere, can shape narratives and influence men's health in ways that align with commercial or ideological interests. We conclude by proposing politically informed strategies that recognise how power, institutional arrangements, and competing interests shape men's health policy within prevailing gender and structural orders. We identify entry points for advancing men's health equity and wellbeing that draw on empirical evidence and technical guidance, are grounded in political realities, and are consistent with a commitment to gender justice for all people.
Males have lower life expectancies and greater disability-adjusted life-years (DALYs) than females, and particularly poor outcomes are seen among males in marginalised contexts. In this paper, we provide an epidemiological overview and highlight the intersectional nature of men's health. We analyse mortality and DALYs data from the 1990-2023 Global Burden of Diseases, Injuries, and Risk Factors Studies to illustrate our intersectional framework and draw attention to how health varies in men and to show key themes. Conditions that contribute most to the poor health of males include non-communicable diseases (eg, cardiovascular diseases and cancers), substance use, suicide, injuries (eg, road traffic incidents and interpersonal violence), and respiratory infections (eg, tuberculosis and COVID-19). Although cardiovascular disease and cancer make the largest contributions to men's higher mortality rates, determinants of health such as violence and war, migration, economic stagnation, and labour market changes due to automation and new technologies will disproportionally affect their health in the future. Injuries, violence, and other external morbidity causes often occur at a young age and in unequal distributions across the sexes, making a large contribution to DALYs. Although biology plays a role, the pattern of many diseases contributing to health differences reflects the intersection of health behaviours, shaped by patriarchy, ideas of masculinity, and structural drivers (including commercial determinants of health); many of these are preventable. Although improvements in some health behaviours are seen, exceptions occur in marginalising social conditions (eg, incarcerated men, men experiencing homelessness, men with mental illnesses, men with substance use disorders, men with low income, men who have sex with men, and those who are gender non-conforming). Multiple data sources detail men's shorter life expectancies and the drivers compared with women, but going beyond sex disaggregation remains challenging and is an urgent priority for research and health monitoring.