Clinical Practice

Healthy blokes talk about it

Getting men to discuss health issues, especially with their mates, could help reduce the gap between male and female life expectancy. By Amie Larter

Compared with their counterparts around the world, Australian men fair well and generally can expect better health and longer life expectancy than males in most other countries. However, on average Australian men have a shorter life expectancy than the women, leaving many questioning why this is so?

Mens' lifestyle choices could be contributing factors seen in the results of recent research that suggests they are 84 per cent more likely to die from gender-common cancers than women.

According to research from Cancer Council NSW in 2011- 2012, by combining less healthy lifestyles that include smoking, obesity and excessive alcohol consumption with ignoring warning signs of a health problem - men are more likely to develop these serious conditions.

Professor David Smith, research fellow in the Cancer Research Division says there are a number of reasons for this.

"Firstly, men are more likely to develop the cancers that are deadly - they have higher rates of lung cancer, bowel cancer and cancers of the head and neck," he said.

"In 2011-2012, more men were overweight or obese than women (70.3 per cent compared with 56.2 per cent), men were more likely to smoke daily than women (18.2 per cent compared with 14.4 per cent) and men were also three times more likely to exceed the alcohol guidelines than women (29.1 per cent compared with 10.1 per cent)."

This leads Smith to the second element skewing the health outcomes of Australian males - lifestyle choices.

"Men are putting their lives in danger by drinking more alcohol, smoking more tobacco and having higher overweight and obesity rates than women."

Smith said health professionals should be vigilant by checking male patients' health, ensure they are adhering to screening guidelines, talk to them about their general diet, lifestyle habits and well-being. Encouraging them to actively look after their health and to come forward with symptoms rather than ignoring them.

The Cancer Council NSW has launched the Sh*t Mates Don't Say campaign to get blokes talking and acting on their health.

The campaign is the first in a number of Cancer Council initiatives solely aimed at men, in particular those in the 30-50 age bracket.

"This is the age where lifestyle habits and behaviours can have the greatest impact on later risks for deadly cancers," Smith said. "Men are encouraged at any age to look after their health, but we are encouraging men to start good habits early in the hope they stick with them throughout their lives."

The professor of primary healthcare and director of the Men's Health Information & Resource Centre at the University of Western Sydney, John McDonald, believes that a lack of communication and engaging with males could be part of the problem.

"Why is it that the health services - doctors, clinical health and nurses - have not been as involved in engaging men as they have been in engaging women?" he asked.

"Some of these answers are easy to get because of child-bearing, but that doesn't justify the neglect I perceive in the services reaching out to men."

While he does admit that overall men do attend fewer services, he believes that a lack of communication in general should be to blame, rather than "only blaming men for not taking care of their health".

In order for medical professionals to be able to connect with males on a more effective basis, MacDonald says our medical services need to become more male friendly.

"We want men to men - we want part of men's agenda to be able to talk to their mates, talk to doctors and nurses - given the occasion. It also requires genders sensitivity. We need to think about men and how nurses, doctors and other professionals can be more gender sensitive."
MacDonald's thoughts are backed up by the National Male Health Policy, created in 2010 as a framework for improving male health across Australia - with a focus on taking action on multiple fronts.

It listed six main priority areas to focus on which included a greater focus on health equity between population groups of males, improved health for males at different life stages and improved access to healthcare for males.

Stephen Lillie, men's health co-ordinator at Hawkesbury District Health Service believes that in addition to better engagement with men, which should include a focus on making services more accessible, that men need to be encouraged to take personal ownership over their health.

"In some sense, the best way of saying it is: 'why would you take your car for a service every six to 12 months but forget your body?'.

"Men do need to take their own health more seriously - it's the biggest vehicle they have got, it's going to last them a lifetime so they need to look after it."

Dr Devesh Oberoi, doctoral research fellow at Curtin Health Innovation Research Institute (CHIRI), believes greater education is necessary to encourage men to take better care of their health.
"There is a need for mass education programs to emphasise the requirement for being more careful about health, not neglecting or ignoring symptoms and to curb delay in seeing a GP for their symptoms even if they are non-specific," he said.

"Mass screening programs for various cancers and limited use of cigarettes and alcohol should be promoted and implemented in the society. There is also a need to check if medical and nursing staff are adequately prepared to address the health needs of men."

Oberoi is currently conducting research into the help-seeking behavior of men in regard to the lower bowel symptoms such as rectal bleeding, persistent change in bowel habit and abdominal pain.

In Western countries, these symptoms are common - with 15-20 per cent of people experiencing these problems. However, the problem lies in how many people are actually addressing the problem with medical attention.

"The rate of seeking medical advice for lower bowel symptoms is quite low with 60-80 per cent of people with these symptoms not seeking medical advice," Oberoi said.

"Thus, my research focuses on the factors that may influence men's decision to seek help."

Over-eating, smoking and drinking

According to Cancer Council NSW and the Australian Bureau of Statistics:

• Compared with women, Australian men are 84 per cent more likely to die of cancers that are common to both. (Source ABS:3303.0_1 - Causes of Deaths)
• In 2007-08, men were less likely to report that they have GP check-ups at least annually than were women (49% compared with 62%). (ABS: 4102.0 - Australian Social Trends, Jun 2010)
• Overweight and obesity: in 2011-12, more men were overweight or obese than women (70.3% compared with 56.2%). (ABS: 4364.0.55.001 - Australian Health Survey: First Results, 2011-12)
• Smoking: Men were more likely to smoke daily than women in 2011-12 (18.2% compared with 14.4%)
• Alcohol consumption: Overall, men were almost three times more likely to exceed the guidelines than women (29.1% compared with 10.1%, respectively)
• Fruit and vegetable intake: taking both guidelines into account, only 5.6% of Australian adults had an adequate usual daily intake of fruit and vegetables. Women were more likely to meet both guidelines than men (6.6% and 4.5% respectively).

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