Men's health crisis: why are men dying younger than women?
Image: Unsplash
In an alarming global trend that has persisted for decades, men across the world are dying younger and experiencing higher rates of illness compared to women. This critical issue demands immediate attention from governments, global health agencies, and funding bodies, as highlighted in a recent article published by the Bulletin of the World Health Organization, authored by Dr Morna Cornell, an esteemed honorary research associate at the University of Cape Town's (UCT) Centre for Integrated Data and Epidemiological Research.
As of 2023, the difference in life expectancy remains stark: men are expected to live to 71 years, five years shorter than women, whose life expectancy sits at 76. Mortality rates reveal an even grimmer reality, showing that 176 out of every 1,000 men die compared to just 113 out of 1,000 women. The data shines a spotlight on male populations who are further marginalised due to race, disability, age, or sexual orientation, particularly in post-colonial societies where disparities are exacerbated.
"In southern Africa, the migrant labour system left a devastating legacy for men's health. Young men lived and worked in harsh, unsafe conditions and carried diseases such as HIV and tuberculosis back to rural communities. This structural harm is still felt today," Dr Cornell said.
Despite presenting clear and sobering evidence, men's health continues to languish in the shadows of public health priorities. International health agencies, funding institutions, and national programmes seldom recognise men as a vulnerable group. Reactions surrounding discussions of men's health often revolve around the misconception that addressing these issues reinforces male privilege rather than tackling genuine health inequities.
'Men and women are too often treated as competing populations, but when we look at the data, men are clearly among the furthest behind,' Dr Cornell stated with conviction.
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'Ignoring men's health undermines progress towards the Sustainable Development Goals' (SDGs) pledge to leave no one behind.'
Over the past 15 years, a handful of countries have begun addressing the malnourishment of men's health in public health policies. Nations like Australia, Brazil, Ireland, Malaysia, Mongolia, South Africa, and Iran have made strides by developing national men's health policies that acknowledge men's mortality rates and their reduced engagement with health services. Innovative entry points have emerged from these policies:
South Africa: Leveraging voluntary medical male circumcision as a means to broaden health service access.
Leveraging voluntary medical male circumcision as a means to broaden health service access. Brazil: Engaging men through initiatives focused on fatherhood.
Engaging men through initiatives focused on fatherhood. Canada: Promoting positive aspects of masculinity to encourage men to seek healthcare.
Promoting positive aspects of masculinity to encourage men to seek healthcare. Australia and Ireland: Concentrating on marginalised men, who are most at risk.
Concentrating on marginalised men, who are most at risk. Mongolia: Integrating men's health into comprehensive development planning.
Integrating men's health into comprehensive development planning. Iran:
Tailoring health policies to local risk factors.
However, Dr Cornell warned that many of these policies lack robust monitoring processes, measurable targets, and set timelines. To date, only Ireland has formally evaluated its men's health policy, uncovering strong community-level impact, yet limited success in addressing the deep-rooted structural risk factors at play.
One of the most pressing threats to men's health is violence, often exacerbated by alcohol and firearm accessibility. South Africa recorded a staggering homicide rate in 2017, seven times the global average, with men aged 15-44 comprising 87% of the victims. Alcohol was implicated in numerous deaths, with firearms linked to one in three cases.
'Reducing violence requires more than health policy. It demands coordinated action against the alcohol and firearm industries, coupled with strong global alliances to protect vulnerable young men,' Dr Cornell stresses.
The paper also underscored the limited integration of men into global health frameworks. A review of 37 policy documents on sexual and reproductive health found that only five included specific targets for men, and discussions that involve men typically revolve around women's health, sidelining men's unique health needs.
To facilitate substantive change, Dr Cornell advocates for a reconfiguration of global health goals so that the notion of gender comprehensively includes both men and women, with SDGs framed to be evidence-based and equity-focused.
Fortunately, some encouraging initiatives are in motion. Over 40 countries now offer human papillomavirus (HPV) vaccination programmes for both boys and girls. The UK's national suicide prevention strategy is particularly geared towards men, while the European Commission recommends prostate cancer screening across its member states. Additionally, a burgeoning number of men's health organisations and dedicated research journals are emerging to inform and shape the evidence base.
Dr Cornell's message is unequivocal: men's health must be at the forefront of the global agenda for universal health coverage. Policies need to be supported by robust monitoring frameworks, adequate funding, and unwavering political commitment. They should also address the root social determinants of health, from poverty and unemployment to unsafe housing and discrimination.
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