Men’s Health Policy Information Paper Executive Summary
Principles Underpinning a New Men's Health Policy
It is proposed that the National Men’s Health Policy be built around five foundation principles:
- Gender equity;
- An action plan to address need across the life course;
- A focus on prevention;
- A strong and emerging evidence base; and
- Needs of specific groups of men most at risk.
Needs of Specific Population Groups
The overall disease burden on men is not evenly spread across all sectors of society, but rather disproportionately falls on some sections of the population.A sense of empowerment over life circumstances is a basic foundation for good health. Different groups have different opportunities to participate in political, economic, social and cultural structures and relationships. Groups that may face barriers to participation include low socioeconomic groups and minority groups, such as Indigenous people.
Aboriginal and Torres Strait Islander men: The health of Aboriginal and Torres Strait Islander men is worse than any other subgroup in Australia. Life expectancy of Aboriginal and Torres Straight Islander men is estimated at approximately 17 years less than average life expectancy for all Australian men (59 years and 76 years respectively for the period 1996-2001).12 There is also a 6 year gap in life expectancy between Indigenous men (59 years) and Indigenous women (65 years).
Men in rural areas: Men in rural regions often have limited access to health services, recreational and support facilities. Men who own or manage farms commit suicide around twice the rate of the national average.13 Work for rural men is often physically demanding and potentially hazardous, particularly as they often work in isolated areas or on their own. Cultural factors and beliefs also contribute to differences such as rural men who are overweight believing that being a ‘big bloke’ is an advantage and sign of strength.14
Culturally and linguistically diverse men: New immigrants to Australia generally have as good or better health than the general population – this is known as the healthy migrant effect. This is due partially to the selection process for new migrants and as well as lower levels of some risk factors. However, there is some evidence that this advantage diminishes with length of stay.15
Significant psychological distress—especially related to war and conflict, but also the disruption of moving and leaving friends and family—has been observed among some migrant groups. These include humanitarian migrants from the Middle East and the Balkans.16 The Refugee Health Research Centre (2007)17 notes that 30% of refugees who have arrived in Australia over the past 10 years have been men aged 20 years and above. The health needs and resettlement issues of refugee men remain largely undocumented.
Socioeconomically disadvantaged men: A substantial body of literature demonstrates that social and economic disadvantage are directly associated with reduced life expectancy, premature mortality, injury and disease incidence and prevalence, biological and behavioural risk factors for ill health. In 2000-02, Australian men in the most disadvantaged areas experienced 21% higher death rates from heart, stroke and vascular diseases than their least disadvantaged area counterparts.18
Men in prisons: At the last prison census (June 2007) there were 25,240 men in custody in Australia’s prisons, 22% of whom were on remand. 19 Indigenous prisoners represented 24% of total prison population. One major Australian study showed overall death rates for men with a prison history was 4 times that of men in the general community.20 Most extra deaths result from suicide, drug and alcohol abuse and homicide, and occur within the first few weeks of release from prison.
Australian Defence Force members and veterans: The Australian Defence Force (ADF) had about 51,700 members in 2007, 86.7% of whom were men. Overall mortality and morbidity in this group is lower than for the general population, probably due to positive effects from the provision of a comprehensive suite of support services to ADF members, including health-care services, the requirement to maintain physical fitness and the supportive nature of military culture.21
For veterans, however, the picture is different. Australian veterans consistently self-assess their health below that of the general community and also below that of military personnel who have not been deployed to operational areas.20
Community concerns: Some communities have concerns over health issues that may not be one of the leading causes of Burden of Disease. For example, fathers’ groups have noted the lack of ante-natal programs for fathers, and difficulty in making contact with child and family health nurses. Many of these fathers lack the intergenerational modelling that helps in learning social roles, and could benefit from such support. There may be other community concerns important to men that are traditionally seen as part of the health portfolio, or affecting small numbers of men that could be none the less important considerations for a men’s health policy.
12 ABS, 2008, Causes of Death, Australia, Cat 3303.0
13 Australian Centre for Agricultural Health and Safety, NSW Farmer’s blueprint for maintaining the mental health and wellbeing of the people on NSW farms
14 O’Kane G, Craig P, Sutherland D 2008 Riverina men’s study: An exploration of rural men’s attitudes to health and body image. Nutrition & Dietetics 2008; 65: 66-71.
15 AIHW, 2008, Australia’s Health 2008, Cat. no. AUS 99, p 91.
16 AIHW, 2008, Australia’s Health 2008, Cat. no. AUS 99, p 91
17 Refugee Health Research Centre, 2007, Researching Refugee Health, Issue 5, Latrobe University, Melbourne
18 AIHW, 2004, Heart, stroke and vascular diseases Australian Facts 2004, AIHW cat no. CVD 27.
19 ABS, 2007, Prisoners in Austrlia, 2007, 4517.0
20 Kariminia, A, Butler, T, Corben, S, Levy, M, Grant, L, Kaldor, J, 2007, 'Extreme cause specific mortality in a cohort of adult prisoners—1988 to 2002: a data-linkage study’ in International Journal of Epidemiology, Vol. 36, pp. 310–316 21 AIHW, 2008, Australia’s Health 2008, AIHW, Canberra