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The men?s health gap: men must be included in the global health equity agenda

Authors: Peter Baker; Shari L Dworkin; Sengfah Tong; Ian Banks; Tim Shand; Gavin Yamey;

The men?s health gap: men must be included in the global health equity agenda

Abstract

In most parts of the world, health outcomes among boys and men continue to be substantially worse than among girls and women, yet this gender-based disparity in health has received little national, regional or global acknowledgement or attention from health policy-makers or health-care providers. Including both women and men in efforts to reduce gender inequalities in health as part of the post-2015 sustainable development agenda would improve everyone's health and well-being. That men tend to be in worse health than women has now been made clear by robust evidence from various sources. The Global Burden of Disease study led by the Institute for Health Metrics and Evaluation in 2010 (GBD 2010 study) showed that throughout the period from 1970 to 2010, women had a longer life expectancy than men. (1) Over that 40-year period, female life expectancy at birth increased from 61.2 to 73.3 years, whereas male life expectancy rose from 56.4 to 67.5 years. These figures indicate that the gap in life expectancy at birth widened between the sexes to men's disadvantage over those 40 years. By 2010, on the whole women were outliving men by an average of almost six years. In the region with the lowest life expectancy at birth--central sub-Saharan Africa--men were living 5.3 years less than women on average. Eastern Europe showed the biggest difference in life expectancy between men and women: women in the Russian Federation were outliving men by an average of 11.6 years. According to the Global health 2035 report, published in the Lancet in 2013, in countries classified as "least developed" and "less developed" by the United Nations adult mortality fell faster among women than among men between 1992 and 2012.2 Explaining the gender gap In many societies, men generally enjoy more opportunities, privileges and power than women, yet these multiple advantages do not translate into better health outcomes. What explains this gender disparity? According to the WHO European Region's review of the social determinants of health, chaired by Sir Michael Marmot, men's poorer survival rates "reflect several factors--greater levels of occupational exposure to physical and chemical hazards, behaviours associated with male norms of risk-taking and adventure, health behaviour paradigms related to masculinity and the fact that men are less likely to visit a doctor when they are ill and, when they see a doctor, are less likely to report on the symptoms of disease or illness". (3) How much more likely to die are men than women as a result of risk-taking behaviours? In 2010, 3.14 million men--as opposed to 1.72 million women--died from causes linked to excessive alcohol use. (4) For many men, excessive consumption of alcohol is linked to notions of masculinity. For example, a study of men in the Russian Federation showed that heavy drinking of strong spirits "elevates or maintains a man's status in working-class social groups by facilitating access to power associated with the hegemonic ideal of the real working man". (5) Of 67 risk factors and risk factor clusters identified in the GBD 2010 study, 60 were responsible for more male than female deaths and the top 10 risk factors were all more common in men. (4) In many countries, research suggests that women are more likely than men to use health services, although this disparity may reflect women's increased use of services during their reproductive years. (6) For example, in England in 2008 and 2009, women aged 15 to 80 years had significantly more consultations with general practitioners than men; the biggest gender gap was noted in the 20--to 44-year age group. (7) In a Lithuanian study of middle-aged university employees, women were found to be significantly more likely than men to get regular dental check-ups. (8) Several recent studies in Malawi, South Africa, Uganda and Zimbabwe suggest that notions of masculinity not only increase the risk of infection with the human immunodeficiency virus (HIY), but they also inhibit men from getting tested for HIV, coming to terms with their HIV-positive status, taking instructions from nurses, and engaging in health-enabling behaviours. …

Keywords

Male, Masculinity, Health Equity, Humans, Public aspects of medicine, RA1-1270, Global Health, Men's Health, Perspectives

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  • citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    153
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
153
Top 1%
Top 10%
Top 1%
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