World Cancer Day (4 February) provides a good opportunity to highlight the little-known fact that men are much more likely than women to develop and die from cancer – and by a considerable margin. The global male age-standardised cancer incidence rate is 205 per 100,000 and the male mortality rate is 126. The comparable respective figures for females are 165 and 83.
The global data reveals very clearly just how badly men’s health is faring in many areas in addition to cancer:
- Male life expectancy, at 68 years, lags five years behind female life expectancy. There is not a single country in which male life expectancy exceeds female. Overall, the gap between the sexes has actually widened since 1970 and will widen further by 2030 – by then, male life expectancy is expected to be seven years shorter than female life expectancy.
- Men have a >40% probability of dying between the ages of 50 and 74 while women have probability of <30%.
- The global suicide rate in men is almost twice that in women; the European region has the biggest male:female ratio (4.0).
Despite these and other worrying indicators, including those relating to male risk-taking (tobacco, alcohol, diet, etc.), occupational health and use of healthcare services, men’s health is seldom discussed at the national or international levels. It is a classic case of a problem hiding in plain sight.
Just three national governments – Australia, Brazil and Ireland – have developed national strategies to tackle men’s health. Virtually all other governments, and global agencies like WHO, the World Bank and the Gates Foundation, are focused primarily on the health of women. Women’s health is hugely important, of course, especially given the multiple disadvantages they face, but this need not necessitate a lack of attention to men’s health. The health of men and women need not be seen as a zero sum game.
In fact, improving men’s health would be good for women too. Healthier men would be productive for longer, contributing more to family incomes, and would have less need of caring support, most often provided by their female partners or daughters. Men with better mental health and with lower levels of alcohol misuse are also less likely to perpetrate gender-based violence.
Better men’s health would also save a considerable amount of money. Men’s premature mortality and morbidity costs the United States economy some £335 billion annually while the economic burden associated with smoking, excess weight, alcohol and physical inactivity in Canadian men has been estimated at about £18 billion a year. The evidence-base for tackling men’s health is now increasingly robust and widely available. Gender-sensitive interventions have been shown to reduce men’s risk-taking, improve their use of health services, increase their participation in screening programmes, enhance their mental health and wellbeing, and encourage them to be more actively involved in the health of their partners and children. There is certainly no longer any need for fatalism when contemplating taking action with men.
Professor Sir Michael Marmot, one of the world’s leading authorities on the social determinants of health, looked at gender in a report for the WHO on health inequalities in Europe. He argued that national governments should now develop strategies that ‘respond to the different ways health and prevention and treatment services are experienced by men [and] women … and [ensure] that policies and interventions are responsive to gender.’
In a more recent report on health inequalities specifically in the UK, Marmot highlighted the fact that deprivation has a bigger negative impact on men’s health outcomes than women’s and called for a greater policy focus on men’s health to help tackle this.
The WHO Constitution says that ‘the highest attainable standard of health [is] a fundamental right of every human being.’ It is time for health organisations at all levels to acknowledge the problems facing men as well as women and to develop coherent and sustained strategies for tackling them. Continued inaction is no longer an ethical option.
Peter Baker is Director of Global Action on Men’s Health (www.gamh.org), a NGO launched in 2014 with the aim of encouraging national governments and international health organisations to take action to improve male health. Peter was previously Chief Executive of the Men’s Health Forum charity in the UK and has written extensively on men’s health issues.