The health of males in Australia lags behind that of females on most measures of mortality and morbidity and males bear a larger share of the overall burden of disease than do females. There are three primary factors contributing to poorer male health outcomes:
- Biology – Sex specific biological differences in utero and early life lead to a higher rate of genetic abnormalities in males than females. Naturally, the specific male anatomy of the testicles and prostate leads to male specific health problems, the latter not until middle age or older. However, biology is at best a marginal contributor to overall health disparities between the sexes. The significant differences in health outcomes that exist between socially diverse groups of males indicate that biological factors are of lesser importance in determining health outcomes for men and boys.
- Behaviour and social influence –These two factors are interconnected. Personal behaviours, including values and attitudes toward health and help seeking, largely result from social influences. These social influences and personal behaviours vary considerably depending on ethnicity, age, education and economic status, resulting in significant health differences between these groups.
- Institutional responses –This includes policies directed at and impacting on health and illness, as well as service provision that focuses on prevention, cure and the management of chronic conditions.
While biology is not readily amenable to change to improve male health, the other two factors may be altered to greater or lesser degrees. Recent attention to improving male health has focused perhaps too much on the area of individual behaviour (nutrition, physical activity, smoking etc.). This is unfortunate as there is no evidence, as yet, to suggest that this factor is more or less influential than that of institutional responses.
In fact there is considerable research evidence indicating that accessible health care, not unexpectedly, has a significant impact on health status. The reasons for the undue emphasis on behaviour and social influence appear to be based more in social politics than in research evidence regarding successful means of population health improvement. Additionally, there is often an unhelpful conflation of the individual with social, so that attempts are made to change individual behaviour while counter-acting unhealthy social influences are ignored.
For example, campaigns to encourage greater consumption of fresh fruit and vegetables by men do not overcome problems of availability and cost for those living and working in remote areas.
In summary, the male health deficit varies between different age, location, ethnic and socio-economic cohorts indicating that poor male health status is not a result of biological sex differences, but rather is the result of social factors that, if addressed, will lead to improvement in the health of many men and boys.