Sex and gender matter

Abstract

Your May 12 news item by Michael McCarthy1McCarthy M “Sex matters”, US report concludes.Lancet. 2001; 357: 1506Scopus (3) Google Scholar adds to the increasing number of publications about sex matters and men's health;2Kondro W Canadian men need a healthier lifestyle.Lancet. 2001; 357: 1512Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar is this reporting the beginning of a paradigm shift? Although the emergence of new focus areas do not necessarily indicate a paradigm shift in which each new paradigm replaces the last, there seems to be a resurgence of men's health issues at the forefront, together with or in place of women's health policy and promotion. Men and women's health have gained widespread attention in popular magazines, television shows, and in the wellness industry. Not surprisingly, there have been many calls to close the gap between men and women in longevity and illness experience. Reports by WHO clearly advocate the importance of a gender perspective to assist in understanding ageing and health, and stress the importance of research in clinical science and public health acknowledging gender differences.3Mathers CD Sadana R Salomon J et al.Healthy life expectancy in 191 countries, 1999.Lancet. 2001; 357: 1685-1697Summary Full Text Full Text PDF PubMed Scopus (306) Google Scholar, 4WHO report: men, ageing and health.Aging Male. 2000; 3: 3-36Crossref Scopus (19) Google Scholar The Canadian report The health divide: how the sexes differ discusses life expectancy and reasons behind differences between women and men.2Kondro W Canadian men need a healthier lifestyle.Lancet. 2001; 357: 1512Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar To comment on the European experience, the differences in life expectancy are striking. In eastern European countries, especially in Russia, the gap is not 6 years, as reported for Canada, but closer to 10 years. In 2000, the WHO report suggested a 77% increased risk of premature death for Russian men between 1987 and 1994. With life expectancy, the gap between the sexes generally decreases as average life expectancy increases. Russia has one of the lowest life expectancies and, therefore, the widest gaps between sexes in healthy life expectancy in the world (66·4 vs 56·1 years for men compared with women).3Mathers CD Sadana R Salomon J et al.Healthy life expectancy in 191 countries, 1999.Lancet. 2001; 357: 1685-1697Summary Full Text Full Text PDF PubMed Scopus (306) Google Scholar Undoubtedly, we must identify men as a high-risk group for premature death in this population. In 1999, the Institute of Social Medicine prepared a scientific report on men's health for the Viennese government, to offer the health system a basis on which to identify focal points on men's health issues.5Schmeiser-Rieder A Kiefer I Panuschka C et al.The men's health report of Vienna 1999.Aging Male. 1999; 2: 166-179Crossref Scopus (7) Google Scholar We concluded that men need to be specifically addressed as a target group for prevention campaigns and that their health can be significantly improved. Not only must appropriate primary and secondary prevention measures be taken, but support for gender-specific research and dissemination or translation of the results into health-care practice needs improvement. Despite the gap in life expectancy between the sexes, overall it is increasing, which means that the absolute number of age-related illnesses in the male population will also grow. Hence, age-related health issues in men, such as osteoporosis, dementia, prostate cancer, and urinary incontinence, will require increased attention. Irrespective of the obstacles related to men's health (ie, lack of participation in preventive activities, gaps in health consciousness, careless attitudes toward health, and risk behaviour) efforts must be made to motivate and encourage men's participation in preventive health measures.