Discussing a long standing health concern is difficult for anyone. However, men have a more difficult time in firstly realising they may have a health issue and secondly discussing it in an open way which would benefit their treatment. Crucial to improving the long term health of men is increasing public education on often understated issues in men's health, and fostering an environment in which health issues can be discussed openly and without ridicule. This week's blog, by Amen Sanghera, one of two analysts here at the centre, looks into the issues men have regarding discussing health concerns and the work charities, such as Movember, do to raise awareness for key issues in men's health.

Remember, remember the month of Movember
Around the world the month of November has become synonymous with Movember, where many men, who wouldn't otherwise do so, decide to grow a moustache to raise funds for charity. The Movember movement started in 2003 with 30 people growing moustaches and has grown to become truly global, with support from over five million people rallying together to raise awareness and tackle serious issues in men's health. In 2016 alone, it raised $80 million (AUD) for men's health through 1,176 million separate donations.1 The key issues supported by the foundation effecting men include prostate cancer, testicular cancer, mental health and suicide prevention, whose global reach is pervasive but often understated:

  • prostate cancer is projected to almost double to 1.7 million cases by 2030 and is the sixth leading cause of death among men
  • testicular cancer is the most commonly diagnosed cancer in men aged 15-40 years in high-income countries2
  • three quarters of all suicides are among men, with half a million men taking their own life each year, or one every minute.3

More specifically, the extent of these issues in the UK are also concerning with:

  • 47,000 men a year being diagnosed with prostate cancer in the UK, with one man dying from prostate cancer every 45 minutes. Moreover, 1 in 8 men will get prostate cancer at some point in their lifetime4
  • an estimated 2,400 men are diagnosed with testicular cancer every year in the UK.5 Though the survival rates for testicular cancer are high (if caught early), the number of cases of testicular cancer have doubled since the mid-1970s. As with prostate cancer, awareness is low, and testicular cancer catches many men unaware, as it is the most common cancer in men under the age of 40
  • men generally being reluctant to voice concerns over their mental health and take action when times are tough, and crucially, they are at a higher risk of taking their own life, often as a result of mental health problems such as anxiety, depression, substance abuse or psychosis. In 2015, the suicide rate per 100,000 population for males across the UK was 16.6 compared to 5.4 for females.6

The challenge
Although all of these health issues have underlying medical and socio-economic causes, the outcomes are often poorer for men because of inadequate communication and openness around health issues with their families, friends and their health care providers. In order to change this situation, there is a need to open up the conversation to get men more engaged in their own health through different strategies, including:

  • increasing awareness and education: a 2013 public awareness study in the UK on prostate cancer found that only 2 in 5 people knew that being aged 50 or over increases the risk of prostate cancer.7 While for testicular cancer, a similar survey of 3,000 men found that 68 per cent of respondents did not know how to check themselves for testicular cancer. Highlighting the need for more effective and informative methods of engagement and education around key male health issues.
  • fostering communication and openness: men can often have an introspective attitude towards their own health, which is especially true when it comes to mental health. Indeed, a survey of 2,500 people in the UK who have had mental health problems, indicated that 28 per cent of men admitted to not having sought professional help compared to 16 per cent of women.8 Indeed, 50 per cent of respondent's in a GP survey on testicular cancer indicated that they would shy away from showing their GP if they discovered a lump.9

Many of the above challenges can be resolved, but only if there is a concerted effort to tackle them. It also requires constructive disruption, being prepared to take risks and adopt novel approaches to solving problems – while acknowledging that achieving real change and improvement across a population requires the support of many stakeholders, including the clinical community and governments. Furthermore, faster results can be achieved through fostering and facilitating collaboration both at a national and international level, focussed on:

  • addressing the way men think and act on their health
  • understanding how traditional notions of masculinity can impact on men's mental health
  • challenging the way health services are provided to men
  • supporting the development of new tests and treatments to slow or stop disease progression
  • transforming health systems to place a stronger focus on outcomes that matter to men.

Though Movember is topical this month, for me, there needs be a greater emphasis on providing a sustained strategy to fostering safe forums for men to discuss health issues be it at home or at their doctor's office; whilst continuing to raising awareness for men's health issues beyond this month. This year, whether you participate in Movember or not, all of us, whatever our gender, can help address key challenges men have in talking about their health. Sometimes having a simple conversation with your male friends and family members around "how are you feeling?" or "is anything worrying you?" more often, can provide the platform to discuss health issues and maybe even save a life.

Footnotes

1 https://cdn.movember.com/uploads/files/Annual%20Reports/Movember%20Foundation%20Annual%20Report_2017_Global_FINAL.pdf

2 http://globocan.iarc.fr/old/age-specific_table_r.asp?selection=133901&title=More+developed+regions&sex=1&type=0&stat=0&window=1&sort=0&submit=%C2%A0Execute

3 https://uk.movember.com/uploads/files/Our%20Work/OurImpact_InvestmentStrategy.pdf

4 https://prostatecanceruk.org/prostate-information/about-prostate-cancer

5 https://orchid-cancer.org.uk/testicular-cancer/

6 https://www.samaritans.org/sites/default/files/kcfinder/files/Suicide_statistics_report_2017_Final.pdf

7 https://prostatecanceruk.org/for-health-professionals/our-projects/public-awareness-study

8 https://www.theguardian.com/society/2016/nov/05/men-less-likely-to-get-help--mental-health

9 http://thejoshcarrickfoundation.org/?p=854

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