In last week’s article, I reviewed the landscape of suicide data after the passing of PGA Tour professional Grayson Murray to show the disparities that exist in those 15-34 years of age as part of recognizing male mental health for Men’s Health Month.
In this week’s piece we look at overdose and suicide deaths of those 15-34 that tells us something about the mental health and the risky behaviors associated with males and females. At all age groups, males are dying of overdose at rates considerably higher than their female counterparts in the same age group and in many instances crossing age groups. For instance, males 20-24, 25-29, and 30-34, are dying at rates higher than all female groups from 2000 to 2022.
Combining the rate of overdose and suicide deaths per 100,000, however, shows an even greater disparity, revealing an even more troubling reality that male despair has more serious consequences when it comes to loss of life. It’s important to look at suicide, overdose, and alcohol deaths (something addressed next week) as stand-alone statistics but always keeping in mind that they are collectively related to despair. Comparing the graph above (overdose death/100,000) to the graph below (combined overdose and suicide deaths/100,000) reveals how much wider the gap expands in all age groups and across all age groups. Notice how different the age clusters present in the graph below and the graph above.
Another consideration is the way data can be misleading and why it's generally a good idea when presenting information regarding deaths of despair (that are overwhelmingly male) to always include the wide differences, even when focusing specifically on the outcomes of females. It’s fine for groups that focus on women’s mental health to acknowledge that 72% of overdose deaths and 75% of suicide deaths are male and remind its audience that its discussion will focus on female reasons. A comparable analogy might be breast cancer, where 1% of deaths are male and 99% of deaths are female. Take a look at this article from Johns Hopkins Medicine.
Male Breast Cancer: A Rare, Increasing Trend
The color pink isn’t exclusive to women, and neither is the disease that it often represents: breast cancer. While breast cancer is more than 100 times more common in women than men, men are much less likely to detect breast cancer early on.
I did not know that males have a “25 percent higher mortality rate of male breast cancer compared to female breast cancer.” But I also know that breast cancer is far more likely to impact women and the article makes a point of acknowledging that fact. Imagine if the title and context of the article was males have 25% higher mortality rate of breast cancer but never acknowledging the wide difference. That would be deceptive.
I feel the same way when writing about deaths of despair. It’s important to write that there is an increase, for instance, of female overdose and suicide deaths. Using the table below, one could write an article that shows females and males 15-19 years of age each showed a 63% increase in combined overdose and suicide deaths without acknowledging that 75-80 percent of those deaths were male. This type of approach is deceptive because it ignores the glaring statistical reality and the different reasons males are more susceptible to deaths of despair. It is always important when reading articles to be conscious of data, particularly around suicide, overdose, and alcohol, where male deaths are greater but a report will focus on the increase in female outcomes while ignoring the elephant in the room: male outcomes.
There have been all sorts of theories associated with these differences, from environmental reasons to ideological ones that look at male stoicism and the “suggested inherent” violence in male behavior, just to name a few. For the record, males are not inherently violent. Too much of our contemporary discussions rest on the notion of male social norm theory and this type of approach is lazy thinking because it does not get at the mechanisms of neuroscience that identify the difference in male and female behaviors, decisions, and reactions related to brain science.
There are a number of studies (like the one in a recent article in the Proceedings of the National Academy of Sciences, PNAS) that reveal “sex is an important biological factor that influences human behavior, impacting brain function and the manifestation of psychiatric and neurological disorders.” New revelations that reinforce older findings are emerging with the value added research now using artificial intelligence.
“Sex plays a crucial role in human brain development, aging, and the manifestation of psychiatric and neurological disorders (my emphasis). However, our understanding of sex differences in human functional brain organization and their behavioral consequences has been hindered by inconsistent findings and a lack of replication. Here, we address these challenges using a spatiotemporal deep neural network (stDNN) model to uncover latent functional brain dynamics that distinguish male and female brains. Our stDNN model accurately differentiated male and female brains, demonstrating consistently high cross-validation accuracy (>90%), replicability, and generalizability across multisession data from the same individuals and three independent cohorts (N ~ 1,500 young adults aged 20 to 35). Explainable AI (XAI) analysis revealed that brain features associated with the default mode network, striatum, and limbic network consistently exhibited significant sex differences (effect sizes > 1.5) across sessions and independent cohorts. Furthermore, XAI-derived brain features accurately predicted sex-specific cognitive profiles, a finding that was also independently replicated. Our results demonstrate that sex differences in functional brain dynamics are not only highly replicable and generalizable but also behaviorally relevant, challenging the notion of a continuum in male-female brain organization. Our findings underscore the crucial role of sex as a biological determinant in human brain organization, have significant implications for developing personalized sex-specific biomarkers in psychiatric and neurological disorders, and provide innovative AI-based computational tools for future research” (my emphasis). Srikanth Ryali, Yuan Zhang, Carlo de los Angeles, Kaustubh Supekar, and Vinod Menon).
Is there something about the male brain that works differently than the female brain and leads to the consequences we see in the data above?
Sex plays a crucial role in our understanding, so there is something more to this than outcome data that does not get enough attention and does not lead to the type of policies and practices that help our boys and men in all sorts of areas of life.
Time for an Age of Reason and Compassion
As my friend Paul often reminds me, the data is great but there is a real lack of caring for boys and men in general and this is a big reason little is done to help them. I’m paraphrasing my friend Paul here but he’s right. The attempt, for instance, to establish the first commission on the status of boys and men in the country was cavalierly dismissed in Washington state where males are 78% of suicide and 70% of overdose deaths. Even with bi-partisan support in both houses, a thorough report by the Global Initiative for Boys and Men on state outcomes in many areas, an address to state representatives by Richard Reeves of the American Institute for Boys and Men to members of the legislature on his book Of Boys and Men, and a state that hosts the Gurian Institute (the leading researcher and practitioner on models that use a boys and girls learn differently approaches in education), there was no movement for the bill to receive a hearing. The bill to establish the commission will be working its way through the legislature again through the work of the Washington Initiative for Boys and Men in hopes of finally recognizing the outcomes of boys and men in a host of areas in a state the does have an important commission on women and desperately needs one for boys and men.
The good news, however, is that the Melinda French Gates foundation has just awarded the American Institute for Boys and Men a $20 million dollar grant, perhaps a first step in recognizing the problems facing boys and men by a philanthropist who has largely and continues to largely support girls and women’s issues but whose eyes and heart are opening up to boys and men’s issues.
We cannot move past the outcome data, and it certainly serves as a reminder of just how far we need to go and why it’s important to move compassionately and more swiftly toward helping boys and men. It’s time to look past lazy thinking and rely more on things like:
evolving brain science
reversing the lack of support from academia, media, and policymakers that rely too much on male social norm theory
and exercising reason and compassion over the habitual practices that dismiss our nation’s sons as defective and privileged.
There are deep biological reasons to how males and females function and respond to the triggers that lead to despair. Let’s spend the time and direct our resources toward avoiding stigmas and taking on the challenges with meaningful policy and practices that look at that data and the best approaches that lead to positive outcomes for our boys and men.
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I think there are 2 factors that account for the change in the behaviors of men beyond testosterone levels in our cultures: 1. The fact that there is a 70% rise in households that are lead by women with no make model for the young boys in the home. 2. Often in education not only is the way a boys’ brain engages in the material to learn is discounted, but adhd drugs and such are prescribed too quickly, rather than getting to the emotional cause of the behavioral problem. Thanks Sean for this informative study. Understanding men as well as women and our family dynamics will lead to a healthier world.
Great post. So many factors at work in overdose deaths among men - curious how you differentiate between overdose suicides and overdoses from boys/men taking their drug use too far. The female brain just seems to have better impulse control than the young male brain with it's testosterone infused partially complete pre-frontal cortex. Given a chance to take anything to the extreme the male brain generally seems more willing. I think this is also the reason we don't see as many women riding high performance motorcycles on their way to go skydiving.