It is often said that men are less likely to look after their health than women, but is this really the case?
According to a recent report by the Australian Bureau of Statistics (ABS), men are more likely to engage in risky behaviours, and have a higher incidence of many conditions, than women.
The ABS says that men are expected to live 4.5 years less than women, with young men more likely to die from external causes, and as age increases, cancers and diseases of the circulatory system are the main causes of death.
So what can be done to improve the health of Australian men?
Our guest blogger Professor John MacDonald, Director of the Men’s Health Information and Resource Centre, University of Western Sydney, gives his view on the state of men’s health in Australia.
Male health: Self care, but it takes two to tango!
There has been a growing interest in male health. The women’s movement has brought attention to the issue of gender and health and the benefits to women are there to be seen in the health programs designed specifically for them. Unfortunately, one result has been that “gender and health” often refers exclusively to women’s health. Women have rightly struggled with the danger of ‘women’s health” being reduced to concerns for the reproductive health of women, likewise, male health has been dominated for some time by concerns around the prostate and more recently, erectile dysfunction, both, in themselves important aspects of male health, but only part of the bigger picture. This medicalisation of men’s health has often been accompanied, not by regular screening for men as there is for women, but by repeated assertions that “men don’t take care of themselves”, “men don’t get in touch with their feelings” and the like. Generally this has been in a blaming tone, compounded by another stream of concern about “men behaving badly” and male violence. Of course, we must accept that good male health is a matter of the engagement of the individual male with his total environment, including the health services which are there and are sometimes underutilised by men (though not as much, as we see from the ABS statistics, as the stereotype would have us believe). And no one, including men, should get away with violence, but there is more to men’s health than that.
But change is on the way! This negative approach to male health has been offset more recently by what can be seen as a more rational and compassionate view of male health. This has come about in part by a growth of interest in the “social determinants” of health, a movement spearheaded by WHO. The Australian National Male Health Policy, launched this year, (www.health.gov.au/malehealthpolicy) tells us that this approach is the way forward. Sure, we have to exercise and watch alcohol intake etc but if a man’s context is one where he commutes two hours in the morning and two at night, let’s get real – “self care” must be adapted to his life situation. Work, stress, the social gradient (where we fit in the ladder of society), social inclusion and exclusion are all examples of the social determinants of health and influence our resistance to illness and disease and provide a useful entry point to looking at male health.
One example is that of work, employment and unemployment: men working to support their families and anxious not to be made redundant, men working in health-threatening jobs, not by choice or carelessness, men finding the adjustment after retirement hard and stressful. All these issues are legitimate and in fact essential factors to look at when dealing with men’s heath. What does “self-care” mean for each of these groups? The shift involved in adopting a social determinants of health approach allows us, for all populations, including men, to acknowledge the importance of personal behaviour (including violent behaviour) but to see this in the broader environments of men’s lives. The Male Health Policy talks about men going more to the doctor but doesn’t say it’s all up to the men. It talks of “male-friendly” health services. Wow! That is a change. Check out what your local Community Health or GP does for young dads, for commuting men (e.g. surgery hours), for isolated older men who are the group most at risk of suicide. I am afraid you won’t find much.
Some Australian circumstances may have relevance for the wider world. National male health conferences have been run in conjunction with Indigenous, Aboriginal and Torres Strait Islander Male Health Conventions and we see there is much to be learned from Aboriginal approaches to health, including male health: a more holistic view of health underpins Aboriginal philosophy and there is a respect for “men’s business” as separate from women’s business. In a globalised world there is much to be learned from other cultures, helping us towards a more rational and compassionate view of men’s health.
2010 has seen the proclamation of an Australian Male Health Policy, only the second country in the world after Ireland to have one. The preparatory documents have stressed the social determinants of male health and also the importance of “male-friendly” health services. Both these elements allow us to move away from the narrow clinical perspective of men’s health (or rather illness), as well as from the blaming men approach. We can now think of building the health of men and boys across the life span as well as changing our perspective about men and health services. Instead of asking, Why don’t men come to services?, we should now be asking, What can services do to make themselves more accessible to men and boys? It takes two to tango!