I went for a walk with a good friend last week. A really good friend, who I have trusted with many of my hardest challenges. I haven’t seen him for more than a year – one of the many little heartaches that have been part of the ongoing fallout from the pandemic. We caught up quickly, as good friends do. He had lost his father a few months prior – and his grief was still palpable. “It’s just so hard to grieve,” he said. “I feel so lonely.”
We walked in silence for a few moments. I wasn’t sure what to say to one of my most gregarious friends – so obviously in pain. The moment passed and we started talking about more comfortable subjects. As we neared the end of our walk he turned to me and said “Thank you. I feel so much better.”
I made my way home but our conversation has stayed with me. I realized that my friend – who has been a source of strength to me for so long, was struggling himself. For the first time in our friendship, he had reached out.
Mental Health Awareness is all around us. In fact, we have just observed Mental Health Week in Canada. I am struck by the pandemics effect on mental health and wellness. It has heightened the sense of isolation that many of us feel. Men in particular are far less likely than women to reach out for help when they are feeling lonely or sad. According to data from the Canadian Mental Health Association, four times as many men than women commit suicide.
With father’s day just around the corner, many of us who have lost our fathers, or our brothers, or our husbands or our friends start to feel a sense of dread. As a female physician who contributes to Men’s Health, the stark statistics that I have learned over the years seem particularly poignant this year.
The average male lifespan is about 5 years less for men than women in Canada, and about 7 years less worldwide. Of the top thirteen causes of death in Canada, including all cancers, cardiovascular disease, accidental and non-accidental trauma to name a few, men lead women in twelve of them. Women tend to die more frequently than men from the ravages of dementia/Alzheimer’s disease. The theory behind this is that men simply don’t live long enough to die as frequently from this disease process.
Men are more likely to smoke, drink alcohol excessively and eat a poor diet. In Canada and in many other countries, men use primary care services less effectively and less often than women.
The Covid-19 pandemic has highlighted these disparities. The virus has killed about 13 men for every 10 women. Nobody knows the precise reason for this. Early research points to a multiplicity of reasons across the spectrum of biologic, behavioral, social, and psychological factors.
The Center for Disease Control in the United States highlights the differences in immune response between the genders. The Covid-19 virus has been shown to use a specific enzyme (angiotensin-converting enzyme 2) to gain entry into and begin to damage normal cell function. Men innately have higher levels of this enzyme than women do. This partially explains the gender discrepancy, but there are numerous other behavioral and psychosocial factors that also contribute.
Men have been found to engage in higher risk behavior with respect to virus transmission. They tend to have lower rates than women when factors such as handwashing, social distancing and mask wearing are studied. Their higher rates of tobacco use and alcohol consumption also contribute.
Society has taught men to hide their fear – an important consideration when evaluating personal response to the unknowns of the COVID-19 pandemic. Research shows that people who respond with fear, tend to downplay risk and are more resistant to risk reduction policies.
Whatever the reasons – the statistics are staggering.
A Time magazine article published earlier this week brought to light another painful statistic. Men are lagging behind women in vaccination rates. Again, the reasons are multifactorial – but the facts continue to emphasize the immense gulf between the health of our men and our women.
It may be that the pandemic is the tipping point. It has truly tested us all – in ways that we may not immediately grasp. The sense of isolation and loneliness that has accumulated over the months of restrictions in gatherings, might actually be helping. Like my friend who admitted to me that he was lonely, men who have been suffering in silence may finally begin to understand that they can reach out for help, and that there are more effective ways to cope than silence.
If population health is to be improved, targeted steps must be taken to improve men’s health as well as women’s. This is not a choice between men’s health and women’s health – as improving the health of men will also improve the health of women. At Calgary Prostate Cancer Center, we are working on developing a multifaceted Men’s Health Center – focusing on mental and physical health. This will be incredibly helpful. We must continue to work toward changing policies focusing on reducing gender inequities in health. In the meantime, let’s use this year’s Men’s Health Month to reach out to the men in our life. Let’s give them the opportunity to open up and talk about the mental and physical health issues that are worrying them. It’s a start.
Shelley J Spaner, MD, FRCP
Founder – Women for Men’s Health
Board Member – Calgary Prostate Cancer Center