The culture of men’s mindful attitude toward their health in the context of managing demographic processes

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Introduction In recent years, Russia has faced an acute demographic crisis. Its signs are the trend towards an excess of mortality over fertility, which began in 2017 and is currently continuing. According to Rosstat, the natural growth rate in the period 2017-2023 ranged from -1 (In 2017) to -7.1 (In 2021). In 2023, the value of this indicator is -3.5. Previously, the population decline was covered by the migration influx, in the last few years the mechanism of population replenishment at the expense of migrants has slowed down. As you know, starting in 2021. The total population in Russia is constantly decreasing. According to A.V. Minakov and N.D. Eriashvili, Russia’s demographic crisis “negatively affects its socio- economic development, and is a threat to economic security and national security in general” [1. P. 87]. Despite the fact that Russia’s demographic problems do not have a quick solution and, as Mikhail Sidorenko shows, “according to the forecasts of the United Nations and Rosstat, Russia’s demographic indicators will tend to decrease” [2], significant management steps are being taken in our country to address them. In particular, the national project “Demography” was implemented in 2019-2024, and new national projects “Family” and “Youth and Children” which are aimed at improving the demographic situation were launched in 2025. The Government’s efforts have made it possible to increase the importance of such an important demographic indicator as life expectancy at birth. In 2023, the value of this indicator was the highest in recent years - 73.41 years (Fig. 1). In 2025, a new national project “Long and active life” was launched, aimed at increasing life expectancy to 78 years by 2030, and to 81 years by 2036. Fig. 1. Life expectancy at birth, years Source: made by D.K. Tanatova, I.V. Korolev according to Rosstat data[21] with the use of MS Excel. Achieving this goal requires the formation of a culture of caring for their health among Russian citizens. This is especially true for such a vulnerable group of the population as men. According to the UN, in almost all regions and countries of the world, women have an advantage in terms of survival[22]. In Russia, life expectancy at birth for men in 2023 was 68.4 years, for women the value of the same indicator is more than ten years higher - 78.4[23][24]. In 2022, in all age groups, the mortality rate among men is higher than among women. But if the mortality difference between men and women is not obvious in the age groups up to twenty years, then after twenty years men die significantly more often than women (Fig. 2). Fig. 2. Age- specific mortality rates in 2022, ppm (0.1 percent) Source: made by D.K. Tanatova, I.V. Korolev according to Rosstat data[25][26] with the use of MS Excel. Men are more likely than women to die from the most common causes of death - diseases of the circulatory system, respiratory diseases and neoplasms (569.2 and 219.2 deaths per 100,000 men, respectively, versus 564.7 and 167.6 deaths of women, respectively)[27]. As shown by A. Oksuzyan, M. Shkolnikova, and other researchers: “Men suffer more from diseases with high mortality, while more women live to old age with less fatal but disabling conditions” [3]. Materials and methods The problem of male hyper- mortality is not something new for scientists. This problem was pointed out by Russian researchers O.M. Drapkina, I.V. Samorodskaya [4], as well as foreign scientists: H. Beltran- Sanchez, Caleb E. Finch and Eileen M. Crimmins [5], Constance Holden [6], Virginia Zarulli, Ilya Kashnitsky, James V. Vopel [7] and others. Several approaches to the explanation of this problem have already been formed in the humanities. The first is the historical approach that explains the higher mortality rate among men in the increasing role of women in civilizational development. The second biological approach is related to the unequal biological resistance of men and women. The third socio- economic approach is based on behavioral differences between men and women [8. P. 82]. Proponents of the third approach point out that “the dynamics of gender differences in mortality indicates that its determinants cannot be purely biological, but also depend on modifiable psychosocial factors and lifestyle” [9. P. 48]. We do not deny the historical and biological approaches, but we believe that the advantages of women over men in terms of a longer life are primarily due to behavioral differences and a higher level of culture of caring for their health. The culture of a thrifty attitude to health largely depends on the individual, the family, as well as on the social environment. This determines the need for a sociological view of the health- saving and health- strengthening practices of the male population. A sociological approach to the topic of men’s careful attitude to their health allows us to identify key barriers and factors influencing men’s behavior to preserve and promote health. Results and Discussion In 2024, sociologists from the Russian State Social University conducted a study of the culture of men’s careful attitude to their health. The method of collecting information is a survey. The target audience is Russian men aged 18 and over. The sample size is 6280 respondents. The sampling error does not exceed 1.25%. The sample is quota- based, it represents the male population of the federal district by age and by the size of the settlements in which they live. The respondents indicated negative health practices present in their lives. Half of men (50%) have frequent stress and anxiety in their lives. Approximately the same proportion of men undergo medical examinations less than once a year (49%) and do not eat right (47%). About two out of five men have irregular work schedules (43%), don’t move much (41%) and have bad habits (38%). Thus, the lives of a significant number of men are filled with practices that do not promote a frugal attitude to health and a healthy lifestyle (Fig. 3). once a year relationships with family and Yes Rather yes than no Total affirmative answers relatives % Fig. 3. Distribution of respondents’ answers about their life practices, % of the total number of respondents, n-6280 Source: executed by D.K. Tanatova, I.V. Korolev based on the results of their own sociological research using MS Excel. The risk of developing various diseases in men is due to the insufficient motor activity of men. You can compensate for the lack of physical activity by walking at a moderate or fast pace. An analysis of the respondents’ responses showed that approximately one in three men (30%) walks for less than 30 minutes a day. It can be concluded that to reduce the risk of morbidity due to low physical activity, a significant number of men need to find opportunities for physical education and sports. The majority of Russian men demonstrate a disdainful attitude towards compliance with the norms of proper nutrition. More than half of the respondents (54%) do not consume enough vegetables and fruits in their daily diet. This attitude of men towards the consumption of vegetables and fruits indicates an insufficient culture of frugality towards their health and a healthy lifestyle. One of the factors preventing men from taking care of their health is a disdainful attitude towards medical exa minations. One in three respondents demonstrates a disdainful attitude towards medical examination. That is, a significant part of men is very inattentive to monitoring their health status. The respondents expressed their opinion on what conditions are primarily necessary to preserve and strengthen human health. A hierarchical cluster analysis of their responses allowed them to be divided into three clusters. The first cluster, “Accessibility of cheap, high- quality medicine,” was formed by respondents who believe that the necessary conditions for maintaining and strengthening health are institutional conditions created by the state. The cluster “Availability of cheap, high- quality medicine” is the largest. It includes 49% of the respondents. The second cluster, Ecology and Tranquility, consists of respondents who believe that it is necessary for human health to live in good environmental conditions and not experience stress overloads. This cluster is relatively small - it includes 29% of the men surveyed. The third cluster, “Personal opportunities and responsible behavior,” consists of respondents who expressed the opinion that the necessary conditions for maintaining and strengthening human health are his financial security and health- saving behavior. The third cluster is the smallest - accounting for 22% of the respondents. It can be concluded that the majority of men in matters of maintaining and strengthening their health are guided by institutional conditions, rather than by their own efforts. The study did not consider the psychological peculiarity of men associated with masculinity stereotypes, according to which men often perceive health care as a manifestation of weakness. Here we can refer to a similar study by V.V. Lemish, who draws attention to the fact that “the behavior of men associated with maintaining health is largely determined by stereotypes of masculinity” [10. P. 30]. Note that men’s commitment to masculinity does not mean that in matters of health they closely monitor the state of what distinguishes them from women, i.e. the state of the reproductive system. As D.F. Aliyev, D.K. Tanatova and I.V. Korolev show, men are extremely rarely examined by an andrologist, but they are usually confident that they do not have problems with reproductive health[28]. The conclusions drawn by the authors primarily emphasize the importance of the behavioral aspect in the issue of preserving and preserving men’s health, and therefore their longer life and strengthening the demographic potential of Russia. The authors agree with Vergeles M.O., who points out that differences in the mortality advantages of women over men are determined, but not limited to the biological basis. In addition to biological causes, men are more likely than women to die because of behavioral risk factors: smoking, dangerous alcohol consumption, risky behavior leading to death from external causes, stress, low medical care, insufficient adherence of men to treatment [11. P. 6]. Conclusion The results of the study clearly demonstrated that Russian men do not have a fully formed culture of caring about their health. Significant steps have been taken in Russia to improve men’s health: the primary health care system is developing, campaigns are being conducted to combat cardiovascular and oncological diseases, children’s healthcare is developing, physical education classes are being popularized, etc. However, it will not be possible to reduce the gap in life expectancy between the sexes without the formation of a conscious attitude towards their health among men. In the demographic process management system, it is necessary to consistently improve the culture of caring for men’s health.

About the authors

Dina K. Tanatova

Russian State Social University

Email: dktanatova@mail.ru
ORCID iD: 0000-0002-7924-2242
SPIN-code: 7675-8938

Doctor of Sociological Sciences, Professor, Head of the Department of Sociology, Ethnography and Sociometry

4 Wilhelm Pik st., Moscow, 129226, Russian Federation

Ivan V. Korolev

Russian State Social University

Author for correspondence.
Email: iv_king@mail.ru
ORCID iD: 0000-0002-1317-2317
SPIN-code: 3585-2844

Candidate of Sociological Sciences, Associate Professor, Department of Sociology, Ethnography and Sociometry

4 Wilhelm Pik st., Moscow, 129226, Russian Federation

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