It is your health, man

Our conversation about one important discrepancy in the health field, inequalities in the health seeking behaviors between men and women, is very important. Aside from gender and biological differences, broader social economic status including the unequal distribution of wealth and power between men and women also influences their exposure to health risks, access to health information and services, misallocation of resources for health programs, and prevention of diseases.

Society may suggest that men should never act weak and that they should be strong and face all challenges in life with ease. However, this stereotype is one of the many reasons why men aren’t quick to acknowledge when they have health problems and seek preventative care that may reduce the risk of developing diseases.

One key reason highlighted for males not interested in talking about health issues is that they are embarrassed to have these conversations. To quote Congressman Bill Richardson, “recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue.” My Google search about men’s health in the United States yielded 263 million results while women’s health produced 600 million results. Even the U.S Department of Health and Human Services’ Health People 2020 initiative does not include men’s health as one of the major topic areas. While it includes maternal, infant and child health programs, matters connected to men’s health are buried in other topics and objectives concerning cancer, family planning and HIV. According to the CDC, in 2010, the number of years lost for all causes of death before age 75 (per 100,000 population) in the United States by females was 4,994.0 years for women and 8,329.5 years for men. Worryingly, I wonder if the reasons for these discrepancies are connected to the general population not talking about men’s health more often, men being afraid of finding out about health issues they are unaware of, men not interested in talking about medical and health issues, or the perception of some men that they don’t need a doctor.

Undeniably, women and men are different in regard to their roles and responsibilities including their decision-making power within their family and communities. This difference influences “causes, consequences and management of diseases and ill-health, and on the efficacy of health promotion policies and activities” (Ostlin et al., 2006). This difference is also evident in cause-specific mortality and morbidity, and exposure to risk factors. Commonly, females (women) tend to think more, and talk about health care needs compared to men because they are generally responsible for the family’s health and well-being. In addition, women tend to seek health education and have a usual source of care which allows them to detect and treat illnesses on time compared to men. According to a report by the Agency for Healthcare Research and Quality (AQHR), this is also reflected in medical screenings among men because “men are 24 % less likely than women to have visited a doctor within the past year and are 22 % more likely to have neglected their cholesterol tests” (AQHR, 2012). Furthermore, the “wait and fix-it” cure approach among men leads to lower utilization of health care and delays in the effective use of services and response of health care interventions – these are precursors to poorer health outcomes. For example, “Men are 24 % more likely than women to be hospitalized for pneumonia that could have been prevented by getting an immunization” (AQHR, 2012).

The differences in gender inequities in health may lead to ineffective health promotion and disease prevention policies for men if we don’t address the root cause of these inequities when we design health systems and programs. Accessing health services and seeking medical advice including visits to doctor offices for regular checkups are important for our males’ health, because it allows them to detect and treat illnesses as quickly as possible, increases their quality of life and ultimately, life expectancy. Also, seeking health care and advice may prevent diseases which may lead to disabilities, and reduce the likelihood of early death among males.

Some of these leading causes of death among males (e.g. heart disease, diabetes, stroke, etc.) in the U.S. are associated with circumstances such as material hardship, depression, unemployment and relationship challenges which drive harmful choices such as smoking, drug abuse and alcoholism. I am not saying women don’t smoke or use drugs when they have to cope with these pressures as well. In fact, women’s problems related to substance abuse interfere with functioning in more areas of life compare to men (Fillmore et al. 1997). Still, fewer women smoke more than men even though the rates between both genders are narrowing. In addition, women are less likely than men to use illicit drugs and develop drug-related problems (Greenfield et al., 2003), while women are less likely than men to develop alcohol-related problems (Fillmore et al. 1997).

So, it is important for men to pay attention to their health problems when they arise because certain types of cancers, heart disease and cerebrovascular diseases are predominantly developed among men due to biological factors. It is essential that men seek health care and other services for their well-being on a regular basis. Since women tend to use primary care more than men, we can increase the utilization of preventative care among males by targeting their wives, sisters, girlfriends, etc. to motivate them to change their health seeking behaviors. In addition, there is a tendency to judge men about their attitudes and knowledge in regard to their use of services in the health care system without looking at the structure of these systems as well. Perhaps, our global focus on maternal, women and child health issues has left the needs of men out of the picture when we create health products and design health systems. Potentially, we can aim to make health services, public health infrastructures (e.g. the workforce), and health policies more ‘male friendly’ and gender sensitive to make the process of seeking care more convenient and appropriate for men’s needs.

Undoubtedly, there is more to be said about the provision of incentives to empower men to seek health services and advice. This should include an increase in the level of health information and education, community involvement and participation in policies that mainstream men’s health into all areas of health and well-being, and supportive environments that are essential for men to access social and health services that will allow them to take more pertinent responsibility for their health care. Even more, health policies and interventions should take into account biological, risks to health, and decision-making differences between men and women to build and implement successful and cost-effective health promotion and disease prevention activities that are connected to men’s health. Conceivably, we can operationalize these health activities into quantitative and qualitative indicators to gauge progress in services, laws and policies connected to men’s health status in the U.S. and globally.

Within our health sector, our healthcare infrastructures and program development should also recognize gender differences and incorporate these distinctions into effective health program strategies that successfully reduce the magnitude of diseases and their health consequences on males. Overall, as a society, we need to disregard stereotypes between men and women about their health seeking behaviors and stop the ‘one size fits all’ health promotion and disease prevention approaches which assume that everything works effectively for men and women similarly.

Sources:

Agency for Healthcare Research and Quality (2012). Healthy Men: Learn the Facts. Agency for Healthcare Research and Quality: Rockville, Maryland. Available at: http://www.ahrq.gov/patients-consumers/patient-involvement/healthy-men/index.html Accessed: October 5th 2013.

Center for Disease Control and Prevention (2012), Years of potential life lost before age 75 for selected causes of death, by sex, race, and Hispanic origin: United States, selected years 1980–2010. Table 21. Center for Disease Control and Prevention: Atlanta, Georgia. Available at: http://www.cdc.gov/nchs/data/hus/2012/021.pdf Accessed: October 6th 2013.

Center for Disease Control and Prevention (2012), Leading causes of death and numbers of deaths, by sex, race, and Hispanic origin: United States, 1980 and 2010. Table 22. Center for Disease Control and Prevention: Atlanta, Georgia. Available at: http://www.cdc.gov/nchs/data/hus/2012/022.pdf Accessed: September 11th 2013.

Fillmore, K.M.; Golding, J.M.; Leino, E.V.; et al. (1997). Patterns and trends in women’s and men’s drinking. In: Wilsnack, R.W., and Wilsnack, S.C., eds. Gender and Alcohol: Individual and Social Perspectives. New Brunswick, NJ: Center of Alcohol Studies, Rutgers University, 1997. pp. 21–48.

Greenfield, S.F.; Manwani, S.G.; and Nargiso, J.E. (2003). Epidemiology of substance use disorders in women. Obstetrics & Gynecology Clinics of North America 30:413–446.

Östlin, Piroska, et al. (2006). Gender and health promotion: A multisectoral policy approach. Health Promotion International 21.suppl 1:25-35.