We need to talk about men’s health in New Zealand - Are we tackling the root causes?
The last 15 years have seen a global increase in the awareness of wider health issues facing men, beyond male-specific illnesses such as prostate or testicular cancers. “Men’s health” itself became an indexed MeSH term in 2008.
The common finding is that men are more likely to experience significant impact from diseases at an earlier age than women and are more likely to suffer a premature death. Despite this, within New Zealand, the health of the male population has received relatively little attention as an area of public health concern. While NZ has a Ministry for Women, Te Minitatanga mō ngā Wāhine (established in 1984), there is no comparable Ministry for Men.
The need for gendered healthcare is indisputable. A 2002 MoH paper reported that in addition to biological differences, much of gender health inequality is a product of social and cultural expectations. Data from the NZ Ministry of Health show that for men 50–75 years old, the overall mortality is 30% higher than that for women, and men’s age-adjusted rates for a range of other important metrics for health and disease are worse than women’s: for instance, high cholesterol (7.9% vs 5.7%), heart disease (4.9% vs 3.1%), diabetes (4.7% vs 3.7%) and gout (2.0% vs 0.2%).
Australian federal and state governments, and other countries including Ireland, Brazil, Iran and South Africa, have established Men’s Health Forums and released national men’s health policies to address health disparities.
It has been suggested that the development of relevant policies should focus on three areas: school: so that boys and young men can develop the correct mindset around “masculinity” and their health; workplace: to guarantee health and well-being, especially of middle-aged men and marginalised men; and men from minority populations, men living in poverty areas and men who have sex with men to ensure that all can enjoy equal health and equal access to health services.
Where do opportunities exist for healthcare professionals to address health inequalities? ACC statistics reveal that each year around 1.2 million New Zealand men contact with at least one healthcare professional for issues unrelated to chronic disease. This is a good touchpoint to offer personalised advice to men.
Men’s health is partly a product of biology, social expectations and systemic discrimination variable of access and quality of care, as well as a consequence of masculinity (a set of male attributes, behaviours and roles): the invulnerable approach to diet and activity, and the ‘man up’ approach to health.
To improve men’s health, it is beneficial to raise men’s health awareness by enabling men to define what health means to them, improve access to healthcare resources, particularly avoiding environments, terminology or judgments that might be negative about masculinity.