Global Man & Health
Article Outline
Obama – great expectation for the world: any impact on Men's Health?
President Barack Obama has made health care a central part of his USA agenda. The Obama administration has an agenda crowded with many priorities – the economy, taxes, Iraq, Afghanistan, energy policy. With every percentage increase in the unemployment rate more people could become uninsured with deleterious consequences for their health and the health system, not only in the USA but in all affected countries around the world. Worsening unemployment has a direct and dramatic effect on health in general and especially on the underprivileged and minorities! In this regard gender is a basic variable in determining health status and longevity throughout the world.
Even in financially secure and solid times men, on average, die younger than women and have higher rates of mortality for nearly all leading causes of death. Although major health disparities exist between men and women, few health initiatives have acknowledged or addressed them. Will the Obama administration? Evidence suggests that the discrepancies in health between men and women can not be explained solely by biological differences. Men are more likely to engage in health risk behaviours, such as tobacco and alcohol use, and are less likely to access the health care system. This defines the two major challenges confronting those wishing to improve the health and longevity of men.
Furthermore, Baerlocher & Verma [1] recently reported that Men's Health topics generate minimal research and are marginalised in scholarly agendas, at least relative to the amount of energy put into Women's Health research. Overall funding for research focusing on Women's Health made up 52% of the total Canadian Institutes of Health Research/Institute of Gender and Health funding, compared to research on Men's Health which made up only 21%. Furthermore, those authors ask the question of whether this is just a Canadian phenomenon? Their answer: NO! They looked into the results of both grant applications to the National Institutes of Health (NIH) in the United States and of articles in MEDLINE. Using the Medical Subject Heading (MeSH) ‘Women's Health’ or ‘Women’ turned up 10,811 and 21,481 hits, respectively. There is no MeSH term ‘Men's Health’ and the MeSH term ‘Men’ turned up only 2,919 hits. What are the reasons for Men's Health being so understudied by comparison to Women's Health? Is it just a lack of interest in Men's Health? By 2009 only four Universities around the world have a ‘Men's Health Research Chair’. The area of Men's Health is still a young area of interest and good evaluations are needed to generate evidence [2]. Large-scale studies should be funded to help to produce evidence that is sufficiently robust to add to the small evidence base currently existing in the field. Furthermore in order to make recommendations on future gender-specific services, it is important for policy-makers to appraise the effectiveness of targeting health promotion interventions at men compared with the same interventions aimed at men and women in general or at various subgroups, such as deprived communities, those with different ethnic backgrounds, etc.
The paper by Cindy M. Gray et al [3] in this issue shows, for example, a gender-specific intervention model for obesity that could be adopted in other primary care settings. It has to be stressed, however, that the Camelon model engaged a significant number of a traditionally hard-to-reach population and is, in these times of a global metabolic syndrome and obesity epidemic, an important approach to a significant problem.
Maria Todorova [4] and colleagues from the Medical University of Sofia add another piece to the obesity puzzle. Their data from Bulgaria confirm that unfavourable metabolic and hormonal alterations occur early in overweight subjects while still clinically healthy, and that life-style modifications and interventions therefore have to be undertaken much earlier than previously thought.
Garth D. Reid [5] and colleagues from Scotland discuss the four lessons learned while evaluating a national Well Men's Service as part of the future of integrating Men's Health into public health. Unfortunately they found that collaborative working is a slow process, a fact which key advocates in the field have failed to recognise! Study participants need to be included in partnership working, particularly men. Partnership working can be arduous and those undertaking it should be prepared for the difficulties ahead. And finally, flexibility is a key element to the successful evaluation of community-based large scale interventions. These are four important conclusions for all working in the field around the world.
Finally Megan L. Ballinger et al [6] report about a – to my knowledge – unique Australian phenomenon, the community-based Men's Sheds. The community-based Men's Sheds are defined as an undertaking to bring groups of men together in a shed setting to do hands-on activities, foster friendships and support men's health and wellbeing. More than 200 community-based Men's Sheds are operating today in Australia. While the number of Men's Sheds is increasing in Australia, it is still an open question as to whether something either similar or in a different format, could be transferred as a role model to one of the four other Continents. The authors conclude that Men's Sheds enhance the health and wellbeing of the men who participate in them. Participating supports their autonomy and supports them to be more actively engaged in life in general and this, the authors conclude, enhances Men's Health.
References
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- . What works with men? A systematic review of health promoting interventions targeting men. BMC Health Serv Res. 2008;8:141;Available at: http://www.biomedcentral.com/1472-6963-8-141
- Addressing male obesity: an evaluation of a group-based weight management intervention for Scottish men. jmh. 2009;6(1):70–81
- . Serum lipids, uric acid and leptin/adiponectin ratio in clinically healthy normal weight and overweight young men, aged 17–20 years. jmh. 2009;6(1):63–69
- . The reality of partnership working when undertaking an evaluation of a national Well Men's Service. jmh. 2009;6(1):36–49
- . More than a place to do woodwork: a case study of a community-based Men's Shed. jmh. 2009;6(1):20–27
PII: S1875-6867(09)00008-6
doi:10.1016/j.jomh.2009.01.004
© 2009 Published by Elsevier Inc.
