Men Missing from National Injury Research Agenda

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Nationally representative U.S. surveys on injury-related visits to hospital emergency departments show that prime-age men suffer about 40% more injuries than prime-age women do. The relative prevalence of injury to men is even greater with respect to violence: men suffer about 55% more violent-injury-related visits to hospital emergency departments than do women. Death from injury is even more biased toward men. About three times as many men die from injuries as do women. Four to five times as many men as women die from violent injuries. While domestic violence against men has been clouded in vicious scholarly controversy, men account for about 40% of U.S. adult domestic-violence victims seeking hospital emergency-room treatment for domestic violence injuries.

Notwithstanding these facts, the U.S. national injury research agenda shows relatively little concern about injury to men. In 2002, the U.S. National Center for Injury Prevention and Control, an organization under the Centers for Disease Control and Prevention (CDC) in the U.S. Department of Health and Human Services, published a 116-page report entitled CDC Injury Research Agenda. The report included one instance of the words “male” or “males”:

Furthermore, while adult males ages 25 to 50 make up the majority of suicide deaths, few interventions focus specifically on this group.^

The report included two instances of the word “men”:

Ninety-one percent of open-water drowning victims are men.

Women experience more chronic and injurious assaults from intimate partner violence than men.^

None of these three mentions of men is connected to any programmatic concern addressing men’s relatively high injury rate.

The 2002 research agenda addressed other specific sub-populations, including women, while ignoring men’s relatively high injury rates. With respect to injuries from initiating or increasing physical activity, the agenda declared:

Special populations, including children, older adults, women, and people who are obese or undernourished, should receive particular attention.^

The factual basis for including women, but not men, in this list of special populations isn’t clear. In 2001, overexertion, which is the most prevalent cause of injury plausibly associated with physical exercise, accounted for 40% more injury-related visits to hospital emergency departments for men ages 15 to 44 than for women of those ages. Men are similarly missing in the research agenda’s treatment of suicide:

Accumulated research evidence indicates that rates of suicidal behaviors and suicide risk profiles can vary widely among distinct social and cultural groups. For example, among American Indians, some subgroups have severely elevated levels of suicide mortality; African American females have especially low rates of suicide mortality, but they may have high rates of nonfatal suicidal behavior. It is not clear whether gay, lesbian, bisexual, and transgendered youths have elevated levels of nonfatal suicidal behavior because findings from different studies have been contradictory.^

In 2001, 4.3 times more men ages 15 to 44 committed suicide than did women of those ages. That huge disparity didn’t register in the injury agenda.

The 2002 injury research agenda didn’t address important public misunderstanding about violent injuries. In 2001, violence accounted for 52% more injury-related visits to hospital emergency departments for men ages 15 to 44 than for women of those ages. The injury research agenda observed:

Many agencies and organizations have developed programs to prevent violence against women and children. … Federal, state, and local government agencies and private organizations currently invest many resources in services for battered and sexually assaulted women and maltreated children.^

The injury research agenda ignored the absence of such programs and services for men. The injury research agenda also ignored prevalent, damaging, false public claims about violence as a cause of injury to women. The research agenda included a chapter entitled “Preventing Intimate Partner Violence, Sexual Violence, and Child Maltreatment.” It declared:

Nearly 25% of women have been raped and/or physically assaulted by an intimate partner, and more than 40% of the women who experience partner rapes and physical assault sustain a physical injury. Women experience more chronic and injurious assaults from intimate partner violence than men. … Women are the primary victims of sexual violence. Approximately 15% to 25% of women experience an attempted or completed rape at some time in their lives.^

Like other claims about violence against women, these are sensational, horrible statistics presented as authoritative. There are serious technical and policy problems with these statistics. The statement that women experience “more chronic and injurious assaults from intimate partner violence” obscures the near absence of services for men who are the victims of such assaults. Reporting of sexual violence occurs with acute anti-men gender bias. CDC reporting of sexual violence categorizes men made to penetrate another as not real rape. Focusing on intimate partner violence and sexual violence exploits general patterns of social communication supporting preferential social concern for females. The injury agenda’s list of priorities for youth violence concluded with expressing concern for “unique needs of females who are at risk for being victimized or victimizing others.”^

The CDC Injury Research Agenda, 2009-2018 shows only slightly more concern about men’s relatively high injury rate, both from all causes and from violence. Some scholars have for decades presented studies showing that domestic violence against men is a significant public problem. Unlike the 2002 injury research agenda, the 2009 injury research agenda recognized that a large number of men are victims of domestic violence:

Data from the 2005 BRFSS (16 states and two territories) indicate that approximately one in four women (26.4%) and one in seven men (15.9%) reported some form of physical intimate partner violence victimization (threatened, attempted, or completed physical violence) or nonconsensual sex by an intimate partner during their lifetime. Twelve-month prevalence of nonconsensual sex or completed physical violence was 1.4% and 0.9% for women and men, respectively, translating to >25 million women and 7 million men annually.{sic} Findings from other national studies have yielded varying estimates; prevalence measures are influenced substantially by the behaviors included and the context (e g , health, crime, or family conflict) in which the questions are asked. Although considerable partner violence occurs to both women and men, women experience greater injuries and harms from intimate partner violence than men.^

The last sentence in the above quote indicates the importance of validating greater social concern for women’s injuries than for men’s injuries. Perhaps in further appreciation for the weight of accumulating research documenting intimate partner violence against men, the chapter title moved “sexual violence” ahead of “intimate partner violence” relative to the similar chapter in the 2002 injury agenda. In addressing suicide, the injury agenda once again hedged against the possibility of relatively greater concern for men:

rates of suicide are higher among males than among females, but studies of suicidal thoughts and nonfatal suicidal behavior routinely indicate females have higher rates than males.^

Among persons ages 15 to 44, about three times as many men as women kill themselves. Publicly expressing concern about that and similar facts seems hardly possible.

Despite highly credible data clearly indicating otherwise, the claim that domestic violence is the leading cause of injury to women became prevalent across a wide range of public discourses. That isn’t a communicative aberration. Lengthy, published injury research agendas from the U.S. Centers for Disease Prevention and Control also show great reluctance to recognize the facts of injuries to men.

The problem is not just sex bias in addressing domestic violence. Injuries to men attract less public concern than do injuries to women. Among persons reporting victimization from serious violent crime, the share of women who receive assistance from victim service agencies is more than twice as high for women as for men. That’s true both for victims who reported their victimization to the police and victims who did not report their victimization.^ Sex disparities in injuries and in services for the injured have attracted virtually no public concern when they are skewed toward harm to men.

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