This review critically examines literature about men and their health status to inform considerations about men’s health in New Zealand.
Purpose
The aim of this review is to examine literature about 'men's health'. Particularly looking for literature which critically examines existing health care models and describes alternatives. There are particular bodies of literature in relation to specific groupings of men which are only briefly addressed in this literature review, in particular 'gay men', men with HIV/AIDS, and men with disability or chronic illness. The review includes a summary of the key issues relating to:
- Men's health in New Zealand
- The status of men's health
- Men, masculinity and health
- Young men and their health
- Initiatives to improve men's health including a description of:
- Workplace initiatives
- Community initiatives, including one-off initiatives and multifaceted programmes which provide a number of different services or target particular groupings of men
- Primary care initiatives including discussion about the influence of the gender of the patient and/or the GP and the discussion about health screening
- Stand-alone initiatives that utilise a primary care philosophy of practice.
Key Results
The review confirmed that health outcomes were poorer for New Zealand men than women, in terms of morbidity, mortality and life expectancy. The literature identified several factors proven or suspected to cause the disparities in health outcomes between men and women. There was, however, little agreement on which of these factors impacted most on men’s health, and how to address these factors. The findings from the review suggested more in-depth research was needed to provide a foundation for effective strategies to improve men’s health.
Most of the literature considered had been written in the past 20 years, with the majority since the mid 1990s. It covered descriptive reports on the biological status of men’s health; comparative studies on men’s and women’s health; philosophical and sociological analyses of masculinity and the male role; health disparity analyses; impact of health professional action on men’s health, and original research on interventions to improve men’s health.
The literature review found that the extent to which biological differences between men and women affect health was debated. There was agreement that the health status of men was linked and shaped both by the nature of social organisation with accompanying socially defined roles, and also economic opportunity which negatively impacted on particular groupings of men. However, it was unknown which of these factors impacted most on men’s health and if and how this could be addressed.
Men are not a homogenous group, and health status varies according to a number of factors; most-notably socioeconomic status and ethnicity. Interventions designed to address these factors have largely not been evaluated. The need for more original research to clarify these factors was signalled. Suggested research should include work on understanding men’s health beliefs; behaviours which facilitate help-seeking, and identifying possible failures in the current health service systems. Masculine roles and ideologies (including those of male health professionals) were most likely to play a part in discouraging men’s help-seeking.
There was agreement that the wider determinants of health must be taken into account, including policy relating to employment, education, housing, social welfare, and justice. Access to health for underserved populations must be improved. In groups of men with increased vulnerability to illness, there needs to be more attention on promoting healthy lifestyles and improving timely access to affordable health care. Policy should aim to address how men’s behaviour and lifestyles contribute to their immediate and long-term health needs. Those involved in local delivery of health care should consider how men can be specifically targeted so their health care requirements can be identified and addressed.