On average, a man will die sooner than a woman. In prosperous countries like Canada, the UK and the US, men die, on average, four to six years before women. And the gap triples in some European countries. Why?
There are risks associated with being a man; the result is a life expectancy gap that has been mostly taken for granted as natural and inevitable - does that make sense? Indeed, it is only over the past decade that exploring the causes for this gap has become significant. That is a welcome change from what has often been resignation to the shorter lives of men with a "that's just the way it is" approach.
First, what does the term "men's health" even mean? One of the best definitions offered says that it is the "conditions or diseases that are unique to men, are more prevalent or more serious among men, or for which the risk factors are different."
Researchers have characterized the possible causes of the life expectancy gap into three categories. Inherited risks include biological factors that make men different from women and increase male vulnerability to certain diseases. The second group includes "acquired" risks of illness and injury to describe how men may be more exposed to higher degrees of physical risks because of work or recreational activities.
The third category of causal factors is the broadest: illness and prevention orientation. Men may be less prepared to identify and take action to address health problems, or to prevent them occurring. This includes engaging in risky behaviours or more subtly, ignoring the signs of a significant health problem. Several behaviour patterns are identified as major contributors to the premature mortality of men.
Risky operation of motor vehicles (faster or more chance-taking) is one behaviour category. A second is the overuse and dependence on alcohol - globally, men die at six times the rate of women from alcohol-related causes. Tobacco use is also more prevalent among men. Unhealthy eating habits, despite knowing better, men are less likely to follow recommended dietary practices. A connected behaviour might be the resistance of men to making healthier lifestyle choices and unwillingness to make changes.
Another behaviour category prevalent among men is under-using health services. Men are much less likely to seek regular health care services. That means missed opportunities for early detection of problems and for receiving guidance for improving healthy living practices.
These characteristics and behaviours combine to create different health outcomes for men as compared to women. The result is that men experience some specific illnesses and conditions at much higher rates, or exclusively. Canadian men have significantly higher incidence of lung cancer, bladder cancer, alcohol dependence, death by suicide, AIDS and a number of other threats to health and survival. We should know why, and work towards changing that unfortunate fact.
Dr. Paul Martiquet is the Medical Health Officer for the Sea-to-Sky.
