Male Health in Australia
The policy vacuum
In 1988 the Health For All Australians report noted that:
“Men in Australia die from nearly all non-sexspecific leading causes at much higher rates than do women …” and that … “These differences in health status largely reflect the prevalence of preventable factors.”
It seems that despite three decades of statistics, male health policy or rather the lack of it, continues to fail the Australian male. Moreover, seven years after the release of the 2010 National Male Health Policy, Australian males are bereft of administrative structures in any State that cater for their specific concerns. Conversely, an Office for Women or equivalent exists in every State and Territory as well as at the national level.
The not so average male
Although the life expectancy for Australian males is high by international standards, there remain significant differences in life expectancy for different groups of males. Australian males living in regional, rural and remote areas die on average about 3 – 4 years earlier than their urban cousins, primarily due to socioeconomic disadvantage, lifestyle factors and lesser access to medical care. Indigenous men have a life expectancy at least 11 years less than non-Indigenous men, mostly as a consequence of significant socio-economic disadvantage, drug and alcohol abuse, cultural dislocation and poor service access. Other groups of males at high risk of premature death and early onset of chronic disease include those with mental illness, war veterans, gay, transgender and intersex people, socially isolated men, men from blue collar backgrounds and non-English speaking males.
The National Male Health Policy (NMHP) 2010, advocates a social determinants approach and health equity for subgroups of males. However, apart from support for Men’s Sheds, a few reports on the status of men’s health and overdue funding for a longitudinal study of male health, its rhetoric is not matched by specific action or funding at National
or State levels.
Excess death and ill health
Research consistently demonstrates a disproportionate sex differential in death and illness for males in Australia. Males have a shorter life expectancy, higher rates of death from most non-sex specific causes across all age groups and a higher lifetime risk of many cancers and chronic conditions. Standardised mortality rates point to over 23,000 excess male deaths per year, most of which are from preventable causes. The leading individual causes of Australian male death are ischaemic heart disease (IHD), cancer, respiratory system disease, prostate and lymph system disease, cerebrovascular disease, suicide, and endocrine disorders. These causes account for approximately 60% of all male deaths and point to potential priority areas for male health policy and planning.
In addition to deaths, about half of the male population over 15 years of age report health concerns. Reporting rates increase with age, corresponding with increasing incidence of chronic conditions as males age. The leading causes of years lost to disability (i.e. non- fatal disease burden) are anxiety or depression, Type 2 diabetes, adult onset hearing loss, asthma and dementia. The causes of these conditions are largely preventable and therefore amenable to targeted intervention.