Men's health

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A symbol of men's health Men's health icon.jpg
A symbol of men's health

Men's health is a state of complete physical, mental, and social well-being, as experienced by men, and not merely the absence of disease. [1] [ failed verification ] Differences in men's health compared to women's can be attributed to biological factors, behavioural factors, and social factors (e.g., occupations). [2] [ failed verification ]

Contents

Men's health often relates to biological factors such as the male reproductive system or to conditions caused by hormones specific to, or most notable in, males. Some conditions that affect both men and women, such as cancer, and injury, manifest differently in men. [3] Some diseases that affect both sexes are statistically more common in men. In terms of behavioural factors, men are more likely to make unhealthy or risky choices and less likely to seek medical care.

Men may face issues not directly related to their biology, such as gender-differentiated access to medical treatment and other socioeconomic factors. [4] [5] [6] Outside Sub-Saharan Africa, men are at greater risk of HIV/AIDS. This is associated with unsafe sexual activity that is often nonconsensual. [7] [8]

Definition

Men's health refers to the state of physical, mental, and social well-being of men, and encompasses a wide range of issues that are unique to men or that affect men differently than women. This can include issues related to reproductive health, sexual health, cardiovascular health, mental health, and cancer prevention and treatment. Men's health also encompasses lifestyle factors such as diet, exercise, and stress management, as well as access to healthcare and preventative measures. [9]

Life expectancy

Despite overall increases in life expectancy globally, men's life expectancy is less than women's, regardless of race and geographic regions. [10] [11] The global gap between the life expectancy of men and women has remained at approximately 4.4 years since 2016, according to the WHO. [12] Life expectancy is a statistical measure that represents the average number of years that a person is expected to live, based on the current mortality rates. It is typically calculated at birth, and can vary depending on factors such as gender, race, and location. For example, life expectancy in many developed countries is higher than in developing countries, and life expectancy for women is generally higher than for men.

However, the gap does vary based on country, with low income countries having a smaller gap in life expectancy. [13] Biological, behavioural, and social factors contribute to a lower overall life expectancy in men; however, the individual importance of each factor is not known. [14] Overall attitudes towards health differ by gender. Men are generally less likely to be proactive in seeking healthcare, resulting in poorer health outcomes. [15]

Global comparison of life expectancy of men vs women in different countries Comparison of male and female life expectancy -world.svg
Global comparison of life expectancy of men vs women in different countries

Men are difficult to recruit to health promotion interventions. The value of adopting a gender-sensitive approach to engage and retain men in health promotion interventions has been reported. [16]

Biological influences on lower male life expectancies include genetics and hormones. For males, the 23rd pair of chromosomes are an X and a Y chromosome, rather than the two X chromosomes in females. [11] The Y chromosome is smaller in size and contains fewer genes. This distinction may contribute to the discrepancy between men and women's life expectancy, as the additional X chromosome in females may counterbalance potential disease producing genes from the other X chromosome. Since males don't have the second X chromosome, they lack this potential protection. [11] Hormonally, testosterone is a major male sex hormone important for a number of functions in males, and to a lesser extent, females. [17] Low testosterone in males is a risk factor of cardiovascular related diseases. [18] Conversely, high testosterone levels can contribute to prostate diseases. [11] These hormonal factors play a direct role in the life expectancy of men compared to women.

In terms of behavioural factors, men have higher levels of consumption of alcohol, substances, and tobacco compared to women, resulting in increased rates of diseases such as lung cancer, cardiovascular disease, and cirrhosis of the liver. [11] [19] Sedentary behaviour, associated with many chronic diseases seems to be more prevalent in men. [20] These diseases influence the overall life expectancy of men. For example, according to the World Health Organization, 3.14 million men died from causes linked to excessive alcohol use in 2010 compared to 1.72 million women. Men are more likely than women to engage in over 30 risky behaviours associated with increased morbidity, injury, and mortality. [21] [22] Additionally, despite a disproportionately lower rate of suicide attempts than women, men have significantly higher rates of death by suicide. [23] [24] [25]

Social determinants of men's health involve factors such as greater levels of occupational exposure to physical and chemical hazards than women. [15] Historically, men had higher work-related stress, which negatively impacted their life expectancy by increasing the risk of hypertension, heart attack, and stroke. [11] However, as women's role in the workplace continues to be established, these risks are no longer specific to just men. [11]

Mental health

Stress

Although most stress symptoms are similar in men and women, stress can be experienced differently by men. [26] The American Psychological Association says that men are not as likely to report emotional and physical symptoms of stress compared to women. [26] They say men are more likely to withdraw socially when stressed and are more likely to report doing nothing to manage their stress. [26] Men are more likely than women to cite that work is a source of stress; women are more likely to report that money and the economy are a source of stress. [26]

Mental stress in men is associated with various complications which can affect men's health: high blood pressure and subsequent cardiovascular morbidity and mortality, [27] cardiovascular disease, [28] erectile dysfunction (impotence) [29] and possibly reduced fertility (due to reduced libido and frequency of intercourse). [30]

Fathers experience stress during the time shortly before and after the time of birth (perinatal period). [31] Stress levels tend to increase from the prenatal period up until the time of birth, and then decrease from the time of birth to the later postnatal period. [31] Factors which contribute to stress in fathers include negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth, and feelings of incompetence related to infant care. [31] This stress has a negative impact on fathers. [31] Higher levels of stress in fathers are associated with mental health issues such as anxiety, depression, psychological distress, and fatigue. [31]

Substance use disorders

Substance use disorder and alcohol use disorder can be defined as a pattern of harmful use of substance for mood-altering purposes. [32] Alcohol is one of the most commonly substances used in excess, and men are up to twice as likely to develop alcohol use disorder than women. [33] Gender differences in alcohol consumption remain universal, although the sizes of gender differences vary. [34] More drinking and heaving, binge drinking occurs in men, whereas more long-term abstention occurs in women. [34] Moreover, men are more likely to abuse substances such as drugs, with a lifetime prevalence of 11.5% in men compared to 6.4% in women, in the United States. [35] Additionally, males are more likely to be substance addicts and abuse substances due to peer pressure compared to females. [35]

Risks

Substance and alcohol use disorders are associated with various mental health issues in men and women. [36] Mental health problems are not only a result from drinking excess alcohol; they can also cause people to drink too much. [35] A major reason for consuming alcohol is to change mood or mental state. [37] Alcohol can temporarily alleviate feelings of anxiety and depression, and some people use it as a form of self-medication in an attempt to counteract these negative feelings. [38] However, alcohol consumption can worsen existing mental health problems. [35] Evidence shows that people who consume high amounts of alcohol or use illicit substances are vulnerable to an increased risk of developing mental health problems. [39] Men with mental health disorders, like post-traumatic stress disorder, are twice as likely as women to develop a substance use disorder. [40]

Treatment

There have been identified gender differences in seeking treatment for mental health and substance abuse disorders between men and women. [41] Women are more likely to seek help from and disclose mental health problems to their primary care physicians, whereas men are more likely to seek specialist and inpatient care. [42] Men are more likely than women to disclose problems with alcohol use to their health care provider. [43] In the United States, there are more men than women in treatment for substance use disorders. [43] Both men and women receive better mental health outcomes with early treatment interventions. [44]

Suicide

World Health Organization: Global Male-Female age standardized suicide rates (2015) Male-Female suicide ratios 2015 (age-standardized).png
World Health Organization: Global Male-Female age standardized suicide rates (2015)

Suicide has a high incidence rate in men but often lacks public awareness. [45] [46] Suicide is the 13th leading cause of death globally, and in most parts of the world, men are significantly more likely to die by suicide than women, although women are significantly more likely to attempt suicide. [46] [47] [48] This is known as the "gender paradox of suicidal behaviour". [47] Worldwide, the ratio of suicide deaths was 1.8:1 men per woman in 2016 according to the World Health Organization. [49] This gender disparity varies greatly between countries. For example, in the United Kingdom and Australia, this men/women ratio is approximately 3:1, and in the United States, Russia, and Argentina approximately 4:1. [50] [51] [52] [53] In South Africa, the suicide rate amongst men is five times greater than women. [54] In East Asian countries however, the gender gap in suicide rates are relatively smaller, with men to women ratios ranging from 1:1 to 2:1. [55] Multiple factors exist to explain this gender gap in suicide rates, such as men more frequently completing high mortality actions such as hanging, carbon-monoxide poisoning, and the use of lethal weapons. [56] [57] Additional factors that contribute to the disparity in suicide rates between men and women include the pressures of traditional gender roles for men in society and the socialization of men in society. [50] [58] [59]

Risk factors

Because variations exist in the risk factors associated with suicidal behaviour between men and women, they contribute to the discrepancy in suicide rates. [47] [60] [61] Suicide is complex and cannot simply be attributed to a single cause; however, there are psychological, social, and psychiatric factors to consider. [58] [61] [62]

Mental illness is a major risk factor for suicide for both men and women. [62] [63] [64] Common mental illnesses that are associated with suicide include depression, bipolar disorder, schizophrenia, and substance abuse disorders. [63] [64] [65] In addition to mental illness, psychosocial factors such as unemployment and occupational stress are established risk factors for men. [47] [66] [67] Alcohol use disorder is a risk factor that is much more prevalent in men than in women, which increases risks of depression and impulsive behaviours. [68] [69] This problem is exacerbated in men, as they are twice as likely as women to develop alcohol use disorder. [33] [70]

Reluctance to seek help is another prevalent risk factor facing men, stemming from internalized notions of masculinity. [58] [66] [71] [59] Traditional masculine stereotypes place expectations of strength and stoic, while any indication of vulnerability, such as consulting mental health services, is perceived as weak and emasculating. [58] [66] [71] [59] As a result, depression is under-diagnosed in men and may often remain untreated, which may lead to suicide. [59] [72]

Warning signs

Identifying warning signs is important for reducing suicide rates world-wide, but particularly for men, as distress may be expressed in a manner that is not easily recognisable. [56] [73] [74] For instance, depression, and suicidal thoughts may manifest in the form of anger, hostility, and irritability. [58] [73] Additionally, risk-taking and avoidance behaviours may be demonstrated more commonly in men. [58] [71]

Common conditions

The following is a list of diseases or conditions that have a high prevalence in men (relative to women).

Cardiovascular conditions:

Respiratory conditions:

Mental health conditions:

Cancer:

Sexual health:

Other:

Organisations

In the UK, the Men's Health Forum was founded in 1994. It was established originally by the Royal College of Nursing but became completely independent of the RCN when it was established as a charity in 2001. [75] The first National Men's Health Week was held in the US in 1994. The first UK week took place in 2002, and the event went international (International Men's Health Week) the following year. [76] In 2005, the world's first professor of men's health, Alan White, was appointed at Leeds Metropolitan University in north-east England.

In Australia, the Men's Health Information and Resource Centre advocates a salutogenic approach to male health which focuses on the causal factors behind health. The centre is led by John Macdonald and was established in 1999. [77] The Centre leads and executes Men's Health Week in Australia with core funding from the NSW Ministry of Health.

The Global Action on Men's Health (GAMH) was established in 2013 and was registered as a UK-based charity in May 2018. It is a collaborative initiative to bring together men's health organizations from across the globe into a new global network. GAMH is working at international and national levels to encourage international agencies (such as the World Health Organization) and individual governments to develop research, policies and strategies on men's health. [78]

See also

Related Research Articles

<span class="mw-page-title-main">Alcoholism</span> Problematic excessive alcohol consumption

Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records, the World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are stigmatizing and discourage seeking treatment, so clinical diagnostic terms such as alcohol use disorder or alcohol dependence are used instead.

<span class="mw-page-title-main">Substance abuse</span> Harmful use of drugs

Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical, and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

<span class="mw-page-title-main">Self-harm</span> Intentional injury to ones body

Self-harm is intentional conduct that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or by scratching, hitting, or burning. The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse, as well as societally acceptable body modification such as tattoos and piercings.

<span class="mw-page-title-main">Alcohol abuse</span> Substance abuse of alcoholic beverages

Alcohol abuse encompasses a spectrum of alcohol-related substance abuse, ranging from the consumption of more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking or alcohol use disorder.

Adjustment disorder is a maladaptive response to a psychosocial stressor. It is classified as a mental disorder. The maladaptive response usually involves otherwise normal emotional and behavioral reactions that manifest more intensely than usual, causing marked distress, preoccupation with the stressor and its consequences, and functional impairment.

<span class="mw-page-title-main">Suicide prevention</span> Collective efforts to reduce the incidence of suicide

Suicide prevention is a collection of efforts to reduce the risk of suicide. Suicide is often preventable, and the efforts to prevent it may occur at the individual, relationship, community, and society level. Suicide is a serious public health problem that can have long-lasting effects on individuals, families, and communities. Preventing suicide requires strategies at all levels of society. This includes prevention and protective strategies for individuals, families, and communities. Suicide can be prevented by learning the warning signs, promoting prevention and resilience, and committing to social change.

There are more than 700,000 estimated suicide deaths every year. Suicide affects every demographic, yet there are some populations that are more impacted than others. For example, among 15–29 year olds, suicide is much more prominent; this being the fourth leading cause of death within this age group.

<span class="mw-page-title-main">Suicidal ideation</span> Thoughts, ideas, or ruminations about the possibility of ending ones life

Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.

<span class="mw-page-title-main">Questioning (sexuality and gender)</span> Process of self-exploration

The questioning of one's sexual orientation, sexual identity, gender, or all three is a process of exploration by people who may be unsure, still exploring, or concerned about applying a social label to themselves for various reasons. The letter "Q" is sometimes added to the end of the acronym LGBT ; the "Q" can refer to either queer or questioning.

<span class="mw-page-title-main">Suicide</span> Intentional act of causing ones own death

Suicide is the act of intentionally causing one's own death. Mental disorders, physical disorders, and substance abuse are risk factors. Some suicides are impulsive acts due to stress, relationship problems, or harassment and bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide such as firearms, drugs, and poisons; treating mental disorders and substance abuse; careful media reporting about suicide; improving economic conditions; and dialectical behaviour therapy (DBT). Although crisis hotlines are common resources, their effectiveness has not been well studied.

<span class="mw-page-title-main">Gender differences in suicide</span>

Gender differences in suicide rates have been shown to be significant. There are different rates of suicides and suicidal behavior between males and females. While females more often have suicidal thoughts, males die by suicide more frequently. This discrepancy is also known as the gender paradox in suicide.

Minority stress describes high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status; well understood causes of minority stress are interpersonal prejudice and discrimination. Indeed, numerous scientific studies have shown that when minority individuals experience a high degree of prejudice, this can cause stress responses that accrue over time, eventually leading to poor mental and physical health. Minority stress theory summarizes these scientific studies to explain how difficult social situations lead to chronic stress and poor health among minority individuals.

In 2014, the WHO ranked Nepal as the 7th in the global suicide rate. The estimated annual suicides in Nepal are 6,840 or 24.9 suicides per 100,000 people. Data on suicide in Nepal are primarily based on police reports and therefore rely on mortality statistics. However, the burden of suicide in communities is likely to be higher, particularly among women, migrant workers, and populations affected by disasters.

The male-female health-survival paradox, also known as the morbidity-mortality paradox or gender paradox, is the phenomenon in which female humans experience more medical conditions and disability during their lives, but they unexpectedly live longer than males. This paradox, where females experience greater morbidity (diseases) but lower mortality (death) in comparison to males, is unusual since it is expected that experiencing disease increases the likelihood of death. However, in this case, the part of the population that experiences more disease and disability is the one that lives longer.

A disease of despair is one of three classes of behavior-related medical conditions that increase in groups of people who experience despair due to a sense that their long-term social and economic prospects are bleak. The three disease types are drug overdose, suicide, and alcoholic liver disease.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on suicide rates</span>

Suicide cases have remained constant or decreased since the outbreak of the COVID-19 pandemic. According to a study done on twenty-one high and upper-middle-income countries in April–July 2020, the number of suicides has remained static. These results were attributed to a variety of factors, including the composition of mental health support, financial assistance, having families and communities work diligently to care for at-risk individuals, discovering new ways to connect through the use of technology, and having more time spent with family members which aided in the strengthening of their bonds. Despite this, there has been an increase in isolation, fear, stigma, abuse, and economic fallout as a result of COVID-19. Self-reported levels of depression, anxiety, and suicidal thoughts were elevated during the initial stay-at-home periods, according to empirical evidence from several countries, but this does not appear to have translated into an increase in suicides.

The social determinants of mental health (SDOMH) are societal problems that disrupt mental health, increase risk of mental illness among certain groups, and worsen outcomes for individuals with mental illnesses. Much like the social determinants of health (SDOH), SDOMH include the non-medical factors that play a role in the likelihood and severity of health outcomes, such as income levels, education attainment, access to housing, and social inclusion. Disparities in mental health outcomes are a result of a multitude of factors and social determinants, including fixed characteristics on an individual level – such as age, gender, race/ethnicity, and sexual orientation – and environmental factors that stem from social and economic inequalities – such as inadequate access to proper food, housing, and transportation, and exposure to pollution.

People who are LGBT are significantly more likely than those who are not to experience depression, PTSD, and generalized anxiety disorder.

References

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