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The Need for a Men’s Health Program

In countries around the world, including Canada, a consistent pattern of life expectancy has developed over the past century: men die at an earlier age than women.

Canadian men have a life expectancy of 76 and in BC live on average 4.4 years less than women. But beyond length of life, more revealing statistics relate to the age at which a person loses their good health (“Health Expectancy”) and the numbers of years of life lost because of dying at an early age (“Potential Years of Life Lost”). With an average health expectancy of 65 years, Canadian men may experience 11 or more years of poor health and disability before they die. And Canadian men have a 20% higher number of potential years of life lost, as they are more likely to die at a younger age when struck by a stroke or heart disease, or as a result of risk taking behaviour, suicide, or workplace mortality.

Granted, these statistics are averages. Many men do better than this, living and thriving well into their nineties. Other men do much worse; in lower socio-economic sectors of our communities, male health expectancy will average 17 years less than life expectancy. Factors beyond biology, such as risk-taking behaviour, substance abuse, poor self-care, lack of awareness, and societal and cultural pressures, clearly impact on gender differences in morbidity and mortality. In 2005, 1,097 Canadians died in the workplace, 97% of them male. Today, military deaths, which almost always involve young males, compound the potential years of life lost.

Early male death through illness, accident or suicide has wide repercussions on the broader family dynamic: the loss of a father’s love and of a male role model has a huge impact on the normal development of children; almost 50% of women are widowed by age 65; more than one half of elderly widows living in poverty were not poor before the death of their husbands; and at age 95 women outnumber men 8 to 1. A glance around any nursing or extended care home in the country will confirm this observation.

In the past decade we have recognized the need to make men’s health a distinct and important issue; however, the science of male health is still in its infancy. Many questions need to be asked and eventually answered on issues affecting all the ages and stages of the male lifespan. In adolescent and young adult males we need to investigate why violence, risk-taking, suicide rates, and substance use and abuse are so prevalent. Why at this age health concerns are generally “off the radar”? An important example is cancer of the testicle, which occurs mainly in this young age group and is so curable by modern treatments when found early. We simply need to get the message to young men about self examination.

In middle aged males, we need to teach about preventive strategies, nutrition, risk assessment, and how to “listen to one’s body”. As an example, diminishing sexual function may be like the canary in the coal mine—it may be the first indication of problems elsewhere such as blockages in the coronary arteries of the heart or the arteries to the brain, diabetes, high blood pressure, or high cholesterol. Middle aged men are key role models for young boys and adolescents so this is a time for them to assess their own health and teach the next generation to do the same.

In the older man, it seems that the more birthdays that pass by, the more losses there seem to be to endure: hormone loss, sexual loss, hair loss, bone loss, muscle loss, and loss of memory, prostate health, and mental health. Clearly, many of these losses are a result of aging and will be with us until we find the fountain of youth, but many of these can be predicted at early stages and possibly delayed through appropriate education and public health intervention in midlife years.

The modern women’s health movement has been strong, vibrant and productive for over 20 years. It is only in the past decade that world governmental and nongovernmental organizations are beginning to address the issues of male-specific health. The development of a Men’s Health Initiative in BC is timely—building on the expertise we currently have across multiple institutions and disciplines, we can become global leaders in the field and develop a strong model of care, awareness, education, and research. We need to work with our government and community leaders to coordinate a system that will better understand men’s attitude to health, invest in male-defined approaches to healthcare provisions, initiate healthcare education early on in life for boys and young men in schools and diverse communities, and develop coordinated health and social policies based on the best available standards of care. Together we can “add 10 good quality years to the middle of a man’s life, postpone and perhaps decrease the inevitable losses of aging, and help men to grow older without growing old”. The time is now.

Men's Health: A Global Perspective, with Dr. Larry Goldenberg - Part 1

Men's Health: A Global Perspective, with Dr. Larry Goldenberg - Part 2