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Is it time to stop beating up on men?

The health sector, strangely enough, has a long history of beating up on those it is meant to serve. Men, for example, have been widely castigated for being “poor patients”. What this means is that they haven’t always done what health services or health professionals think they should – ie turn up for appointments, seek help earlier rather than later and so on.

The Federal Government is due to release the country’s first national men’s health policy sometime soon. It’s likely that the policy will try to change some of the rhetoric around men’s health – instead of blaming men for not engaging, the policy may just turn the tables, and ask health services to take a hard look at themselves and what they could do to become more men-friendly.

At least that’s the guess I’m making after reading the information paper that was released earlier this year to support the policy’s development.

“It may be that it is the nature of services that determines willingness to seek help, suggesting the explanation of ‘masculinities’ for lower rates of men’s use of services may not be accurate,” says the paper. “Considerations of availability, access and suitability of services in line with men’s values and practices is likely to offer more fruitful explanations and ways to better engage men with appropriate health service use.”

Men’s health expert, Professor John Macdonald, believes the policy offers a “watershed” moment for men’s health. He writes:

“There will be an Australian National Men’s Health Policy this year, only the second in the world. Unnoticed by many, there has been a national discussion across the country about men’s health needs, initiated by the Department of Health and Ageing.

Instead of academics or medicos saying what men’s health needs are, men themselves were actually asked.

Among other things, the document used to promote this national debate speaks of a social determinants approach to men’s health as well as the need to think of male-friendly health services.

In the first instance, let’s look at the context of men’s lives: the impact of schooling on their health, of work- think of the high rate of industrial accidents in jobs men have to do, or the impact of job insecurity, of social isolation (the population most at risk of suicide in our country is older isolated men), the terrible effects of racism on Aboriginal and Torres Strait Islander men. The call to look at the social determinants of men’s health seems enlightened and compassionate.

The mention of “male-friendly” services marks a watershed.

Men themselves are often seen in our culture to be responsible for their poorer health and blamed for “not going to the doctor”. Whatever truth there may be in this, for once the spotlight can be turned on the doctors and community health services and we can (and I do) ask: “what are you doing to make yourselves “male-friendly”? Not very controversial, one might think. Alas, not so.

Leaving aside the issue of medicine (in this case urology) wanting the top place at the table (of men’s health, and indeed it should have a place), a recent issue of the Health Promotion Journal of Australia shows us that the knives are out to try to ensure the vision of the discussion document gets jettisoned.

Instead, two articles tell us, we should place male violence squarely at the centre of any men’s health policy, and focus on “hegemonic masculinity”.

Australia, Australia! Violence IS a Public health issue. The contradictions of men’s behaviour should not be avoided. Many countries are acknowledging it, both at its worst in sexual abuse but also the physical and psychological manifestations. of course, “No to violence against women!” (Also “No, to violence against children!” the main perpetrators of which are women, incidentally. Check it out!).

But I know of no other country in which academics would rise up in the year of a men’s health policy to demand that violence be central to that policy. S

ome would even say that gender equity as a social determinant is only about the imbalance of power between men and women in society and therefore nothing to do with the inaccessibility of many health services to men.

Gender as a social determinant would be only about this same imbalance and so we don’t have to look at the things already mentioned: health of boys in schools (unless we believe that the enormous amount of Ritalin dispensed to young boys (mainly) is because of their participation in hegemonic masculinity; likewise the many health-damaging male – another manifestation of hegemonic masculinity; socially isolated older men at risk of suicide – their masculinity is the problem, it seems. Aboriginal an Torres Strait Islander men, maybe they die 17 years younger than the rest of us because of the original sin of being “masculine”.

If we want a rational and compassionate men’s health policy, why would we start from the negative?

As a man, I will be castigated for challenging this “received wisdom” So be it.

Thank goodness there are many women who will also be sad if the government is cowed into changing tack and bringing out a men’s health policy focused on non-evidence based sociological constructs to please a certain lobby.

Let’s move away from gender wars and try to work with government to build a balanced, rational, not-afraid-to-look-at-all-contradictions–of-gendered-behaviour health policies for men and women, boys and girls.

• Professor John J Macdonald is Foundation Chair in Primary Health Care and Co-Director, Men’s Health Information and Resource Centre, University of Western Sydney

Comments 6

  1. Biskit says:

    I’d love to ‘check it out’ that women are more violent to children – could you provide a link or a reference please? Ta.

  2. Croakey says:

    Bernard Denner, a men’s health consultant, asked for these comments to be posted:

    “Johns comments….wow…but he is right about Violence not a good place to start or basis of NMH Policy

    What he and others seem to forget is that the emphasis has always been on At Risk men….what about the general community of men who ‘suffer’ from lack of Understanding of their health/lack of skills to deal with issues eg…parenting/relationships when they go bad/dismissal/change of who they are/being ‘older’ and more vulnerable/status and the simple but impacting…general health issues that take men so earlier based on ignorance or lack of knowledge of their bodies/or genetic history

    John…seems to forget that the average bloke is just as at risk from….early mortality as the man at risk of suicide and CVD/Cancers/etc etc…far out way the cause for early mortality of men

    As for our Indigenous men….or for that any matter remote males (& women)….early mortality is imminent as emergency medical intervention is not available as in urban areas. When we separate the Indigenous urban populations we find that Indigenous life expectancy is so far better when they are urbanized and have the access to health services….

    It’s funny that no one gets real upset about ‘white people’ who have up to a 7 yr less life expectancy if they live in rural Aust.

    Interesting times ahead for MH and the Policy….hope it simply provides men with better access to services and more male friendly as he (John) is very right about health services taking some responsibility in the way the access men and provide access for men…this is probably the main issue..access and male friendly services.

  3. Doctor Whom says:

    Mens Health Issues are real. But we do see a polarisation from rhetoricians of all ilks.

    Some, not all, see the roots of many of womens ills (mental illness, poverty, homlessness, injuries due to violence to name a few) as lying in a patriarchal society that is orientated to men as the dominant group. Some of womens ills causes lay with individual men.

    There has been some success with making some specific services women friendly and a great deal of success in making mainstream serves more women friendly.

    Women friendly doesn’t always mean friendly for all women – some GLB services aren’t all that friendly feeling for hetro women and many mainstream service are not welcoming for GLB women. Some services for younger women aren’t working well for older women and vice versa. Some service work well for educated middle class women but not for others. In general women friendly services should also be child friendly.

    Teenage friendly services is another challenge altogether however apart from a few key areas teenagers are relatively healthy bunch.

    The same principles, not necessarily the exact same services, should work for men. At the moment it largely finger pointing at the men and blaming with not much looking at what can be done to deliver services in a way that is accessible to men.

    Its becoming a bit of a cliche but in some places Mens Sheds are doing some innovative things with older mainly retired guys around health and inclusion and connectedness.

    Workplace schemes have a great potential to be the new way to engage both men and women who are not currently engaged in looking after their own health.

    In these areas interesting models arising in aboriginal health where self run, self managed groups of aboriginal men are looking at their own health and healing. There is a health focus and a political reconciliation focus. And an acknowledgement of anger at injustice and alcohol and its role in violence toward aboriginal women and their own health.

    Similarly with smoking – the higher socio economic classes have got the message – we need now to work with men of lower socio economic groups to see what will work to assist them to stop smoking.

  4. Croakey says:

    John Macdonald asked me to post this response to Biskit’s comment:

    I welcome the query.

    I think the focus should be on the children.
    I also think we should not lump together “violence against women” which
    is clearly mainly perpetrated by men and “Violence against women and
    children” if this implies that the perpetrators are mainly men

    I would welcome any comment on these two websites (below)

    I have notice a difference between the response of both women and men
    – those who work in the community in a general way and who generally
    agree with what I say
    – those who have worked with battered women in refuges etc and who
    understandably have a certain perspective
    – a group of academics both women and men who seem to find it difficult
    to accept that women can be perpetrators of violence of any kind, e.g.
    of elder abuse

    I think if we want to help we must be clear about facts and
    compassionate when called for

    Her are the two websites

    http://www.menshealthaustralia.net/index.php?option=com_content&task=vie
    w&id=626&Itemid=81

    http://www.menshealthaustralia.net/index.php?option=com_content&task=vie
    w&id=556&Itemid=79

    Hoping for a dialogue

    John Macdonald

  5. Biskit says:

    thanks for the links. I didn’t necessarily disagree with the statement, I just wanted to see it substantiated.

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Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu