Chapter 18
Men’s Health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Longevity and Mortality in Men
Rates of longevity are increasing for both
men and women.
Gender disparity for life expectancy and mortality has
decreased, but mortality rates for men remain higher
than those for women.
Factors influencing mortality rates include race or
ethnic origin, socioeconomic status, and education.
Males continue to be at risk for death resulting from
unintentional injury and homicide.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Morbidity in Men’s Health
Men tend to perceive themselves to be in better
health than do women.
Women are more likely to be ill, whereas men are at
greater risk for death.
Incidence rate for acute and chronic conditions is
higher for women than for men; injuries are higher for
men than women.
Women have higher morbidity rates than men, but
men have higher morbidity and mortality rates for
conditions that are the leading causes of death.
.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Precursors of Death Frequently NOT Addressed
by the Present Health Care System
Heart disease and
stroke
Hypercholesterolemia
Hypertension
Diabetes mellitus
Obesity
Type A personality
Family history
Lack of exercise
Cigarette smoking
Cancer
Sunlight
Radiation
Occupational hazards
Water pollution
Air pollution
Dietary patterns
Alcohol
Heredity
Certain medical
conditions
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Men’s Use of Medical Care
Men do not engage in health protective
behaviors at frequently as women.
Most men do not have routine check-ups,
including screenings.
Men seek ambulatory care less often than
women.
➢
Men delay medical treatment → are sicker when
they do seek health care → therefore they require
more intensive medical care.
Men tend to have longer lengths of stay in the
hospital than women.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Male-Female Health Paradox
Females are sicker,
but males die sooner?
– Verbrugge and
Wingard (1987)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
6
Male-Female Health Paradox
(Cont.)
Biological factors
➢
Genetics, effects of sex hormones, and
physiological differences Influenced by
genetics, hormones, and environment
Socialization
➢
Men enculturate their sons to believe
that risking personal injury
demonstrates masculinity.
➢ Men are more likely to change health
behaviors when supported by female
family members.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Male-Female Health Paradox
(Cont.)
Orientation toward illness and
prevention
➢
Stereotypical view of men as strong and
invulnerable is incongruent with health
promotion.
➢ Men lack the somatic awareness and are
less likely to interpret symptoms as
indicators of illness.
➢ Men may have a desire to rationalize
symptoms and deny their susceptibility
to disease, thus delaying treatment.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Male-Female Health Paradox
(Cont.)
Data collection on health behaviors
may not be accurate:
➢
Males are less likely than females to
participate in the data collection process.
➢ Social pressure for males to be less
expressive (suppress their emotions)
may help explain gender differences in
reporting health behaviors.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Nurse’s Responsibilities with Men’s
Health
Use gender-specific interview techniques to
obtain the most accurate health history.
Be aware of personal gender bias in data
collection.
Be aware of the accuracy and interpretation
of secondary sources of information.
Help men learn how to provide support to the
caregiver or to develop a caregiver role.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Nurse’s Responsibilities with Men’s
Health (Cont.)
Acknowledge that gender-linked behaviors
increase risks:
➢
➢
➢
Lifestyle factors (e.g., use of tobacco, substance
abuse, poor preventive health habits and stress,
lack of emotional channels)
Men’s unwillingness to seek preventive care
Men’s unwillingness to seek health care when a
symptom arises
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Barriers to Health Care for Men
Little effort has been made to create a malespecific health care climate
Access to care
➢
Focused on maintaining an effective workforce
➢ Financial support for curative—not preventive—
care
➢ Reluctance to take time off from work for care
Lack of health promotion
➢
➢
Disease prevention and health promotion not often
reflected in a man’s perception of health
Focus on disease cure in the present health care
system
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Men’s Health Care Needs
Permission to have concerns about health
and talk openly to others about them
Support for the consideration of gender role
and lifestyle influences on their physical and
mental health
Attention from professionals regarding factors
that may result in illness or influence a man’s
expression of illness, including such things as
occupational factors, leisure patterns, and
interpersonal relationships
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Men’s Health Care Needs (Cont.)
Information about how their bodies function,
what is normal, what is abnormal, what action
to take, and the role of proper nutrition and
exercise
Self-care: testicular and genital self-exams
Physical exam and history-taking that include
sexual and reproductive health and illness
across the lifespan
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Men’s Health Care Needs (Cont.)
Treatment for problems of couples, such as
interpersonal problems, infertility, family
planning, sexual concerns, and STDs
Help with fathering (i.e., being included as a
parent in child care)
Help with fathering as a single parent,
particularly with a child of the opposite
sex, in addressing the child’s sexual
development and concerns
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Men’s Health Care Needs (Cont.)
Recognition that feelings of confusion and
uncertainty in a time of rapid social change
are normal and that they may mark the onset
of healthy adaptation to change
Adjustment of the health care system to
men’s occupational constraints regarding time
and location of health care sources
Financial ways to obtain these goals
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Primary Prevention Measures
Provide health education and
screening in the workplace
Participate in interest groups and
research focused on men’s health
Encourage interest in physical
fitness and lifestyle changes
Include the male perception of
health in policy formation
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Secondary Prevention Measures
Tailor health care clinics to men’s needs
Provide screening services for men
➢
➢
➢
➢
➢
➢
➢
➢
Dental examination: Yearly
Eye examination: Every 3 to 5 years
Blood pressure check: Every 2 years
Blood cholesterol check for men aged 53 years and older
Prostate examination: Every year after age 50; blacks every
year after age 40
Colorectal screening: Every 3 to 5 years
Tobacco use and cessation information every year
One-time screening for abdominal aortic aneurysm for men
65 years old if the male has smoked
– The U.S. Preventive Services Task Force (2004)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Tertiary Prevention Measures
Provide rehabilitation with sex role and
lifestyle considerations
➢
Provide counseling on lifestyle, role changes, and
job retraining.
➢ Give men permission to express emotions.
➢ Adapt goal setting to meet men’s needs.
➢ Keep time away from work to a minimum.
Develop new concepts of community care
➢
Provide specific services for men; adapt care to
meet needs of male population in the community.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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