The gender gap in health: Changing the perception of men's health

June 16, 2020

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Men should also begin to be more health conscious and consider health screening especially once they cross over 40 years of age.

Happy to be born as a man? We speak of gender equality but when it comes to general health, men have always taken a back seat. This is not only a pressing situation but it is a reality throughout the world.

Non-communicable diseases that kill, affect men more than women. The life expectancy of women exceeds men in many countries by as much as 2 to 7 years and this is seen across all income groups. According to World Health Organisation (WHO), the prevalence of hypertension, diabetes and heart disease is higher among males. Communicable diseases such as HIV is also more prevalent among men.

Is there a genetic element to this observed difference? It is important that we do not blame it all on genetics and start to consider the lifestyle and behaviour pattern of men in general. In the WHO Global Tobacco Epidemic Report 2009, men far outnumber women smokers. The prevalence of male smokers varies from 30 - 60% in regions across the world.

Are men more reckless in their behaviour? Perhaps more rebellious in nature? Again according to WHO, mortality rates from road traffic accidents (RTA) among men far exceeds women. In 2008, in Malaysia, 57.6 per 100,000 deaths from RTA involved men and only 12 per 100,000 involved women.

Sickness a sign of weakness?
Dato Dr Selva (pix) from Sunway Medical Centre Velocity (SMCV) pointed out that many men fail to get routine check-ups, preventive care or health counselling.

'They often ignore symptoms or delay seeking medical attention when sick or in pain,' he says.

'In medical practice, a difference is often observed in health seeking behavior between women and men. Women are more health conscious and often do not hesitate to seek treatment.

'It is common scenario to see the spouse or female partner who drags the male counterpart to seek medical attention.

'Oh, I'll be alright, this thing will pass off and surely I'll be okay soon' are common words we hear from men. And even when men consult the health practitioner, they would deny the severity of their symptoms and prefer to suffer in silence. This behavior may be noted from the notion that men do not like to be told what to do. It may also stem from the stigma that sickness may be a sign of weakness in men.

The evidence for this exist when we look at the statistics of male related cancers in Malaysia. Cancers that predominantly affect males include prostate, testis and penile cancers. As high as 60% of prostate cancers are seen at an advanced stage. Similarly, penile and testicular cancers that generally affect younger males are also seen at an advanced stage.

The good news is that, these cancers are potentially curable if detected at an early stage. Undoubtedly, there is an increased need for awareness to educate men that early detection is key.

Preventive measures important than early treatment
He also further emphasizes that as much as early treatment is paramount, taking preventive measures is equally, if not more important.

'Although many of these cancers and non-communicable diseases have some association with genetic preponderance, but healthy lifestyle must be emphasized and this should start from childhood.

'Good dietary habits, regular and consistent exercise, avoiding bad habits such as smoking and substance abuse must be stressed from young. We know that childhood obesity is on the rise in Malaysia and obesity is the root cause of many illnesses including cancer.

'Men should also begin to be more health conscious and consider health screening especially once they cross over 40 years of age. This is more so if they have a strong family history of cancer or non-communicable diseases. Prostate cancer and breast cancer are examples of cancer that have a strong genetic link.'

Public health approach to men's health
Health education is equally important and the public needs to be well informed and not misinformed. There are many myths and misinformation out there, especially in the era of digital technology; proper reference to reliable educational material and advice from healthcare personnel is crucial.

As an example; there have been reports of 'prevention of prostate cancer' by frequent ejaculation. This statement may cause confusion and probably stress to the female partner. The truth of the matter is that there are conflicting data on this issue and in actual fact only ejaculations more than 21 times a month has been shown in some studies to reduce the risk of prostate cancer but may not necessarily prevent the man from getting prostate cancer.

Have there been policies by various governments to address men's health?
'We often hear of women and children's health but no such importance has been given to men's health. Perhaps it is time for us o redefine men's health as an area that should attract interested general practitioners, family physicians, urologist and public health doctors to discuss best practices in reducing mortality and morbidity from communicable and non-communicable diseases among men. This would go in tandem with increasing awareness and health education for men with the intention of improving lifestyle and better health seeking behavior,' he added.

All in all, men should be taught to take ownership of their own health and lives. The importance of preventive health and a healthy lifestyle should be stressed to all men, their spouses and families.

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