Saturday, March 12, 2011

Douglas Todd - Why men die young - A Roadmap to Men's Health

Douglas Todd pens The Search, a regular blog/column in The Vancouver Sun dealing with spirituality and diversity. I have become a fan of his writing over the past year or two, especially enjoying when he tackles less popular topics (broken gurus, the pay gap between CEOs and average workers).

This is another good column. He is reporting on the work of Simon Fraser University psychologist Dan Bilsker, Vancouver General Hospital urologist Larry Goldenberg, and University of B.C. urologist Joyce Davison - they have authored a major report on the crisis in men's health - the 131-page A Roadmap to Men's Health.

Why men die young. Why three B.C. health officials care

By Douglas Todd
5 Mar 2011

Betty Friedan was always ahead of her time. She was arguably the most influential leader of North America's modern women's movement.

Friedan's pioneering 1963 book, The Feminine Mystique, championed bringing women into "fully equal partnership with men."

The cause will be celebrated March 8th on the 100th anniversary of the beginning of the United Nation's International Women's Year, which began in Germany.

Friedan (1921-2006) was more comprehensive than most, however. She was among the first feminists to go out of her way to remind everyone not to forget the well-being of men.

By the 1970s, feisty Friedan was fearlessly telling any person who would listen not to attack men. The two sexes are interdependent, she said, they need each other.

The advance of women, Friedan said, should not lead to the neglect of men, since any declines in men's economic, psychological or medical health would also lead to the suffering of families, women and children.

In recent decades, Friedan's egalitarian urgings have often been ignored in mainstream North America. But three leading figures in B.C.'s medical community are rising up to her challenge to take men's well-being more seriously.

In what the authors say is, unfortunately, a rare attempt in Canada, Simon Fraser University psychologist Dan Bilsker (photo lower left), Vancouver General Hospital urologist Larry Goldenberg and University of B.C. urologist Joyce Davison have put together a major report on the crisis in men's health.

Their 131-page Roadmap to Men's Health, which relies on the expertise of 15 other B.C. medical researchers, centres on what could be called a "killer" fact in gender-related health data: Canadian men die on average four to six years younger than women.

Shouldn't we care more than we do? the health professionals ask in the report. Their detailed response to that question in the report adds up to a brilliant analysis of both the complexities of the male psyche and the vagaries of society's attitude to men's health.

{Check out "A New Vocabulary for Men"}

{'Dealing with the casual devaluation of manhood," and more on men}

Goldenberg, who specializes in prostate cancer, says families will be the winners if the gap between men and women can be narrowed on life expectancy. (In B.C. men die on average 4.4. years younger than women.) Too many Canadian children, Goldenberg says, lose their fathers prematurely. And too many women become widows too soon. Of Canadians who live into their 90s, he says, women outnumber men eight to one.

"Having a Y chromosome should not be seen as possessing a self-destruct mechanism," say the authors. Men's shorter lifespan should not be seen as "natural and inevitable."

The Roadmap to Men's Health cites the four main sources of men's premature death rates in Canada:

- Cardiovascular disease, from which middle-aged Canadian men die at a rate more than three times higher than women;

- Suicide, from which men die at a rate three to four times higher than women;

- Motor vehicle accidents, from which men die three times more than young women;

- Workplace accidents, with men being the victims of more than 97 per cent of all workplace deaths.

There are many social and psychological reasons men don't live as long as women, says the report.

Men are often expected to work at more dangerous jobs. They also have fewer social supports, and they are more averse to preventive behaviours such as exercise, nutrition and moderate drinking. The authors maintain that evidence of men's inferior health have generally been greeted with "resignation," as something to be accepted rather than addressed.

"Given the striking discrepancy in life expectancy, one would expect to find that men's health has been a high priority for many years, drawing substantial investment of financial and intellectual resources from policy-makers and researchers," say the authors.

"But, in fact, the domain of men's health has been neglected, receiving serious and widespread attention only in the last decade."

Compared with other western democracies, say the authors, Canadian public health officials have been among the worst offenders. They've shown little interest in men's health research or programs (beyond a recent emphasis on prostate cancer screening).

The three authors lament that improvements made so far in dealing with men's health challenges in Canada have been trivial.

Why? In the 1960s, the report recounts how American and Canadian researchers finally began taking into account women's unique physical and psychological characteristics.

It was a response to the blinkered way that medical studies had been done up to that time: when researchers mistakenly focused only on male subjects, thinking what they found with them would always be relevant to both men and women.

It wasn't true in many cases. And the realization lead to a revolution in research spending.

Bilsker, Goldenberg and Davison cite recent a Canadian study that found women's health research now receives more than double the funding allocated to men's health.

"An example ... is the B. C Centre of Excellence for Women's Health, established in the early 1970s in response to unmet health needs identified by leaders in the women's movement," says The Roadmap to Men's Health, which was funded by the Men's Health Initiative of B.C.

"The Centre has identified and provided comprehensive health services to women for the past 25 years -- but there is no equivalent centre for men."

The Roadmap to Men's Health -- which defines health as much more than the absence of disease -- makes many recommendations for improving the physical and emotional wellbeing of men and boys, and outlines many reforms needed in Canada's public health care system, some of which have been shown to work in other countries:

- The major priority for men's health research in Canada should be cardiovascular disease, followed by suicide prevention. The specific focus of the latter should be: "Why is the suicide rate in Canada highest for middle-aged men?"

- Physicians should be trained and encouraged to provide greater focus on men's health issues, such as risky drinking, suicidal thoughts and poor nutrition.

- Innovative ways need to be found to engage men toward healthier behaviour, including controlling risky drinking and dealing more effectively with dark moods. A few new educational programs are now underway in B.C., including the website

- Governments should open male-friendly health care services. Some countries have set up men's health-screening clinics at sporting venues and in male-majority workplaces.

Of course, part of the answer to improving men's health is men themselves. Earlier medical researchers argued that real change won't come until men transcend many of the traditional ideas of what it means to be masculine.

The Roadmap to Men's Health outlines how previous medical researchers accused men of following unhealthy masculine values, such as winning, keeping emotions under control, taking risks, aggression, frequently changing sex partners, dominance, the primacy of work and the pursuit of status.

The authors don't dismiss the potential downside of these so-called male values, but they do judge them as misleading stereotypes, which don't at all apply to all men.

They also point out how such labelling of men can easily lead to "blaming the victim," in much the same way women were dismissed 50 years ago for not being as capable as men in the workplace.

Just as importantly, the authors stress that many of these so-called "masculine" behaviours, such as aggression and emotional control, can at times be positive, for both men and women. There are often times when members of both sexes have to be strong, determined and courageous.

As well, society often relies on men to exhibit some of these "masculine" traits, particularly risk-taking. They're necessary for many dangerous male-majority jobs, whether in the military, construction, logging or police forces.

Lastly, the authors worry that overemphasizing some of the negative things associated with traditional masculinity will simply turn men off, by shaming them. By asking them to "apologize for being men."

It's hardly the route, these wise B.C. medical specialists say, to encourage men to embrace the health care system and take better care of themselves.

Twitter: DouglasTodd

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