The role of human resource management practices in promoting men’s health: a systematic review

2.1 Protocol and registration

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines [30]. The protocol for this systematic review was registered in the PROSPERO database (CRD420261301036) prior to data extraction. The registered protocol described research objectives, search strategy, eligibility criteria, quality assessment tools, and data extraction procedures to ensure transparency and minimize bias in the review process. This review has been conducted and reported in full compliance with PRISMA 2020 standards, as evidenced by the flow diagram in Fig. 2 and the structured Methods section (Sections 2.1–2.7). The complete search strategy is available from the corresponding author upon reasonable request.

Fig. 2.PRISMA 2020 flow diagram shows records identified through database searching: PubMed (n = 1247), Scopus (n = 982), Web of Science (n = 876), Business Source Complete (n = 654), totaling n = 3759 database records. An additional 47 records were identified through hand-searching reference lists (total records before deduplication: n = 3806). HRM: Human Resource Management.

2.2 Search strategy

Four major electronic databases, Business Source Complete, Scopus, Web of Science Core Collection, and PubMed (including MEDLINE) were searched for relevant content. These databases were chosen to gather pertinent research on HRM and employee well-being from the fields of management, organizational behavior, public health, and medicine [31]. To represent the contemporary moment in which workplace wellness and gender-specific health promotion have received significant scholarly attention, the search was limited to peer-reviewed studies published in English between January 2010 and August 2025.

The search strategy combined three concept blocks using Boolean operators: (1) HRM practices terms including “human resource management”, “HR practices”, “personnel management”, “talent management”, “workforce management”, “employee relations”, “occupational health policy”, and specific HRM functions (recruitment, training, compensation, performance management, benefits, work-life balance, employee assistance); (2) men’s health terms including “men’s health”, “male health”, “masculine health”, “gender-specific health”, “male employees”, “working men”, and “men workers”; and (3) outcome terms including “health outcomes”, “well-being”, “wellness”, “cardiovascular”, “mental health”, “stress”, “healthcare utilization”, “preventive health”, and “health behaviors”. Reference lists of included studies and relevant systematic reviews were hand-searched to identify additional eligible articles [32].

Table 2 presents a summary of the database search strategy, including the specific search fields used and records retrieved from each database, yielding 3806 total records before deduplication.

2.3 Eligibility criteria

Studies were included if they met the following criteria: (1) examined one or more HRM practices as independent or moderating variables; (2) assessed health outcomes specifically for male employees or provided gender-disaggregated results, enabling extraction of male-specific findings; (3) employed quantitative, qualitative, or mixed-methods research designs; (4) were conducted in workplace or organizational settings; and (5) were published in peer-reviewed journals in English. HRM practices were defined broadly to encompass recruitment and selection processes, training and development programs, performance management systems, compensation and benefits structures, employee wellness initiatives, work-life balance policies, and EAPs.

Studies were excluded if they: (1) examined general population samples without workplace context; (2) focused exclusively on female employees without male-specific data; (3) assessed only organizational-level outcomes (e.g., productivity, turnover) without individual health measures; (4) were conference abstracts, dissertations, book chapters, or non-peer-reviewed publications; (5) described intervention protocols without outcome data; or (6) were conducted in military settings, given unique contextual factors limiting generalizability to civilian workplaces.

2.4 Extraction of male-specific findings from mixed-gender studies

A central methodological consideration in this review was the extraction of male-specific findings from studies that included both male and female participants. Given that workplace health research often employs mixed-gender samples, we developed explicit criteria for determining whether studies contributed meaningful evidence about men’s health outcomes specifically. Studies were categorized into three groups based on their approach to gender:

1. Male-only studies: Research conducted exclusively with male participants (e.g., studies in male-dominated industries such as construction or mining, or gender-targeted interventions like the POWERPLAY program). These studies directly address men’s health without requiring gender disaggregation.

2. Mixed-gender studies with gender-stratified analyses: Research that included both genders but reported separate analyses or subgroup findings for male participants, enabling the direct extraction of male-specific effect sizes, prevalence rates, or qualitative themes.

3. Mixed-gender studies with gender as a moderator or covariate: Research that tested whether HRM-health relationships differed by gender through interaction terms or moderation analyses, allowing interpretation of how findings apply specifically to men.

Studies reporting only aggregated results across genders without any gender-specific analysis were excluded, as they do not permit conclusions about men’s health specifically. For included mixed-gender studies, we extracted the male-specific findings, sample sizes, and effect estimates where available.

2.5 Study selection

All records found through database searches were loaded into the Covidence systematic review software for screening and deduplication. Titles and abstracts were screened by two independent reviewers in accordance with eligibility criteria; when a consensus could not be achieved, conflicts were settled by discussion or consultation with a third reviewer. Using a uniform eligibility checklist (Supplementary material), both reviewers separately retrieved and evaluated full texts of possibly eligible articles. Cohen’s kappa statistic was used to calculate inter-rater reliability; values greater than 0.80 indicated strong agreement [33]. The PRISMA flow diagram in Fig. 2 documents the selection procedure.

2.6 Data extraction

Data from the included studies were collected using a standardized questionnaire developed for this study and pilot tested on five articles. The extracted data included study identification (authors, year, country, journal), study design and methodology, sample characteristics (industry sector, sample size, age range, occupation types), HRM practices examined, health outcomes measured, significant findings regarding HRM-health relationships, and study quality indicators. For quantitative studies, effect sizes (correlation coefficients, odds ratios, regression coefficients) and confidence ranges were extracted when available. For the qualitative studies, significant themes and illustrative quotes were noted.

2.7 Data synthesis

A narrative synthesis approach was employed rather than meta-analysis due to the anticipated heterogeneity in study designs, HRM practices examined, and health outcomes measured [34]. Findings were organized thematically by HRM practice category and synthesized within each category based on the type of health outcome (physical health, psychological well-being, health behaviors, healthcare utilization). The strength of evidence for each HRM-health relationship was evaluated based on sample sizes, effect magnitudes, methodological quality, consistency of findings across studies, and quality of gender-specific reporting.

Table 3 (Ref. [35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48]) indicates, for each included study, whether it was a male-only study or a mixed-gender study with gender-disaggregated results, ensuring transparency about the basis for male-specific conclusions.

3.1 Study selection and characteristics

The systematic search identified 3759 records from the four electronic databases and 47 additional records from hand-searching reference lists of included studies, totaling 3806 records prior to deduplication. After deduplication, 2418 unique entries were screened by title and abstract, and 329 of them were assessed in full. Applying the eligibility criteria resulted in 14 studies in the final synthesis. Strong inter-rater agreement was found for full-text screening (Cohen’s κ = 0.84). The PRISMA flow diagram in Fig. 2 provides a detailed description of the selection process and justifications for exclusion at the full-text stage.

The included studies were published between 2011 and 2023, with the majority (n = 10, 71%) appearing after 2017, reflecting increased research attention to this topic. Studies originated from diverse geographical regions, including North America (n = 9), Europe (n = 3), and Asia-Pacific (n = 2). Sample sizes ranged from 72 to 12,459 participants, with a median of 755. Industry sectors represented included university/education (n = 3), healthcare (n = 1), information technology (n = 1), male-dominated industries (n = 2), construction (n = 1), and multiple sectors (n = 6). Study designs included three randomized controlled trials (RCTs), four longitudinal cohort studies, one cross-sectional survey, two systematic reviews, one qualitative study, one mixed-methods study, one pre-post study, and one quasi-experimental design.

Regarding the approach to gender-specific findings, five studies (36%) focused exclusively on male populations, while nine studies (64%) employed mixed-gender samples with gender-disaggregated analyses. Among the male-only studies, two examined gender-targeted wellness interventions in male-dominated workplaces [35, 36], one conducted qualitative research with male EAP users [37], and two systematic reviews addressed male-predominant occupational contexts [38, 39]. Among mixed-gender studies, all provided either gender-stratified results or tested gender as a moderating variable, enabling the extraction of male-specific findings. The characteristics of all 14 included studies are presented in Table 3, including the designation of the gender analysis approach for each study.

3.2 Quality assessment results

Methodological quality varied across included studies. Among quantitative observational studies assessed using the Newcastle-Ottawa Scale, scores ranged from 5 to 8 out of 9 possible points, with a mean of 6.8, indicating moderate to good quality. Common limitations included reliance on self-reported health outcomes, insufficient control for confounding variables, and cross-sectional designs precluding causal inference. The three RCTs demonstrated low to moderate risk of bias, with concerns primarily related to the blinding of participants and outcome assessors, given the nature of workplace interventions. Qualitative and mixed-methods studies generally met CASP (Critical Appraisal Skills Programme) and MMAT (Mixed Methods Appraisal Tool) criteria for appropriate methodology and a clear statement of aims, though reflexivity reporting was variable. The two systematic reviews were of high methodological quality.

3.3 HRM practices and men’s health outcomes

4.1 Gender-specific considerations

A key contribution of this review is highlighting how masculine gender norms mediate the relationships between HRM practices and men’s health outcomes. Traditional masculine ideals emphasizing self-reliance, emotional stoicism, and physical toughness impede men’s access to organizational resources supporting health (a pattern supported primarily by qualitative evidence from Matthews et al. [37] and broader theoretical literature rather than by multiple primary studies within this review) [51]. These findings underscore the need for gender-sensitive HRM approaches that recognize and address masculine-specific barriers rather than assuming that gender-neutral program designs will be equally effective for men and women.

Studies identifying effective strategies for increasing male engagement provide actionable insights. The POWERPLAY studies [35, 36] demonstrated that competitive structures, team-based challenges, and masculine-appropriate framing increased wellness program participation among men. Manager referrals and organizational culture interventions that normalize EAP use may reduce stigma barriers to mental health service utilization. Framing health behaviors in terms of functional performance (e.g., strength, energy, productivity) rather than illness prevention resonates more effectively with masculine values [52].

Fig. 3 presents the barriers and corresponding HRM strategies.

Fig. 3.Barriers to men’s health engagement and corresponding HRM facilitating strategies. This figure illustrates the primary barriers to male employees’ engagement with workplace health resources and evidence-based HRM strategies to address each barrier. HRM: Human Resource Management.

4.2 Organizational and sectoral variations

Findings from this review suggest that associations between HRM practices and men’s health outcomes may vary across organizational contexts and industry sectors. Construction is a male-dominated industry with elevated injury risks, and the Cochrane review by van der Molen et al. [39] identified substantial gaps in safety intervention research for this sector. The POWERPLAY studies conducted in male-dominated workplaces highlighted the importance of tailoring interventions to masculine workplace cultures. Conversely, the Illinois Workplace Wellness Study, conducted in a university setting, reported modest effects that may reflect different worker demographics and health profiles.

Organizational size and resources also appeared to influence HRM-health relationships. Comprehensive wellness programs demonstrating the strongest engagement effects tended to incorporate multiple components, including competitive elements, team challenges, and organizational culture change [17]. Small and medium enterprises may face resource constraints limiting their ability to implement comparable interventions, suggesting the need for scalable, cost-effective approaches.

From a business-case perspective, the return on investment (ROI) of gender-sensitive HRM interventions remains underexplored in the literature. While workplace wellness programs have been estimated to generate 1.50–3.00 in savings per dollar invested through reduced absenteeism and healthcare utilization, the Illinois RCT evidence challenges these estimates for university settings. For male employees specifically, programs that reduce occupational injuries and improve EAP utilization may yield particularly high ROI given the disproportionate costs of male occupational injury and untreated mental health conditions. Future economic evaluations should model gender-disaggregated cost-effectiveness to provide the business-case evidence needed to justify organizational investment in gender-sensitive HRM practices. A further consideration is the bundling of HRM practices. Theoretical frameworks, particularly high-performance work systems (HPWS), suggest that HRM practices produce synergistic effects when implemented as coherent systems rather than isolated interventions. For example, wellness programs may prove more effective when paired with flexible scheduling and a supportive organizational culture. The studies included in this review predominantly examined single HRM practices, preventing conclusions about bundled HRM effects on men’s health—an important direction for future research.

Findings from this review carry several implications for HR professionals seeking to promote men’s health. Table 4 summarizes evidence-based recommendations by HRM function, including training, compensation, wellness programs, work-life balance, employee assistance, and performance management.

5.1 Limitations of the review

Several limitations should be considered when interpreting this review’s findings. First, the restriction to English- language publications may have excluded relevant studies published in other languages, potentially limiting geographic representation. Second, heterogeneity in HRM practices examined, health outcomes measured, and study designs employed precluded meta-analytic synthesis. This determination was made conceptually by comparing outcome categories, measurement instruments, and study populations across included studies, rather than through formal statistical heterogeneity testing (e.g., I² statistics), which would require a pooled quantitative dataset. Third, the relatively small number of included studies (n = 14) limits the strength of conclusions regarding specific HRM-health relationships. Fourth, reliance on self-reported health outcomes in most studies introduces potential for common method bias and social desirability effects.

Additionally, the geographic concentration of included studies in North America (n = 9) and Europe (n = 3) limits the generalizability of findings beyond Western contexts. HRM practices, masculine norms, and workplace health cultures vary substantially across regions, and interventions effective in individualist Western workplaces may require significant adaptation for collectivist or high-power-distance cultural settings common across Asia, Africa, and Latin America. Future research should explicitly address how cultural context moderates the relationship between HRM practices and men’s health outcomes.

The small number of included studies likely reflects a combination of factors: a genuine research gap at the intersection of HRM scholarship and men’s health; methodological shortcomings in the broader literature where mixed-gender studies rarely report gender-disaggregated outcomes; and potential publication bias favoring positive findings in larger wellness program evaluations. The absence of gender-specific reporting in many workplace health studies is itself an important finding, and researchers and journals should consider adopting mandatory gender-disaggregation standards for workplace health research.

Fifth, included studies varied substantially in how male-specific findings were reported, with some providing fully gender-stratified analyses while others examined mixed samples with gender as a covariate or moderator. This variability required careful interpretation to ensure conclusions accurately reflected evidence about men specifically. Sixth, the concentration of wellness program research in university settings limits generalizability to other sectors. This is particularly problematic given that men’s health disparities are most acute in male-dominated industries such as construction, manufacturing, and emergency services, which are underrepresented in the evidence base. The Illinois Workplace Wellness Studies, while methodologically rigorous, were conducted in predominantly educated, white-collar university populations that differ substantially from manual labor workforces in demographics, health risk profiles, and organizational culture. Findings from university settings should therefore be interpreted cautiously when extrapolating to sectors where men face higher occupational health risks.

5.2 Limitations of primary studies

Beyond review-level limitations, weaknesses in primary studies warrant acknowledgment. Selection bias was evident in studies relying on voluntary program participation. Attrition bias affected longitudinal studies with extended follow-up periods. Confounding by unmeasured variables remained inadequately addressed in most observational studies. Publication bias likely affected the evidence base, with positive findings more likely to reach publication than null results.

Fig. 4 illustrates the research gaps and future priorities.

Fig. 4.Research gaps and future priorities in HRM and men’s health research. This figure maps identified gaps in current evidence to recommended priorities for future research. HRM: Human Resource Management; ROI: return on investment; SMEs: Small and Medium-sized Enterprises.

5.3 Future research directions

Several priorities for future research emerge from this review. First, longitudinal studies with repeated measurements of both HRM practices and health outcomes are needed to strengthen causal inference. Second, intervention research should evaluate gender-targeted HRM approaches in male-dominated industries, including construction, manufacturing, and emergency services, where occupational health risks are elevated. Third, research examining intersectionality is critically needed. Gender does not operate in isolation: the health effects of HRM practices likely differ substantially across intersecting identities, including race, ethnicity, socioeconomic status, age, sexual orientation, disability status, and occupational class. For example, men of color in low-wage male-dominated industries may face compounded structural barriers to health-promoting HRM practices. None of the included studies reported intersectional analyses, representing a significant gap in the evidence base that future research should prioritize. Fourth, studies examining bundled HRM systems rather than isolated practices would advance understanding of synergistic effects. Fifth, economic evaluations assessing the cost-effectiveness of gender-sensitive HRM approaches would strengthen the business case for organizational adoption.