Breaking news! Men’s health isn’t just about penises and prostates (although problems with these “organs” can sometimes signal other serious medical conditions, such as heart disease, hormone abnormalities or diabetes). When it comes to overall personal health issues, many men are still in denial, and we have a long way to go to catch up to progress women have made over the past few decades. It’s time men start looking at the bigger picture, especially as today’s changing world brings new and greater challenges to the delivery of healthcare. One of the ways UBC and the Vancouver General Hospital (VGH) Department of Urologic Sciences hope to meet these demands is through their new initiative, a centre of excellence being created to specifically address men’s health.
Welcome to the 21st century
The world population is aging fast. Figuring about six-and-a-half billion people in 2006, with 10% over age 60, it’s estimated this number will rise to over nine billion by the year 2050, with 22% of people aged 60 or older. Demographic changes will lead to a whole new set of challenges, including climate and other environmental concerns, fuel and food issues, etc. Social and healthcare costs will rise. In addition, lower fertility and birth rates will mean there are fewer people in the workforce to support the growing elderly population in our Western world.
While people are living longer, quality of life in their so-called “golden years” is often affected by more illness and disability. The gap between life expectancy and “health expectancy” is about 10 years worldwide (this translates to a loss of 10 years of healthy living). Centres of excellence such as the UBC/VGH program are needed to reduce this gap, by:
- helping people prolong their independence and delay frailty through the maintenance of physical, social and spiritual activities throughout their younger years;
- ensuring consistent, cost-effective, evidence-based care for the elderly population.
Men’s health: what’s the problem?
In many ways, men are more at risk in terms
of their health than women (see box, page 6).
Yet men still lag far behind women in looking after themselves, both physically and mentally. The following are some of the reasons for the discrepancy.
Men have a higher risk ratio than women:
- Statistics show that from the beginning of life, boys are more prone to developmental disabilities and certain diseases, such as autism and Tourette’s.
- Males are more likely to suffer from spinal injuries or substance abuse, be victims of violent accidents or crime, or die from
suicide attempts. - 75% of fatal heart attacks happen to men.
- In general, men die five years earlier
than women.
Macho behaviour:
- Men are less likely than women to see
doctors, seek preventive care and have all the proper immunizations. - Only 66% of men have an annual checkup (compared to 84% who get their cars checked every year!).
- Many men still subscribe to stereotypical attitudes such as bravado, risk-taking,
“take it like a man,” and denial when it comes to lifestyle or health matters.
Some still think it’s “unmanly” to worry
or complain about their health.
Community gaps:
- Men have not yet been targeted for
male-specific research to the same extent
women have. - There’s a lack of gender-specific health
centres in major hospitals, as well as resources, networks, endowments and
role models for men.
What lessons do men have to learn from women? Men need to develop “gender pride” and start to communicate and collaborate with one another around health issues. They should also establish contact with a physician at an earlier age and begin to look at risk assessment and prevention in midlife.
The BC Men’s Health Initiative
Since the spring of 2008, plans have been underway for a new BC Men’s Health Initiative. The program will be “an umbrella initiative dedicated solely to the pursuit of excellence in men’s health — or ‘women’s health for men’.” Its vision is to establish a world-class, leading research and education institute to promote health, disease prevention and standards of care in areas such as cardiac, bone, mental, sexual and testosterone health. The centre will bring together existing experts and resources in all areas of men’s health to support family physicians and specialists, with a view to true shared care and interdisciplinarity. The focus will be on several needs: developing and distributing recommendations on diagnosis, standards of treatment, and best practices for physicians in the community, based on the latest evidence; providing resources and facilitating the distribution of education material to public and professional groups; spreading the message of illness prevention to men and their families. First projects will include creation of a comprehensive overview of men’s health from a population health perspective, development of a database of existing men’s health resources, and a needs assessment (starting with BC, and then possibly national depending on the results).
Action groups will be formed to research a broad range of areas across a multitude of socioeconomic and racial strata, including: cardiovascular health; couple’s sexual health and fertility; testosterone deficiency; prostate health; bone health, osteoporosis; mental health; lifestyle issues, sports and fitness, nutrition; gay men’s health; risk-taking behaviours; the impact of disease (health, family, economic).
The initiative is seeking the support of provincial health authorities, national organizations (such as Health Canada, Osteoporosis Canada, the Canadian Prostate Cancer Network, etc.) and philanthropic partners to address gaps in healthcare delivery for men. Hopefully, it will succeed in becoming a champion of men’s health in BC and a model for Canadian men.
Tell your sons and grandsons
So what’s the take-home message? Men, it’s time to forget the bravado, break the silence, and work together on these important health matters. We need each other and we need women to lend their support. Men, women and future generations stand to reap the rewards.
Dr. S. Larry Goldenberg is Professor and Head of the Department of Urologic Sciences at the University of British Columbia (UBC) and Director of Clinical Research at the Vancouver Prostate Centre. He was inducted into the Order of British Columbia in 2006 for his contribution to healthcare in BC.
