Men are less likely to wear masks. They are also dying of coronavirus at higher rates in L.A. County

SANTA MONICA-CA-JULY 21, 2020: People visit the Santa Monica Pier on Tuesday, July 21, 2020. California has again reported its highest number of coronavirus cases in a single day Monday. (Christina House / Los Angeles Times)
People visit the Santa Monica Pier on July 21. (Christina House / Los Angeles Times)

Men have a mask problem.

That is the view of Los Angeles Mayor Eric Garcetti and health officials, who are urging guys to cover their faces in public to slow the spread of the coronavirus.

Men outside of institutional facilities are dying from COVID-19 at a higher rate than women in Los Angeles County, and recent polling has found that American men are less likely to always wear masks than women.

"Men: Mask up. Men: Wash your hands. Clean your surfaces. Men: Don’t get together with other households," Garcetti said.

The call comes as health officials say face coverings are a key element if California and the rest of the world are going to conquer the pandemic. But in America, masks have become a political issue, with conservatives more likely to oppose government orders for people to wear masks. Places such as Huntington Beach have emerged as symbols of mask resistance, with many refusing to cover their faces.

During a briefing Wednesday evening, Garcetti said that of the roughly 2,000 coronavirus-related deaths in the county that have occurred outside of institutional living facilities — like nursing homes, jails and shelters — two-thirds have been men.

"Let us lead to make sure we as men acknowledge that we are the most vulnerable and dying outside of our institutional settings at twice the rate in L.A. County of women," Garcetti said.

Overall, slightly more COVID-19 cases have been confirmed in women than men, according to figures from the L.A. County Department of Public Health. In total, men account for 57% of coronavirus-linked fatalities in the county, including those in institutionalized settings.

From the earliest days of the pandemic, researchers have noted that men tended to die from COVID-19 at a higher rate than women.

A number of possible explanations have been floated: including that men worldwide are much more likely to smoke cigarettes, which damages their lungs and creates other health issues; that there’s something about estrogen that protects against the ravages of coronaviruses; or that testicles may actually increase the risk of longer, more severe illness.

Although the science is still out on COVID-19 specifically, it's not entirely unexpected that men would have higher morbidity than women.

"If you look at the pandemics in the past, it’s a trend that we are familiar with," said Neha Nanda, medical director of infection prevention and a healthcare epidemiologist at the USC Keck School of Medicine.

One contributor, Nanda said, could be that certain underlying health conditions that can increase a person's risk for severe illness if they're infected by the coronavirus — such as hypertension or cardiovascular disease — tend to be more prevalent in men.

"Because it’s a novel virus, I think just time will tell," she said.

Garcetti's plea to men comes as health officials and policymakers continue to call on residents to do their part to stymie the spread of COVID-19 amid an ongoing surge in infections and unprecedented daily death tolls.

Often-urged practices include regular hand-washing, keeping physical distance from those you don't live with and wearing a face covering when in public.

While recent public polling shows there is fairly wide support nationwide for wearing and requiring masks in public, some surveys show that men are still more resistant than women.

According to a July 13 Gallup poll, 34% of men said they always wear a mask when outside their homes, and 29% said they did so very often. Meanwhile, 54% of women surveyed said they always wear masks, while 27% reported doing so very often.

A fifth of the men surveyed said they never wear masks outside, compared with only 8% of women.

While a number of factors probably play into men’s comparative reluctance to cover up, one study released in May found that “men less than women believe that they will be seriously affected by the coronavirus, and this partly mediates gender differences in intentions to wear a face covering.”

Another factor, according to researchers Valerio Capraro of London’s Middlesex University and Hélène Barcelo of the Mathematical Sciences Research Institute in Berkeley, was that “men more than women agree that wearing a face covering is shameful, not cool, a sign of weakness and a stigma.”

California Health and Human Services Secretary Dr. Mark Ghaly said Tuesday that widespread public mask wearing — which has been required in California for weeks — could cut coronavirus transmission in half.

“Having that mask on or handy is a very important tool as we continue to see the evidence grow that it can help reduce the spread of COVID-19 and not only protect our families and communities but help us move on the road of economic recovery, help us get closer to having more schools open across the state,” Ghaly said.