A Proposed Longitudinal Study of Boys' and Men's Health and Well-Being in Greater Sydney, Australia

By Monaem, Abdul; MacDonald, John J. et al. | International Journal of Men's Health, Summer 2008 | Go to article overview

A Proposed Longitudinal Study of Boys' and Men's Health and Well-Being in Greater Sydney, Australia


Monaem, Abdul, MacDonald, John J., Woods, Micheal, Hughes, Rodney, Orchard, Michael, Jasprizza, Elizabeth, International Journal of Men's Health


Men's and boys' health is a significant public health issue in Australia and, by most indicators, it is poorer than that of women. Numerous epidemiological studies have found premature deaths in this population from heart disease, cancer, accidents, injuries and suicide. There is little research evidence, at least in the Australian context, of the negative or positive influence of social determinants on the health of boys and men. This paper makes the case for a pilot study to be run with selected boys' and men's cohorts over a period of time. The aim is to understand better how health outcomes (physical health, mental health, positive health and resilience, access to health services, and other important health issues) are influenced over time by social determinants. The framework for such a study is provided for selected health regions in Greater Sydney, Australia.

Keywords: men's health, social determinants of health, resilience, epidemiological study, pilot longitudinal study, cohorts, CATI system

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There is a growing interest in the health of boys and men in Australia and elsewhere, not least because of the high rates of suicide in the male population (Macdonald, 2000, 2005; Nielson, Katrakis, & Raphael, 2001). Assumptions are made about male health but there is little in the way of male-specific investigation, especially in regard to male perceptions of health and health services and the social dimensions of their physical and mental well-being. One state health department in Australia has produced two significant reports regarding relevant issues in boys' and men's health that draw attention to the fact that they do have specific health problems, needs, and concerns (NSW Health, 1999, 2000).

Most epidemiological indicators suggest a markedly low health status in mortality and morbidity among Australian men (AIHW, 2004a; Draper, Turrell, & Oldenburg, 2004; Lee & Owens 2002; NSW Health, 2004a). Life expectancy at birth in 2000-02 was 77.9 years for men and 83.0 years for women (AIHW, 2004a). Age-specific death rates are also adverse in men compared with women. Sex-ratios in these rates indicate that men aged 15-24 and 25-44 show a two-fold increase in mortality compared with women of similar ages (see Table 1).

Premature death rates in men and boys are well documented and, in Australia, are associated with certain patterns of illness, principally higher rates of heart disease, lung cancer, and injury (AIHW, 2004a; Gizzi & Monaem, 2001; Mathers, 1994; NSW Health, 2004a).

Injury-related deaths are high in men; almost one-third have occurred in men aged 20 to 44 (AIHW, 2004a). Deaths from cancer remain very significant in men. There were 20,417 male deaths compared with 15,902 female deaths from cancer (deaths from skin cancer not included) in Australia in 2001. Lung cancer accounted for 22.8% of all cancer deaths in men, followed by prostate cancer--13.3%, and colorectal cancer--12.7% (AIHW, 2006). It is known that most lung cancer in Australian men is attributable to tobacco smoking; it accounts for about 11.3% of all new cases in men compared with 7.1% in women in 2001. The higher percentage in men is due to their heavier smoking habits over the past several decades (AACR, 2003; AIHW, 2004a & b; AIHW, 2006).

Examining deaths and incidences of all cancers, Figure 1 shows that Australia has the third highest incidence of cancer in men, after New Zealand, and the U.S.A.

[FIGURE 1 OMITTED]

Suicide is also a major public health issue in Australian men (Ansari, Chipps, & Stewart, 200 l; Monaem, 2005; Wesley Mission, 2004). There were suicide 2,098 deaths in Australia in 2004, and men accounted for 80% of these (ABS, 2006a). Suicides are significantly higher among men aged 25-29, 30-34, 35-39, 40-45, and 75 and over (see Figure 2). The causes are many. Mental health disorders, mental problems, and substance abuse are found to play an important role in suicide attempts and deaths (Maris, Berman, & Silverman, 2000; Overholser, Freiheit, & DiFilipo, 1997). …

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