Monday, April 13, 2009
Men's Health & Gender
Why men die and suffer more than women
By James Achanyi-Fontem,
Coordinator, WABA MWG
Women’s health has always an important part of national priority in most countries of the world, but unfortunately no counselling centres or offices for men’s health exist in most countries. It is within this frame work that one can rightly say that men are silently suffering through what can be described as a serious health crisis. Lifestyle is used to explain the differences in longevity between men and women.
One begins to question whether the mere suggestion that men need their own health counselling centres or health clinics or that men must advocate for their rights like a victimized minority would not rankle women’s health advocates, especially as some politicians are reluctant to take men’s health on as a cause, for fear of alienating women.
Apart from the exception of Alzheimer’s disease, takes the lives of more women than men, men die of just about every one of the leading causes of death at younger ages than women, from lung cancer to influenza and pneumonia, chronic liver disease, diabetes, sickle cell disorder and AIDS. Topping the list for both sexes is heart disease.
Cancer also strikes men disproportionately: one in three women at some point in life; one in two men. In part, that is a result of the fact that more men than women smoke, and possibly of occupational exposures.
On the other hand, men’s vulnerability appears to start quite early. More male foetuses are conceived, but they are at greater risk of stillbirth and miscarriage, scientists find. Even as infants, mortality is higher among newborn boys and premature baby boys.
Behaviour plays a role in some of the extra deaths and illnesses among men: they tend to be more aggressive than women and to take more risks. Men smoke at higher rates than women, drink more alcohol and are less likely to wear seat belts or use sunscreen. Men also suffer more accidental deaths and serious injuries and are more likely to die of injuries and car accidents. They are three times as likely to be victims of murder, four times as likely to commit suicide and, as teenagers, 11 times as likely to drown.
Some experts think that depression contributes to these reckless and self-destructive behaviours, but that just as heart disease was initially defined by men’s experiences and therefore ignored or missed in women, depression may have been framed by women’s experiences and therefore may be missed and go untreated in men.
As a result, even though more baby boys are born, among people in their mid-30s, women outnumber men. Among people age 100, women outnumber men by 8 to one. During a research study carried out by Dr. Legato, he tried asked a number questions, which tried to clarify analysis of male vulnerability like: “Why are there more miscarriages of boy foetuses? What is it about the sexing of the foetus that makes a male more vulnerable? What makes a boy less mature in terms of lung function after he’s born? And what is this propensity for risk-taking?”
One theory is that males are vulnerable because of their chromosomal makeup: where women have two X chromosomes, men have an X chromosome and a Y chromosome. “It is said that even before implantation in the wall of the uterus, the newly fertilized XX entity has a leg up,” Dr. Legato said, “because it can use that extra X to combat mutations in the chromosome that might be lethal or detrimental. And that might be a reason why females have a more sturdy constitution.”
Scientists and advocates who are concerned about men’s health are encouraging men themselves to take the first steps by accepting responsibility for their health status, seeking preventive care and making changes in habits, if necessary. New drugs for erectile dysfunction have helped bring men into doctors’ offices in recent years, experts say, but that is not enough.
Dr. Ken Goldberg, a urologist and the author of “How Men Can Live as Long as Women,” says in his work that “Men need to take as good care of their bodies as they do of their cars and trucks”. Men should stop thinking that they are bulletproof and invincible.
Research based on a 2000 survey by the Commonwealth Fund found that almost a quarter of all men had not seen a doctor during the previous year, compared with only 8 percent of women, and that one in three men had no regular doctor, compared with one in five women. More than half of men had not gone in for a routine check-up or cholesterol test during the previous year. Even if something was bothering them, the survey found, men often expressed reluctance to seek medical help. Nearly 40 percent said they would delay care for a few days, and 17 percent said they would wait at least a week.
Other studies have found that because poor women with children may qualify for Medical aid, poor men are more likely to lack health insurance. Advocates say that research must be directed at how specific diseases develop in men, but that studies should also be done to explore the underlying reasons that men do not take better care of themselves.
Dr. William Pollack, director of the Centre for Men at McLean Hospital in Belmont, Mass., USA affiliated with Harvard Medical School thinks that the problems are rooted in how boys are raised. Very often, “we’ve socialized men from the time they are boys that ‘You have to stand on your own two feet,’ ‘If you have a problem, handle it by yourself,’ ‘Be a man, take one for the team. “All of these mean, men do not have to complain, don’t have to ask for help and they have to solve their problems by themselves.’ ”