In Canada, the top three causes of death for men are cancer (31.1%), heart disease (21.6%) and unintentional injuries (5.0%). The top two are the same for women, although with slightly different percentages: cancer and heart disease account for 28.5% and 19.7% of all deaths among women, with stroke (7.0%) coming in third. In the US, men die at an overall rate 1.4-times higher than women, of heart disease 1.6-times more, and are twice as likely to die from an unintentional injury.
In fact, women outlive men by 4.5 years on average worldwide – 66.5 years vs 71.0 years. This difference increase to 7 years in the developed world. Not only are men more likely to die from the causes above, men are also more likely to commit suicide than women. This gender difference increased following the recession. A time trend analysis from the UK found that approximately 850 more men, and 155 more women committed suicide than would have been expected based on historical trends following the 2008 economic downturn, with the highest increases in those regions that were most affected by rising unemployment.
But what leads to these outcomes? Given we live in a world where people can get help when they need it, why should men be dying at a rate that is that much higher than women for (almost) the same diseases? And why are they dying younger than women?
Much of it is a direct result of the socialization of men at a young age. Admitting weakness is drilled out of you, and men as a result do not seek out help when they need it. Much research has investigated differences in health seeking behaviour between genders, with examples as innocuous as back pain. A study by Jensen et al found that women were more likely to seek out care if they had moderate levels of back pain vs low back pain, while men would not seek out help. Meanwhile, both men and women were likely to seek out help if they experienced high levels of back pain. The difference observed here highlights one of the major differences between men and women on health behaviours: women are more likely to see a health professional before things escalate compared to men. A recent study by Pinkhasov and colleagues further investigated this phenomena using data from the CDC on health care utilization and concluded:
Men are less likely to utilize health care visits to doctor’s offices, emergency departments (ED), and physician home visits than women. They are also less likely to make preventive care, hospice care, dental care visits, and have fewer hospital discharges and shorter hospital stays than women.
So how do we tackle this. We’ve talked a lot about building “awareness,” on the blog and the inherant problems with it at a societal level. “Awareness” can manifest in a number of ways, ranging from slacktivism at worst, i.e. “I know it exists, and that’s enough,” and overuse of health systems at worst, i.e. exposing people to unnecessary tests. But as long as people know about health risks and preventative health measures, this is inherently a good thing. If it helps people seek out help when they need it, this is a positive outcome, and if it means people encourage others to seek out help, this is even better.
However, raising awareness around men’s health issues is different to raising awareness for women – as mentioned above, women will seek out help while men won’t. So while men might know about a health concern, they won’t actually seek out help if they suspect they have it. As a result, the first act of any “awareness” campaign is to normalize the discussion of men’s health, and normalize seeking help. One example is the Real Men, Real Depression campaign, which aimed to tackle the stigma around admitting and discussing mental health problems among men, especially depression*. The Canadian Mental Health Association summarized the campaign best:
What do a firefighter, police officer, US Air Force First Sergeant, college graduate and publisher have in common? They are all male and they have all suffered from serious depression. They told their stories for the National Institute for Mental Health “Real Men. Real Depression.” campaign.
This is one of the biggest problems facing men’s health. Open, supportive venues where men can talk about their health, and this is the major reason why I support the Movember campaign. While Movember started off as a charity to raise awareness about prostate cancer, the #1 cancer among men in the US and Canada, it has since expanded to include other aspects of men’s health, including testicular cancer and mental health. For those who aren’t familiar with Movember, the campaign aims to increase awareness by encouraging men (Mo Bros) to grow moustaches (Mo’s) for the month of November, and raise funds that will be given to various men’s health initiatives, as well as promote men’s health by encouraging the open and frankly discussion of men’s health. They also encourage women to get involved and support the cause (Mo Sistas). As I said last year:
If you’re a Mo Bro, get your annual physical. Get checked out. Go see the doctor if you need it – don’t wait. Talk to a healthcare professional if you need it, and make an informed decision on your future. Many health issues are curable and treatable if caught early – the longer you wait the worse they can get. For all the Mo Sistas and Mo Bros out there, support your Bros. Mo Bros are likely to put off seeing the doctor and ignore health concerns, but with support this attitude can shift.
And this is why I really like Movember. It’s encouraging society as a whole to change attitudes around (men’s) health. If seeking out help is considered “normal,” then men are more likely to seek out help when they need it, and that could make all the difference between early and late diagnosis, and thus positive and negative outcomes. In addition to the obvious benefits to men, opening up conversations about health issues has benefits for society at large. If we, as a society, feel comfortable discussing issues such as cancer screening and especially mental health, this should result in us being more accepting and accommodating to others, regardless of gender. And that’s a good thing.
If you would like to support my Movember campaign, feel free to donate here. (EDIT: Fixed link)
Gordon, Derrick M., et al. “The Many Faces of Manhood Examining Masculine Norms and Health Behaviors of Young Fathers Across Race.” American journal of men’s health (2013). Link
Barr, Ben, et al. “Suicides associated with the 2008-10 economic recession in England: time trend analysis.” BMJ: British Medical Journal 345 (2012). Link.
Jensen, Jens Christian, et al. “The significance of health anxiety and somatization in care-seeking for back and upper extremity pain.” Family practice 29.1 (2012): 86-95. Link.
Pinkhasov, Ruben M., et al. “Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States.” International journal of clinical practice 64.4 (2010): 475-487. Link.
*I’d be remiss to not point out here that women are typically diagnosed from depression a rate higher than men, although there is evidence to suggest that women recognize their symptoms more readily, and thus seek out help while the numbers for men may be underreported. This is an area that needs to be further researched to disentangle the reasons for these differences between genders.