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April 2018, Volume 68, Issue 4

Editorial

Men\'s health - A public health issue

Ibrahim Hashmi  ( Specialist Public Health, APPNA Institute of Public Health, JSMU )
Qudsia Anjum  ( Specialist Family Medicine, Medcare Hospitals and Health Centers, Dubai )

Investing in health has been a priority for most nations especially the third world countries. Local, national and international organizations pay more emphasis on healthcare; however, it has been observed that women and children are their target population. This raises a question why men\'s health is subjected to gender disparity, although discussion on equality is ongoing. Men\'s Health, a subject that has been seldom discoursed, is receiving attention and becoming a matter of concern recently.1 In the sustainable development goals even, the term gender equality is used, so as to provide equal rights to both men and women. The needs of both the genders are different, physically, socially, related to health and society, though both genders have an equally important role in the community and society. Hence in order to strike the balance for a healthy society it is equally important to discuss men\'s health issues as of the women\'s. There is growing concern and evidence of "men\'s health gap" being discussed and highlighted in literature.1 Moving a step ahead and raising this agenda locally and internationally, is imminent without compromising women\'s health. Global Action on Men\'s Health is the recent advocacy move by one of the organization internationally.2 Men are considered bread earners in most of the societies, despite women\'s contribution to economy. The health of a man can be indirectly influenced by the quality of life he enjoys. There have been instances where male health seeking behaviour is poor as compared to their female counterparts.3 There are various reasons contributed to it including health not being part of men\'s everyday discourse, poor health seeking attitude as in seeking healthcare only when very sick and men reluctant to seek help and would only do so when they don\'t have any option left in the matter. Instead of seeking help men were seen to deny weakness, ensure medical symptoms, become self-reliant and wait for the body to heal itself. Men also experienced structural, psychological and social barriers to help seeking.2 Health is among the least prioritized areas for most people, which can be dangerous to one\'s social and mental well-being in addition to physical state. Neglecting health is just like pushing the dust under the carpet, believing all to be well. Taking in account of this behavior, a study showed that United States loses an estimated 479 billion dollars annually due to men\'s premature morbidity and mortality.4 This shows how men\'s health contributes to the economic loss of a country. This fact was reinforced by a Danish study highlighting under usage of primary health care services by men, resulting in the utilization of more expensive hospital services.5 Taking into account the occupational perspective, men are usually preferred over their female counterparts in laborious activities such as mining, agriculture etc. This makes them vulnerable to risk of occupational injuries, disability or death. A recent analysis depicted almost 750,000 men who died from job-related causes, as opposed to just over 102,000 women.6 Disability or disengagement of workforce affects not merely individuals and families, but overall economy of a country is also jeopardized. The impact of removing 750,000 trained people out of workforce bracket each year would be enormous. A person permitted to lose his job due to disability would find it difficult to make both ends meet. He might end up with psychological illnesses and even indulge into illicit drug abuses. Extremes of ages require extra attention and care, so compromised health of the spouse influences the other, not only physically but also psychologically. This was proved by another study showing men\'s physical health could affect their spouses, giving due importance to men\'s health will prove to be beneficial for families and societies.7
Much work has been in progress to improve women\'s health, be it maternal and child health programmers or tackling the issues related to women health, which
should be given importance. In the global burden of disease study, led by Institute of Health metrics and evaluation in 2010 (GBD study), it was stated that in the period from 1970-2010, women had longer life expectancies than men. In this 40 years period, female life expectancy improved from 61.2 to 73.3 years whereas male life expectancy increased from 56.4 to 67.5 years.6 In another document of Global Health report 2035, published in 2013, it was stated that in countries classified as "least developed" and "less developed" by the United Nations, the adult mortality rate fell faster among women than in men between the years 1992 to 2012.8 This report is very encouraging with regard to the health status women are enjoying; and reflects on the effectiveness and success of the programmes being conducted to improve women\'s health. However, there is dire need for more programmes and activities to improve health of the male members of the community. A study has reported that only three countries (Australia, Brazil and Ireland) have tried to address men\'s burden of ill health through the adoption of national, male-centered strategies.9 It is high time to take preliminary steps to the importance of men\'s health, which many of the countries of the world have not started so far. To conclude, Equity is and should be the basis of all the future health programmes. Both genders have their respective needs and they should be addressed accordingly. It is imperative to take initiative of working towards Men\'s Health as an entity to bring a positive change in society and community. Combined global action towards men\'s health gender gap could be promising in bringing impact on society and economy.

References

1.  Hennessy M, Mc-Namara PM. Gendered perspectives of Men\'s Health and help seeking: Implications for public health and health promotion. IJMHSR,2014; 1: 13-28.
2. "Global Action On Men\'s Health". Menshealthforum.org.uk. N.p., 2017. Web. Cited on 16 June 2017.
3.  Hawkes S, Buse K. Gender and global health: evidence, policy, and inconvenient truths. Lancet. 2013; 381: 1783-7
4.  Brott A, Dougherty A, Williams ST, Matope JH, Fadich A, Taddelle M. The economic burden shouldered by public and private entities as a consequence of health disparities between men and women. Am J Mens Health. 2011; 5: 528-39.
5.  Juel K, Christensen K. Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Public Health (Oxf). 2008; 30: 111-3.
6.  Lim S, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2224-60.
7.  Hagedoorn M, Sanderman R, Ranchor AV, Brilman EI, Kempen GI, Ormel J. Chronic disease in elderly couples: are women more responsive to their spouses\' health condition than men? J Psychosom Res. 2001; 51: 693-6.
8.  Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global Health 2035: a world converging within a generation. Lancet. 2013; 382: 1898-955.
9.  Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G.Perspectives. The men\'s health gap: men must be included in the global health equity agenda. Bull World Health Organ 2014; 92: 618-20. 

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