Too many men have been dying too young for too long. In 2019, before COVID-19 began to kill disproportionately high numbers of men, the average male lifespan was just 71 years globally. A boy born in that year in Lesotho or Central African Republic can expect to die at about the age of 50.
The causes of poor men’s health are not a mystery. They are not, except to a small degree, genetic. Much more pertinently, men’s health has been largely neglected by policymakers and service providers. This has been highlighted in governments’ responses to the pandemic: no serious effort has been made anywhere to develop ‘male-friendly’ prevention campaigns to encourage hand-washing, mask-wearing or vaccination.
Men themselves, because of the gender norms with which they are expected to comply, often take too many risks with their health – smoking, drinking excessively and driving dangerously – and delay seeking medical help. Mainly because of a lack of engagement with primary care services, 25% of men with HIV are unaware of their status, 45% of men with HIV are not receiving anti-retroviral treatment, and 53% do not have a suppressed viral load. There is a similar picture for men with tuberculosis and for common mental health conditions, such as depression and anxiety.
But there are now some positive signs of change. Seven countries have developed dedicated men’s health policies – most recently, South Africa – and a men’s health strategy for the European region was published by the WHO in 2018. The WHO has recommended that greater attention be paid to men’s health in work to deliver the Sustainable Development Goals and Universal Health Coverage.
There is also a growing body of research and practical experience that can be drawn on to support practical steps towards sustainable and measurable improvements in men’s health. Global Action on Men’s Health has reviewed this evidence and, in its recently-published Delivering Men’s Health report, it suggests 10 key actions that policymakers and service providers can take to ‘build back better’ for men.
- Collect, analyse and publish wide-ranging and regularly-updated data on men’s health to provide a guide to where action is needed and to its impact and effectiveness.
- Engage senior decision-makers, including politicians, to achieve faster and more significant progress.
- Listen to men’s voices to understand better what their needs are and how best to meet them.
- Introduce men’s health policies that address their health needs and integrate men’s health into other health policies, all with clearly identified and realistic deliverables.
- Develop outreach services that engage men ‘where they are’, such as local communities, sports venues, faith organisations or online.
- Recognise the differences between men and focus attention on those groups facing multiple layers of disadvantage and who experience the worst health outcomes. An intersectional approach is essential.
- Take account of gender norms by using appropriate ‘male’ interests and language to engage men in health (but without inadvertently reinforcing ‘traditional’ male gender norms).
- Ensure that the needs of boys and young men are reflected in the development and delivery of health policies and services.
- Use International Men’s Health Week and other health weeks and days as opportunities to promote men’s health.
- Take a ‘male-positive’ approach which builds on men’s strengths and is more likely to engage men and achieve changes in their health practices and the use of services (with the understanding that unacceptable behaviour by men must always be challenged).
Delivering Men’s Health is a practical guide – providing easily-accessible and user-friendly information – designed to inform both planning and delivery. It is accompanied by an online database of policies, journal papers and reports that provide more detailed evidence should that be needed.
Any action taken to improve men’s health must not be at the expense of women’s health. Resources must not be transferred away from women’s programmes. There is not a binary choice to be made in a zero sum game. Moreover, men’s and women’s health are inextricably linked and there is good evidence that better men’s health as well as greater gender equality improves the health of everyone.
Policymakers and service providers who want to ensure better health for men and boys now have a tool that enables the systematic action that is required to achieve this goal.
If not now, when?
The views expressed in this post are those of the author and may not reflect those of the UCL Centre for Gender and Global Health.