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Information about men's health issues for Indigenous Aboriginal and Torres Strait Islander peoples is provided here.
- » What are male health issues?
- Summary of Indigenous men's health
What are male health issues?
A men's health issue has been defined as 'any issue, condition or determinant that affects the quality of life of men and/or for which different responses are required in order for men (and boys) to experience optimal social, emotional and physical health' [1]. That is, male health issues include things related to his biology (sex) and his gender. 'Sex' is the classification of a person based generally on 'their reproductive organs and functions assigned by chromosomal complement', while gender 'refers to a person's self representation as male or female, or how that person is responded to by social institutions based on the individual's gender presentation. Gender is rooted in biology and shaped by environment and experience' [2].
Historically, most attempts to understand the health status differences between males and females focused on biological aspects. However, increasing attention has been directed over the past 20-30 years or so to the role of gender, which is now seen as 'a key influence on the patterning of men's health risks, the ways men perceive and use their bodies, and men's psychosocial adjustments to illness itself' [3]. At the same, new discoveries in human biology suggest that chromosomal aspects can have 'a much broader influence on an individual's health than was previously thought' [2].
Thus, the distinct health status differences between males and females reflect both sex and gender. A dramatic result of these differences is the fact that life expectancy for males in Australia in 1999-2001 was 77 years, around 5 years less than that of females (82 years) [4]. (Interestingly, this difference has narrowed from 7 years in 1981 - males 71 years and females 78 years). Specific examples of differences in death rates per 100,000 people for the total Australian population in 1997-2000 are:
- cancer: males - 238; females - 147;
- ischaemic heart disease: males - 190; females - 120;
- strokes: males - 66; females - 66;
- chronic lower respiratory diseases: males - 47; females - 23;
- accidents: males - 36; females - 18;
- suicide: males - 22; females - 5.5;
- diabetes: males - 19; females - 14;
- influenza and pneumonia: males - 14; females - 11;
- motor vehicle traffic accidents: males - 13; females - 5.5;
- mental disorders (including dementia): males - 9.3; females - 10.8 [5].
The extent to which each of these differences is influenced by sex and gender is uncertain, but gender aspects certainly play an important role in male:
- risky behaviours;
- lesser use of preventive behaviours;
- lesser use of health services;
- later presentation at health services for health problems [6, 7].
The links between gender and risk-taking behaviour are complex, but studies demonstrate that there are expectations of risk-taking for boys and men, and, thus, men are more likely than women to experience the adverse health and social consequences of this type of behaviour [6].
Gender differences also include perceptions of health status, help-seeking
for health problems, the presentation of symptoms and readiness
to take health prevention action. Some groups of men are more vulnerable
to the adverse effects of risky behaviours than others - according
to their ethnicity, social class, education, age and employment
[8]. These are likely to affect the development
of gender roles and identities, patterns of substance use and help-seeking
behaviour . At different times in a man's life there are a variety
of positive and negative influences on health. For example, young
to middle aged males may participate in healthy activities such
as sport, but may take health risks with excessive alcohol consumption,
smoking, dangerous driving and risky sexual behaviour.
Males generally underutilise health services . For example, males
are less likely than females to consult their general practitioner
[9]. A lower proportion of males (76%)
than females (87%) attended a general practitioner (GP) at least
once in 1999-2000. Males attended at lower rates (average 5.1 services
per annum) than females (6.2 services) with the most significant
differences between the ages of 15 and 54 years and over 75 years.
There were significant differences in the age distribution of male
and female patients. Male patients were more likely than female
patients to be aged between 0 and 14 years and between 45 and 74
years and less likely to be aged 15 to 44 years and 75 years or
older. There were minimal differences between the sexes for the
most common patient reasons for encounter, but for hypertension
(the most commonly managed condition) males attended their general
practitioner significantly less frequently than did females. Male
patients were more likely than females to see their general practitioner
because of problems related to the respiratory and musculoskeletal
systems, the skin and the ear, and less likely to present due to
problems related to the neurological system and the genital and
urinary systems. Prescribed medications reflected the conditions
treated, with males more likely to have cardiovascular, respiratory
and musculoskeletal medications prescribed, and less likely to be
prescribed medications for psychological, hormonal and urogenital
conditions.
Regardless of the specific contributions of sex and gender to the
differences between males and females in health status, health-related
behaviours, and the use of health services, it is important that
the role of each is fully recognised. It is important also that
further research is undertaken into the roles of sex and gender,
so that preventive, diagnostic and therapeutic activities can be
developed appropriately, and thus contribute to health improvements.
References
1. NSW Department of Health (1999) Moving
forward in men's health. Sydney: NSW Department of Health
2. Wizemann TM, Pardue M-L,
eds. (2001) Exploring the biological contributions to human
health: does sex matter? Washington, DC: National Academy Press
3. Sabo D (2000) Men's health studies:
origins and trends. Journal of American College Health;49(3):133-142
4. Australian Bureau of Statistics (2002)
Deaths Australia 2001. (Cat no. 3302.0) Canberra: Australian
Bureau of Statistics
5. Australian Bureau of Statistics (2002)
Mortality atlas, Australia. (Cat no. 3318.0) Canberra:
Australian Bureau of Statistics
6. Thom B (2003) Risk-taking behaviour
in men: substance use and gender. London: Health Development
Agency
7. Francome C (2000) Improving men's
health. London: Middlesex University Press
8. O'Donnell M, Sharpe S (2000) Uncertain
masculinities: youth, ethnicity and class in contemporary Britain.
London: Routledge
9. Bayram C, Britt H, Kelly Z, Valenti L
(2003) Male consultations in general practice in Australia,
1999-00. (Cat no. GEP11) Canberra: Australian Institute of
Health and Welfare and the University of Sydney
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