為何男性如此不健康——以及可以採取哪些措施

This month, the government in England is set to launch a consultation for its men's health strategy, a move that experts believe is long overdue. Men are significantly more likely to die prematurely compared to women, raising questions about the underlying reasons for their poor health and what can be done to improve it. Andrew Harrison, who once ran a men's health clinic in Bradford, recalls an incident where a young man climbed a drainpipe to ask for condoms instead of going through the reception. This story highlights the challenges men face regarding their health, including risk-taking behavior and a lack of confidence in seeking help. In the UK, men are more prone to smoking, excessive drinking, drug use, and high cholesterol and blood pressure. These factors contribute to a lower life expectancy for men, who live about four years less than women. Men are more likely to suffer from heart disease, lung cancer, liver disease, and accidents. Prof Alan White, co-founder of the Men's Health Forum charity, emphasizes the need for greater attention to men's health issues. He points out that during the pandemic, 19,000 more men than women died from Covid, questioning the lack of outrage and attention given to this disparity. He argues that it is too simplistic to attribute men's health problems solely to their lifestyles, stating, 'It's much more complex than that. ' Biological factors also play a role, as the male immune system is less effective at fighting infections. However, as illustrated by the story of the young man seeking condoms, many men lack the skills to access health services. Prof White explains, 'Men are less health-literate, meaning they don’t develop the skills to talk about their health or recognize when they need help. ' Unlike women, who have regular contact with health services for contraception, cervical screenings, and childbirth, many men go years without seeing a health professional. Dr Xand van Tulleken advocates for more men to visit the doctor regularly. Mark Brooks, a policy adviser for the All-Party Parliamentary Group on Men's and Boy's Issues, highlights societal expectations placed on men. They are often told to 'man up' and be strong, which can hinder their willingness to seek help for health issues. Additionally, Brooks points out the impact of deprivation on men's health. Men living in the poorest areas have a life expectancy that is ten years shorter than those in wealthier areas. In the most deprived communities, men are 3. 5 times more likely to die before the age of 75. He states, 'You cannot ignore the stark differences when it comes to left-behind communities and those working in blue-collar jobs like construction and manufacturing. ' The current design of health services is not effectively meeting the needs of men. NHS health checks, which are offered every five years to individuals aged 40 to 74, are crucial for addressing many diseases that lead to early male mortality. However, fewer than four in ten men take advantage of this offer. Brooks explains that men working in construction often struggle to take time off for health checks or doctor visits. He believes that employees should be entitled to paid time off for health checks and that these services should be made available in workplaces where blue-collar workers are employed. Many men in these roles are reluctant to confront health issues that arise in their 40s and 50s, often ignoring warning signs or concealing illnesses from their employers due to concerns about job security. Job-related stress, financial worries, and relationship problems are significant contributors to the high suicide rates among men, with three-quarters of suicide victims being male. Despite this, only a third of individuals referred for talking therapies are men, suggesting that services may not adequately address men's needs. Prof White notes, 'How services are set up to recognize signs of depression and anxiety is not how men express them. ' Men are more likely to exhibit anger, abuse alcohol, or withdraw from social interactions rather than openly discussing their feelings. Ethnic differences also play a role in men's health. For instance, black men in England are twice as likely to be diagnosed with prostate cancer, while men from Indian or Bangladeshi backgrounds face a higher risk of diabetes. However, this does not imply that men are uninterested in their health. Prof Paul Galdas, a men's health expert, asserts, 'Men will open up and want to be engaged, but to do that you have to base it around actions and activities. ' He has developed a six-week mental fitness program in collaboration with the Movember men's health movement, which has been trialed with NHS frontline workers following Covid. This program is now being utilized by Leeds United football club for its youth players. The initiative provides men with support to understand how their behaviors impact their moods, encouraging them to track their habits and set goals for healthy activities. These activities can include going for walks, socializing with friends, playing sports, and developing problem-solving skills to safeguard mental health. Good mental health is closely linked to good physical health. Similar activity-based initiatives can be found in various local areas where charities, councils, and men's groups collaborate to establish programs. The Men's Sheds movement is one of the most recognized, encouraging men to come together, bond, and support each other while working on practical projects. Prof White believes that now is the time to build on these foundations, and a national men's health strategy is essential. He argues that such a strategy will help 'shine a spotlight' on men's health issues, similar to the women's health strategy implemented in 2022, which led to the establishment of women's health hubs and champions within the government. He also hopes it will serve as a 'wake-up call' for men themselves. He suggests some straightforward steps every man should consider. 'Look at your waist size. If you are carrying extra weight, try to do something about it. Get moving, get out, and talk to people. Take every opportunity to get a health check or screening. If you notice changes in your body or how you are managing problems, seek help.