HOW YOUR ATTITUDE TOWARD HEALTH CAN KILL YOU 

I am your typical male. I’m in pretty good shape, I think. Perhaps a few too many Guinness’ in my youth may yet catch up to me, and I am starting to ask why concerts have to be so loud and why it takes a week to get over a pickup game of soccer, but I think I am doing OK. Although I have just turned one of those age milestones and there are a few aches and pains showing up now and then, often in weird places too, I don’t often feel the need to seek out a doctor.

I am also British and have that whole stiff upper lip thing so I would have to have an arm hanging off by a sinew before I deign to visit a doctor. And every pain and ache I have recently developed must be the result of that unverifiable, last-second game-winning sports injury I got when I was young — nothing to do with getting older or anything. Apparently, all this isn’t a good thing.

According to Peri Venkatesh, instructor at the school of nursing at the University of Manitoba, the way men relate to their own health and the healthcare system is dangerously dysfunctional.

Our upbringing, social attitudes and sense of  machismo mean we men don’t take our own health seriously and put ourselves in danger. Venkatesh has made it his mission to change that.

He was the driving force behind the creation of Men’s Health: Concerns, Issues and Myths, a nursing elective that is now offered as part of the four-year nursing baccalaureate degree at the University of Manitoba. With the course now offered at other sites outside the university, the U of M can proudly claim it is leading the way in this field of nursing education.
“I looked at the nursing curriculum and there was no men’s health course. There was a specific course on women’s health but nothing devoted to issues surrounding men and how they relate to their own health and interact with the healthcare system,” says Venkatesh, whose passion for men’s health issues goes back to his master’s thesis on prostate cancer. “There is this myth that, in the past, health research was focused on men to the detriment of women. But health research tended to be non gender-specific and, as a result, a number of women’s issues were under-studied but so were male specific issues. Today, while we see a lot of study into issues like breast cancer and menopause we are still ignoring male issues. We know that gender is a determinant in health outcomes and that men do worse than women in almost all major health categories, but it is only now that we are starting to explore the reasons for that.”

Among the leading causes of death in adults, men often have higher mortality rates. Men lead women in the number of fatal heart attacks, strokes, most cancers and liver disease. Men also die and suffer from illnesses and conditions once thought of as women’s diseases, such as breast cancer, osteoporosis and the male equivalent of menopause – andropause. Add to that we are victims of almost all work related accidents, unintentional injuries and a majority of homicides it’s a wonder any of us make it to retirement at  all. Over the last one hundred years the average life expectancy for both men and women has increased significantly. Yet the gap between both has also remained constant.  

On average, women live six to eight years longer than men. This significant gender gap is  one of the things Venkatesh is trying to explain with his men’s health course.

“Men are much more reluctant to seek medical help and tend to ignore pain often until it is too late. Women are much more proactive and are not afraid to go to the doctor or talk to a nurse,” says Venkatesh. “Many times it is the spouse who forces the man to seek attention. Men are brought up to be stoic and macho. We are brought up to believe illness equals weakness. We worry that illness will prevent us from doing our jobs and providing for our families. Men experience disease differently. This course is designed to look at some of these attitudes and how they can be addressed and even changed.”

The course has proved to be popular with both male and female students. As an elective, it was not planned to be offered every year but the demand is so high the course remains on the curriculum. Venkatesh’s goal was also to make the information available to as wide an audience as possible. With no nursing prerequisites required, students from any faculty can take the course for credit. “I wanted this course to be about awareness and the more people who can become aware of men’s health issues the better. Most of the people who take the course come away saying they learned something new. Even the nursing students say they come away with a new understanding of how they can relate to their male patients.”

Societal attitudes are slowly changing. With the avalanche of oblique television ads for Viagra and Cialis the issue of male sexuality and aging is out in the open. There are now many publications that promote men’s health (although you could be forgiven for thinking “men’s health” actually meant “men’s abs”). Prostate cancer is now talked about openly, and what used to be a simple stilted “how are you doing?” chat between doctor and male patient now features “that” examination. Of course, women roll their eyes at such anxiety having had to go through a battery of equally invasive exams from their teens on, but men are still very uncomfortable talking about things like rectal exams and colonoscopies as if undergoing them is an assault on their manhood.

According to Venkatesh there is still a lot of work to do. Many men still don’t perform self exams for testicular cancer, are still reluctant to seek out exams for prostate cancer and still abuse their bodies with much higher rates of alcohol and drug abuse than women. Men also seem to have a harder time dealing with death and disease. “This course tries to address where men are coming from and why they have the attitudes they do. Why do men do what they do? How do men deal with stress, anger and depression? What is the impact of aging, unemployment and fatherhood on men? We also look at how spouses, partners, the healthcare system and men themselves can encourage better outcomes.”