International Men’s Day is celebrated on 19 November each year, and in 2020 the theme is “Better health for Men and Boys”.
Founded in in 1999, International Men’s Day is relatively new compared to International Women’s Day which was first celebrated in 1909. It is not intended to compete against International Women’s Day, but exists to highlight men’s experiences, the positive value they bring to the world, and to raise awareness of men’s health.
The objectives of International Men’s Day are set out as 6 Pillars:
- To promote positive male role models; not just movie stars and sports men but every day, working class men who are living decent, honest lives
- To celebrate men’s positive contributions to society, community, family, marriage, child care, and to the environment
- To focus on men’s health and wellbeing; social, emotional, physical and spiritual
- To highlight discrimination against men; in areas of social services, social attitudes and expectations, and law
- To improve gender relations and promote gender equality
- To create a safer, better world; where people can be safe and grow to reach their full potential
In researching men’s health I’ve found it to be a complex issue. Health issues due to biological differences to women (such as prostate and testicular cancer) are more obvious, but it’s the attitudes and behaviour of men that gives rise to some of their greatest health challenges.
Gender in itself is a complex construct. Whilst often used interchangeably with sex, the UK government refers to sex as being biologically defined, whereas gender is “a social construct that is an internal sense of self, whether an individual sees themselves as a man or a woman, or another gender identity”. Gender can include many different identities such as transgender and may also be non-binary (that is, the person not identifying either as a man or a woman).
So, we see that concepts like masculinity are a sub-set of biological males, but does not define the entire group. Men are as diverse as women and make up all colours of the rainbow – health, race, age, religion, disability, sexuality and so on. When looking at men’s health issues we can gain insights based on the general population, but always remember that across any group there is variation.
In general, men have a shorter life expectancy. In England for instance, men have an average life expectancy of 79.9 years compared to 83.6 year for women, and the gap is showing no signs of narrowing. (Office for National Statistics)
The top overall cause of death of men in England and Wales (2019) continued to be ischaemic (blockage) heart disease (13.1% of all male deaths) and it is the top cause of death for men in the age range 50 – 79. In 2019, suicide became the leading cause of death for men aged 35 to 49 years and is now the leading cause of death for men in the large bracket of ages 5 – 49.
A large number of lifestyle-related risk factors for heart (or cardiovascular) disease can be controlled or eliminated altogether – these include obesity, smoking and physical inactivity. Heart disease risk is increased by stress (due to the unhealthy habits it can cause) and having a mental health condition.
Other significant risk factors for heart disease include high cholesterol, high blood pressure and diabetes. Risky behaviour such as partaking in unhealthy habits (e.g. smoking and drinking) and an unhealthy lifestyle (e.g. not exercising and having a poor diet) significantly increases the risk of developing these conditions. Studies have shown that men are far more likely than women to participate in three or four of these risky behaviours, perhaps in order to signal their masculinity.
These three medical conditions are sometimes referred to as “silent killers”, meaning that they mostly have no obvious symptoms and can therefore progress to an advanced stage before they are discovered. It’s for this reason that regular medical check-ups are vital in the fight against heart disease.
Yet men are far less likely than women to visit their GP, with one study showing that in the 20-40 age group women went to their general practice twice as often as men. The reasons for this gap is varied and complex. Maintaining an identity as a ‘real’ man may cause some men to play down symptoms, not being entirely honest about them. They may delay seeking help until only absolutely necessary and may be more likely to resist treatment. (various studies, source Mens Health Forum)
Men’s hesitance to seek medical treatment has been the focus of many campaigns, including the Cleveland Clinic’s MENtion It campaign, which to prove the point found that nearly three-quarter of men would rather do household chores like cleaning the toilet than go to the doctor!
Men’s knowledge about health also plays a part, illustrated by one study which found that men’s “health literacy” was less than half that of women. Having a reasonable level of knowledge about health issues is vitally important to maintain health and wellbeing – from preventing health issues, to knowing what signs and symptoms to look out for, how to manage a condition, and exercising caution over purchasing medication over the internet (as examples).
Suicide remains a significant issue for men. Of the 5,691 suicides registered in England and Wales in 2019 (ONS), around three-quarters were among men (4,303 deaths), which follows a consistent trend back to the mid-1990s and is the highest it’s been since 2000. Men aged 45-49 remain at the highest risk of suicide.
In a recent Guardian article, Vicki Nash, the head of policy and campaigns at the charity Mind, said: “Not all suicides are mental health-related but many are, and we know that a significant proportion of people who take their own lives have asked for support for their mental health within the last 12 months, which means that services are failing people when they need help the most.”
In the same article, the then CEO of the Samaritans Ruth Sutherland said: “With the impact of the pandemic this year taking a huge toll on people’s mental wellbeing, we should be even more concerned”
Although there are various risk factors for suicide, COVID-19 has exacerbated a number of issues in particular worries about finances and isolation (loneliness). The statistics show that suicide rates rise in times of recession and groups such as middle-aged men who are often hardest hit by economic downturn are at greatest risk.
Unfortunately men are less likely to seek help for a mental health issue – various studies show that men are far less likely to talk about their mental health, so it’s no surprise that only 36% of referrals to NHS talking therapies are for men. Some of the reasons behind this has been covered, such as societal expectations and traditional gender roles – expectations that men should behave or look a certain way such as being strong, dominant and in control. Such expectations can be damaging as they can make it harder for men to recognise symptoms of mental health problems in themselves, open up and reach out for help.
However, not all is lost. Societal expectations are slowly shifting, particularly in developed countries; there is increased awareness of mental health in the public domain; and there is research to suggest that men will access help when it meets certain criteria such as being easily accessed, meaningful, and engaging.
What are some of the other key issues?
I have intentionally focused on heart disease and suicide, but health issues that impact men are much broader. Some issues are common with women (such as domestic abuse) whereas others (such as testicular cancer) are biologically unique.
Male-specific health issues
- Prostate cancer: there were 49,029 diagnoses of prostate cancer in 2018, a 19% increase on the year before, overtaking breast cancer as the most common cancer in England. (Prostate Cancer UK)
- Testicular cancer: There are around 2,300 new testicular cancer cases in the UK every year (more than 6 per day. Incidence rates have increased by around a quarter (24%) since the early 1990s and in the UK is projected to rise by 12% between 2014 and 2035. It particularly affects younger men, with the highest incidence in those aged 30 to 34. (Cancer Research UK, reported years 2015 – 2017)
- Erectile dysfunction (impotence): impotence rates have more than doubled in the last 25 years and whilst the risk often increases with age, it impacts up to half of men under the age of 50. (NHS & The Independent)
Shared health issues
- Alcohol addiction and disease: Rates of male deaths due to alcohol are twice those of females (16.4 vs 7.6 deaths per 100,000). (ONS)
- Workplace deaths: In 2019/20, 108 (97%) of all worker fatalities were to male workers, despite only making up just over half of the total workforce. (HSE)
- Road traffic accidents: 57% of male drivers have been involved in a crash (compared to 44% of women); 46% of men had what was described as a ‘close call’ with a cyclist or pedestrian (compared to 35% of women); and 68% of UK women have a clean driving licence, against 64% of men. (Jennings Motor Group)
- COVID-19: For every ten COVID-19 deaths, six will be male. (ONS)
- Rough Sleeping: 85% of those who slept rough in 2019 are male (where gender known). (UK Government)
- Domestic Abuse: one in three victims are male (2018/19 786,000 men). (UK Government)
- Sexual Violence/Abuse: 140,000 men were estimated to have been victims of sexual assault in 2017/18. 12,000 men were raped or victims of attempted rape in 2017/18. (UK Government)
- Fatherhood: In 96% of cases, the parents who apply to court for access to their children are men. (Nuffield Foundation)
- Male infertility: 1 in 7 couples in the UK are unable to have a child; in 50% of these couples, the problem lies wholly or partly with the male partner. (The British Association of Urological Surgeons)
What can employers do?
Poor health is a significant risk to employers – it leads to lower productivity, absenteeism, and loss of valuable talent. In this article I have highlighted a broad range of issues that impact men’s health, from their biological differences to women to specific behavioural aspects. The data also shows how broad and complex an issue this is.
To give us the best chance of driving positive change and increasing health and wellbeing amongst employees, it’s vital that we gain a deeper understanding of the different issues that impact groups of employees (including men) so that interventions can be tailored and targeted. Bringing all this together, my top tips for improving the health of men in your business is as follows:
- Take a strategic approach to gender health issues, understand the differences between men, women, transgender and non-binary employees and tailor your interventions accordingly. Set out clear objectives, and regularly review progress against these.
- Offer a comprehensive health and wellbeing programme, covering a broad range of dimensions including emotional wellbeing, physical wellbeing, financial wellbeing, social wellbeing, and career wellbeing.
- Create a positive workplace culture where employees feel that they can open up about any issues they may face, including with their mental health.
- Raise awareness about mental health issues to normalise the topic and tackle any stigma. It is good practice to provide more in-depth training to those who offer support to employees – such as line managers, Human Resources, and Mental Health First Aiders.
- Raise awareness of specific health conditions such as cancer, heart disease, high cholesterol, high blood pressure, and diabetes – help employees to understand the concept of the “silent killers”, the importance of regular check-ups, and seeking medical advice for any niggles early on.
- Offer a health assessment programme that enables employees to have a regular health check up – guiding them on how to prevent health issues from developing, and making it easy for employees to receive early diagnosis of any existing issues (especially the “silent killers”).
- Promote prevention through targeted health and wellbeing campaigns on the core physical wellbeing components – diet, alcohol, weight, exercise, smoking – but also stress as it can increase the risk of poor lifestyle and unhealthy behaviour.
- Use the workplace as an opportunity to create positive social wellbeing, reducing feelings of isolation and loneliness, and creating stronger support networks.
- Promote a Diverse, Equitable and Inclusive workforce that breaks down barriers between different groups, and celebrates how our differences can make us stronger.
- Ensure you have the right mix of benefits, services and support available for employees, and make these easy to access. Examples include private GP services, an Employee Assistance Programme and Private Medical Insurance. Review any policies to ensure they do not exclude gender-specific health issues or apply unreasonable limitations that impact an employee’s ability to be supported back to health.
How can Aon help?
Aon’s expert team of Healthcare and Wellbeing consultants advise employers on all aspects of gender based health strategy, and offer access to a comprehensive eco system of benefits, services and interventions. Please get in touch to discuss your specific requirements.
Additional references and resources
International Men’s Day global site https://internationalmensday.com/
International Men’s Day UK site https://ukmensday.org.uk/
UK charities supporting various men’s health issues https://ukmensday.org.uk/supporters/
Men & Boys Coalition (a network of organisations, academics, journalists, professionals and leaders committed to highlighting and taking action on the gender-specific issues that affect men and boys) http://www.menandboyscoalition.org.uk/
If you are struggling to cope, please call Samaritans for free on 116 123 (UK and ROI), email [email protected] or visit the Samaritans website to find details of the nearest branch. Samaritans is available round the clock, every single day of the year, providing a safe place for anyone struggling to cope, whoever they are, however they feel, whatever life has done to them.
In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at www.befrienders.org.
This article is written by Charles Alberts, who is Head of Wellbeing Solutions at Aon in the UK.
He leads the team of experts who advise employers on people health risk. During Charles' 20-year career in the Health, Risk and Wellbeing industry he has worked with many diverse organisations helping them to achieve their employee wellbeing and benefits aspirations.
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