Can We Help Men Take Care of Themselves? Implications from The PRAMS Study

January 2021

Stanton Honig, MD
Professor of Clinical Urology
Yale Urology
330 Orchard Street, Suite 164
New Haven, CT 06511

203-785-2815
Stanton.Honig@yale.edu

We know that men are not great at going to the doctor. In fact, between the ages of 18 and 40, most men rarely visit their doctor unless they have a major problem. As a result, their decreased use of health care, increased exposure to occupational hazards, and higher rates of substance abuse may be causes of shorter life spans in men. A recent study conducted in Puerto Rico (1) confirms this and gives us an opportunity to find ways to improve health care for men.

The PRAMS Study, (Pregnancy Risk Assessment Monitoring System), reported in JAMA (Journal of the American Medical Association), was performed by interviewing men on their health-related behaviors and participation in fatherhood-related activities surrounding pregnancy. The study suggested that less than half of men whose wives were pregnant went to the doctor in the 12 months prior to the birth of their newborn. The most frequent reason for a visit was for a regular checkup, followed in decreasing order by dental cleaning, illness, injury, and mental health.

Interestingly, the men in the study were found to help their partners in many ways. 87% went to prenatal visits with their partner, were present at birth (83.1%), and helped to prepare for the newborn’s arrival by preparing the home (92%) or by purchasing supplies (94%). This presents an interesting opportunity for public messaging directed towards fathers during this period of childbirth, as well as an opportunity to reach men with targeted health information related to pregnancy and baby products.

As a new father, men should seek evaluation for certain conditions, including cancer screenings, screening for diabetes high blood pressure, and the opportunity for counseling regarding risky behavior, nutrition and exercise, and mental health improvement.

Physicians and providers at men’s health clinics and primary care clinics have the opportunity to educate our patients when we see them in the office. At Yale Urology, we see men of ‘new father’ age for counseling regarding family planning, testicular conditions, sexually transmitted diseases, sexual dysfunctions, and fertility evaluations. It is our obligation to counsel patients who may have access to other family members regarding cancer screening, and mental health including suicide, risky behaviors, etc.

The PRAMS Study also showed that certain populations were more likely to be involved with prenatal and perinatal care: being Hispanic (97%), age greater than 25 years (74%), some college education or higher (63%), employed (85%), and presence of health insurance (86%). It is critical to determine how we can reach the population of men that is younger, unemployed, has less than a college education, and is without health insurance. Accessing this population is critical to the mission of Yale Medicine and Yale Urology specifically.

At Yale Urology, we strive to keep our entire population healthy and informed regarding men’s health. We do this through counseling men, providing information at their visits, and by reaching out to producers of education materials featuring pregnancy-related information or supply companies to help reinforce the importance of men’s health care and the valuable involvement of men in pregnancy and child-related activities.

Please visit the Yale Urology website for information about men’s health issues, as well as cancer screening information through Smilow Cancer Hospital.

1. Salvesen von Essen B, Kortsmit K, D'Angelo DV, Warner L, Smith RA, Simon C, Garfield CF, Virella WH, Vargas Bernal MI.Opportunities to Address Men's Health During the Perinatal Period - Puerto Rico, 2017. MMWR Morb Mortal Wkly Rep. 2021 Jan 1;69(5152):1638-1641. doi: 10.15585/mmwr.mm695152a2. PMID: 33382678