Men's Health

An Introduction

Diana Karczmarczyk, Susan A. Milstein

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781351022606
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

This comprehensive book addresses men's health and wellness in the context of the male psyche, provides up to date research on men's health, discusses theoretical frameworks, shares perspectives from men and lists consumer resources and tools.

Men's Health explores social, cultural, physical and psychological approaches to men's health with sections focusing on the psycho-social issues, the body, relationships, healthy living and aging, while taking into account cultural differences. Each chapter:

• provides a review of the current science and emerging research of the topic;
• outlines theoretical frameworks, best practices and recommendations for advancing men's health through service delivery, research, education, policy and advocacy;
• features a personal assessment tool on the topic; and
• includes vignettes from men, their friends and families, and care providers.

Suitable for students taking undergraduate courses on men's health and wellness, this broad-ranging textbook is the ideal introduction to the topic.

Part I

Male psyche

1Introduction to men’s health

Susan A. Milstein and Diana Karczmarczyk

What is health?

In order to have a discussion about men’s health, it’s important to first define the word “health.” In decades past, being sick or healthy were seen as two sides of a coin, you were either one or the other. Looking at health this way is limiting because it does not take into account that while someone might not be sick, that doesn’t mean they’re healthy. Defining people as only being sick or healthy also doesn’t speak to their quality of life.

Did you know?

In the preamble of its constitution, the World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

(2019a, para. 1)

In the 1980s the wellness movement became recognized worldwide, and this helped to change how we talk about health (WHO, 2019b). This movement brought with it a new way of looking at health, creating models where there were multiple dimensions of health and wellness instead of focusing solely on whether someone is sick or healthy. Today the terms health and wellness are often used interchangeably, and there are multiple models of health and wellness that exist. Most models use four similar basic dimensions of health: physical, spiritual, social and psychological, and all of these dimensions can be thought of as existing on a continuum. It’s important to include a discussion of these dimensions in a book on men’s health because many men equate physical health with general health, while often ignoring the other dimensions.

Physical health is how the body is functioning. Physical health is not the same as one’s overall health. It’s possible to have a healthy looking physique, and have high cholesterol. It’s possible to be managing a long-term chronic disease, and ultimately die because of old age and not complications related to the disease.

Spiritual health is a person’s understanding that their life has purpose. For some people, spiritual health is linked to their religious beliefs. Whether a person is religious or not, spiritual health is still an important component of one’s overall health.

Social health is about the relationships that one forms with other people. It’s important to note, especially at a time when some people focus on the number of followers they have on social media and the number of likes or views their posts get, that social health is not necessarily about the number of friends you have. Social health is about the quality of the relationships you have with others, whether they are offline or online.

In some models, emotional and mental health are separated into two distinct dimensions, but in others they are presented under the umbrella term of psychological health. Psychological health is not merely the presence or absence of mental illness. It’s also about people’s ability to recognize and understand emotions and the ability to express emotions in a healthy way.

Did you know?

Men are 24% less likely than women to have visited a doctor in the past 12 months.

(AHRQ, 2012)

In his own words

Ali Rezaian, George Mason University, student – class of 2016

The fact is that a majority of common health issues affecting men are not receiving the attention that they should. Much of this may simply have to do with men attempting to align with the commonly held perceptions of them in today’s society, where their masculinity is seemingly compromised if they take an interest in seeking help. Statistics on health discrepancies between men and women are alarming to say the least. Men also deal with many more emotional troubles than people realize, as well.

Socio-ecological model

There are many theories about what shapes the health behaviors of individuals. The socio-ecological model (SEM) describes the different levels of influence that explain people’s behaviors and who or what may impact them in changing their behaviors (Kilanowski, 2017). At the core of this model is the principle that individuals are shaped by their environment and those around them, and how individuals can impact the environment and those around them. The model is typically depicted with nested circles with the innermost circle being the individual, referred to as intrapersonal (see Figure 1.1). Individuals have their own knowledge, beliefs and existing health behaviors. In health promotion efforts, the focus on this level usually results in directing education and/or developing the skill set of the individual to improve their health. The next circle closest to the individual is indicated by the interpersonal level of influence. This level includes the individual’s friends or family. These are the people in the individual’s life that can impact the choices they make about health. For example, an individual who smokes is influenced by their family members. So, if the individual wants to quit smoking but the rest of the family continues to smoke, then the likelihood of that individual being successful lowers. However, if the rest of the family members that smoke also quit, then the chances are higher that the individual will be able to successfully quit.

Figure 1.1Levels of influence in the socio-ecological model.

Source: Developed by Susan A. Milstein, 2019.

The next level of influence is typically indicated as community. This can include where the individual lives, works, plays or prays. For example, if the individual works in a company that promotes physical activity and there is a soccer/football field nearby, then the individual may be more likely to join the soccer/football team and play on a regular basis. Finally, the model recognizes that policies and/or laws at the local, state and national levels can influence behavior. However, a policy alone may not change behavior. For example, there may be a law in place that drivers and all passengers in a motor vehicle wear their seat belt. Though many will use their seat belts, there is not a guarantee that all will. So, if all levels are addressed simultaneously with public health promotion efforts, then it increases the chances that an individual may learn new information or a skill, be reminded to behave in a specific way because a friend also learned new information or a skill, be reminded, or even supported, to behave in a way in their community, or follow the direction of a policy.

Using the SEM as a framework to view men’s health is important. Just by reading this book it is possible that individuals may change their beliefs about men’s health. It is also possible that some may change their own behaviors. If someone learns new information or develops a skill as a result of this book and shares that with another individual, then the second level of influence (interpersonal) comes into play. Ultimately, the messages that are shared throughout this book will challenge communities across the globe to consider how they support men in achieving optimal health and wellness. These philosophical shifts can then be supported with legislation.

Did you know?

Men are twice as likely as women to meet the criteria for alcohol dependence at some point in their lives.

(Hasin, Stinson, Ogburn, & Grant, 2007)

Men’s health

The past

Historically, men were the focus of medical research. This meant that the understanding of signs and symptoms of disease, as well as treatment options, were male centered. Women were essentially neglected in the research. Eventually there was a recognition that what applied to men didn’t always apply to women, so there was a movement toward focusing on women and dedicating research to their specific needs. What has happened as a result of this is that women’s health has improved, but men’s health has not. Also, while the early research may have focused on men, it did not focus on how men access medical care, or how their needs might be different when seeking and receiving information.

In recent years, a new type of medicine has emerged, called gender-specific medicine. Legato (2019) explains that “[g]ender-specific medicine is not the study of women’s health; it is the study of ways in which biological sex and gender impact normal human function and the differences in men’s and women’s experience of disease” (para. 1).

In his own words

Anonymous, Interviewee #4, shared by Kayla Hense and Thomas Brunot

Growing up, his idea of being a father was providing food and house. That was it. We never really did father-son things, typical things like throwing a ball around. He was always working, so what I got from that was take care of your friends and family, and to me that’s a masculine thing to do – being there for people financially. My mother and my older sister taught me how to be there for people emotionally. They taught me how to be a gentleman – how to treat women with respect and simple stuff like that. Everything else about how to be a man (well what my idea of what a man should be) I learned on my own.

The present

In general, when we talk about health, we’re usually talking about it because things aren’t going well. The truth is that there is something wrong with the health of men, and we haven’t done enough to improve their health. Men are suffering more than women. While it may be that they interpret pain differently from women, the data supports that pain is negatively impacting their quality of life. Men are dying younger than women in every region of the world (Baker et al., 2014). In order to even begin addressing the health disparities between men and women, we need to address one of the biggest issues impacting men’s health, which is that of masculinity.

There are many ways that masculinity can be manifested. Traditional masculinity implies that men are strong, that they feel no pain, and that they don’t need help with anything. What these views have done is create generations of men and boys who feel that their need to be strong is more important than their need to take care of themselves. Traditional masculinity has taught men that it’s not okay to be emotional, but that it’s okay to be violent and aggressive. This directly impacts men’s mental and physical health, as well as their relationships with others. If a man is taught that he doesn’t feel sad or hopeless, he is not going to willingly seek out help for mental health issues. What he may do instead is turn to alcohol to mask what he’s feeling, which can then impact those around him.

What this also means is that when the topic of men’s health is discussed, some men may see it as an attack on their masculinity, implying that they are weak or damaged. This perceived attack may make some men feel vulnerable, embarrassed, or scared which may prevent them from seeking medical care. These feelings can also be exacerbated by the fact that many of the questions that are asked by doctors may put them on the defensive, for example, “Why didn’t you do something about this sooner?” This is one of the reasons why, when men do go to the doctor, the illness or pain has progressed to a point where they have limited treatment options.

Did you know?

Men are almost four times more likely to die by suicide than women.

(Centers for Disease Control and Prevention, 2015)

In his own words

Larry Jayson, 72. Father, grandfather

In August or September of 2018 when I got out of the shower, I noted a little drop of blood on my left nipple. It happened two or three times, it was never more than a trickle, and I put on a band aid and the next day there would be no blood. The third time it happened, I called my doctor’s office. I got a call from her office the next day saying “get your butt over to the cancer center and do it now.” They did some tests and found cancer on the left side, and one or two spots on the right side. At the beginning of October, I had a double mastectomy. My doctor said that only 3% of cases he’s ever done were on men. When it first happened I didn’t feel like I wanted to talk to anyone about it. I told my board of directors and my staff, but other than those ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• List of figures
• List of tables
• List of contributors
• Preface
• Acknowledgments
• Part I Male psyche
• Part II The body
• Part III Relationships
• Part IV Staying healthy
• Index