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A boy born today will live nearly four years less than a girl born in the room next door. One in four won’t live to retire. What are the biggest killers of Kiwi men – and what can we do about it? For Mens Health Week, Jamie Morton looks at four troubling statistics.
It might not be the deadliest cancer among men – but prostate remains the most commonly diagnosed one, with around one in eight Kiwi males developing it within their lifetimes.
While the incidence of prostate cancer is increasing in New Zealand – largely due to better outcomes from early diagnosis and improved treatments available – its causes still aren’t fully understood.
“If you have a first-degree relative who’d had a diagnosis of prostate cancer, then you yourself are twice as likely to be at risk of the disease than someone in the general population,” he said.
Because prostate cancer often doesn’t produce symptoms until the condition is quite advanced – it’s typically found after treatment is sought for problems with urinary function – doctors can’t stress enough the need for men over 50, or over 40 if they have a family history, to get tested.
Cardiovascular diseases are the main cause of death, followed by strokes which happen when an artery in the brain is blocked or leaks, and remain the largest cause of disability in adults here.
Some of the risk factors for the most common type of heart disease, coronary artery disease or CAD, can’t be avoided – and these range from age and ethnicity to family history.
Cardiologist and Heart Foundation medical director Associate Professor Gerry Devlin said New Zealand’s mortality rate from heart disease had fallen by around 75 per cent from a peak in the late 1960s and early 1970s, when one in two Kiwis smoked.
Yet rates hadn’t come down nearly low enough – given annual hospital admissions from heart attacks hadn’t dropped far below a new baseline of around 15,000 cases over the last decade.
“New Zealanders might be living longer – but we’re also living longer with heart disease and other conditions, and I think it’s important for us to recognise and respond to that.”
“A million New Zealanders are living with hypertension. A 5mm [by Hg] reduction in systolic blood pressure reduces your chances of having a heart attack or stroke by 10 per cent.
People should seek regular heart and diabetes checks if they have a family history of heart problems, or are over certain ages: that’s 45 and 55 for European men and women respectively, and 30 and 40 for Māori, Pacific and South-Asian men and women respectively.
While working as a clinical psychologist in an inpatient hospital, he noticed the bulk of patients were men – while many of the women there were the victims of violence from men.
“It became pretty clear to me that there was a pattern with gender: and when you’re in the deep end of mental health, you begin thinking, why are these people showing up?”
Again, mental health is an issue far from exclusive to men – and women in New Zealand are more likely to experience and report depression, anxiety and mental distress.
O’Sullivan said he’d been shocked to see men battling mental health problems journey through the health system without sharing their emotions – and often choose outlets such as drinking, anger and violence instead.
A sense among men of needing to preserve masculinity was a common theme he’d seen in his work in the sector – and also through his travelling documentary series, Tough Talk.
“They certainly don’t want to be seen as weak – and there’s also this idea of success, and not wanting to be seen as unattractive to partners or potential partners.”
One 2018 report investigating the building sector’s high suicide rate – something the national programme Mates in Construction is now trying to tackle – singled out a culture of toxic masculinity.
O’Sullivan pointed out that Māori men – particularly younger ones – also had higher suicide rates than other ethnic groups, and he saw a need for Pākehā to recognise and address how colonisation had played a harmful role.
Clinicians recommend eating well-balanced diets, staying physically active, avoiding turning to drugs and alcohol, staying connected and talking with loved ones – and perhaps most importantly, always asking for help.
A disproportionate rate of coronavirus-linked deaths have involved Māori and Pasifika people, who, even after taking age and pre-existing conditions into account, were respectively two and half and three times more likely to need hospital level care for Covid-19.
Among men in particular, Māori males have a life expectancy of just 73 years, and Pacific men 74.5 years, compared with about 80.3 years for their non-Māori counterparts.
While cancer remains the major cause of death – Māori men are 1.7 times more likely to die from it than non-Māori – heart disease is the second biggest killer, and deaths among Māori and Pacific men happen to occur five to 15 years earlier.
None of these appalling statistics are at all surprising to Adrian Te Patu – the first indigenous person appointed to the World Federation of Public Health Associations.
“We know an unfair burden of unwellness is carried by 20 to 25 per cent of the population in this country – and that’s not a political statement,” the Māori health advocate said.
Māori and Pacific people live with higher co-morbidities, but also face inequity and structural racism within the health system, and, as Covid-19 vaccination rates have illustrated, have poorer access to care.
Even today, Māori on average earn two thirds of the average European income while home ownership rates are less than half of the national average of over 64 per cent.
Given this, Te Patu didn’t blame many Māori for moving across the Tasman to Australia, where they could earn higher incomes, enjoy better health services and raise tamariki in warmer, drier homes.
He thought it worrying that New Zealand was having to pour tens of millions of dollars into providing care for preventable diseases like diabetes, which accounts for about six per cent of Māori deaths.
source: New Zealand Herald