Statistics now show that men have a shorter - Info Sihat

Statistics now show that men have a shorter life span and are at a much higher risk of contracting various dangerous diseases,

compared to women. Read on and find out how men’s health can be improved for a better,

brighter and healthier future.

This special educational report is brought to you by Family Health Development Division, Ministry of Health Malaysia.

Enhancing His HealthMen have a shorter life expectancy at birth and a death rate that is twice that of women. If nothing is done, there may be far more women than men in Malaysia

by the year 2030.

By Joan Fam

T raditionally, men are seen as the ‘head’ of the house. Even in modern times where

both husband and wife go to work, the typical scenario of a household in Malaysia is where the husband will make most of the major decisions while the wife will look after the children and the house.

These roles naturally tend to carry over into health and wellbeing. A woman is expected to look after her own health as well as her children’s and husband’s health. Unfortunately, most women are met with resistance from their husbands. Many men insist on being the ‘head’ of their own health but this ‘head’ is not doing a good job.

According to statistics extracted from literature review:

• There is a high death rate in men aged 15 to 65, compared to women of the same age

• Men have a shorter life expectancy at birth

• The death rate among men is twice that of women

What the statistics mean Some and literature show that there’s no reduction in the mortality rate of men between 25 to 50 years of age for the past 10 to 20 years. The life expectancy at birth for both men and women has improved, but the gap of

to six years between men and women is still there. That is, women live to six years

longer than men. There’s also a pattern showing that the death rate is at a 2:1 ratio so men are twice as likely to die compared to women. In fact, by the year 2030 when there is an aging population in Malaysia, the percentage of women will be more than men.

Vital Statistics In Malaysia

Health facts 2014

World Health Statistics 2009, 2014

Dr. Zakiah Binti Mohd SaidPublic Health Physician

In 2002, the Family Health Development Division (FHDD) of MOH collaborated with the United Nations Population Fund (UNFPA) to focus on men’s health and to form a plan of action for improvement. The division, which offers health services for a person’s entire life span starting from the womb (prenatal) to the tomb, has increased monitoring and active gathering of information as well as strategising on men’s health.

Public Health Physician of the Adult Health Sector, FHDD, Dr. Zakiah Binti Mohd Said explains that the National Health Morbidity Survey data show a worrying pattern of the morbidity and mortality among Malaysian men in terms of the life expectancy of men and other diseases like cardiovascular disease.

In view of this, the FHDD held discussions with related divisions in the MOH as well as Socso, Kementerian Pembangunan Wanita, Keluarga dan Masyarakat Malaysia (KPWKM) and universities, to discuss further development and plans to improve men’s health in Malaysia. “Our current vision and mission is to get a clear, evidence-based policy to improve men’s health,” says Dr Zakiah. “From the statistics, we can see that men need to give attention to their health now.”

Why men neglect their healthResearch shows that men tend to neglect their health due to poor health seeking behaviour. Health seeking behaviour relates to concern about one’s health and making the effort to go for regular health screenings to prevent or detect diseases which may be treatable at an early stage.

If you have good health seeking behaviour, you’ll go for health screenings to see if you have a clean bill of health or you’ll see a doctor when you feel under the weather. However, it has been found that men tend to avoid health screenings and will only go to see a doctor when they are very sick.

The reasons for poor health seeking behaviour among men could be due to the prevailing culture, as well as factors related to masculinity and education. Generally, men like to be seen as masculine and tough so they will ignore small but vital signs of an

underlying disease. They will seek medical attention only when it’s too late, such as, when they experience a heart attack or stroke.

A vital step forward

The three leading causes of death for men are heart diseases, and road Cardiovascular disease is still the number one cause of death in Malaysia, for both men and women. The two leading risk factors for cardiovascular diseases are diabetes and hypertension.

In view of this, the MOH has developed a short and long term men’s health plan of action to encourage men to go for regular health screenings and to improve health seeking behaviour. The plan of action will be implemented by various agencies involved with men’s health.

Reducing the premature mortality of men and boys.Promoting greater empowerment towards responsible living, timely and appropriate healthcare servicesPromoting greater responsibility and active participation in sexual reproductive healthProviding equal opportunities in the improvement of health for men, women and children

Besides Malaysia, only three other countries are carrying out a men’s health plan of action. They are Brazil, Australia and Ireland.

The statistics and data collected by MOH indicate clearly that the life expectancy for men as well as their health seeking behaviour need to change. With plans and new policies in place, it is hoped that men will start to take charge of their own health for a brighter, healthier future.

The Men’s Health Plan of Action:

Why It’s Needed…

1. High morbidity and mortality (according to the statistics) in men

2. Inequality of health care because more focus and attention was given to women in earlier years.

3. Shared responsibility in sexual and productive health. Men have a responsibility towards family planning and parenthood and their health is important in this respect.

4. Social economy implications. The social implications for men as fathers, brothers, sons and husbands. Economic implications for employers who lose productive employees plus cost of medical care. It’s also the concern of the government and society including the cost of caring for dependents left behind.

Strategies for Men’s Health by MOH

1. The Malaysian Men’s Health Caring House was developed in collaboration with University Malaya Medical Centre.

2. Any male accompanying women or children to Klinik Kesihatan will be approached by the staff on the

with a form to is so they can have simple tests done such as a blood pressure reading or a random blood sugar test. The readings are then matched against the Clinical Practical Guideline (CPG). There will be a follow-up with individuals who have negative readings.

3. Celebration of International Men’s Day (15 November) to give health awareness to men with the criteria for 100 percent male participants.

4. It was found that the mass population in the workplace is 67%, out of this, 80.7% of men are in labour force. Employers are encouraged to request for health screening at their premises. Workers found with abnormalities will be referred to clinics or hospitals for continuation of health services.

There is no doubt about it… the state of men’s health in Malaysia is a matter of grave concern. The University

of Malaya Men’s Health Research Group, led by Professor Ng Chirk Jenn and his co-researcher, Mr Teo Chin Hai, from the Department of Primary Care Medicine, University of Malaya Medical Centre

research and the Asian Men’s Health Report. The team collaborates with NGOs, other local and international universities, and the Ministry of Health Malaysia (MOH).

The Institute for Health Metrics and Evaluation reported that about 60 Malaysian

men die from heart attacks every day. In addition, compared to women, more men die from cancer, injuries and suicide. The Malaysian National Health and Morbidity Survey also found that one out of three men suffers from high blood pressure, one out of every three men has high cholesterol and one out of six men has diabetes. Why men avoid health check-upsMen generally don’t go for health screening. The University of Malaya Men’s Health Research team found that this is mainly due to four reasons:

1. The Male Factor

knowledge than women. They are less aware of the necessity to screen, how to prevent diseases and improve their health. One possible theory is that as children, girls are informed about health when they had their

strong and not to cry if they are ill or in pain. This societal expectation remains as they grow into men and talking about health is considered a sign of weakness.

Men, especially younger men, are less likely to go for health screening, citing having no time or having too much work to do as the reasons. However, this may change and they are more open to health screening when they reach their 50s or 60s. This is when their work is more stable. At this age, they are also more motivated to focus on their health because they or their friends are beginning to suffer from different diseases.

2. FamilyWhen it comes to the social domain, men are usually “pushed” to take care of their health, especially by their wives. Many studies found that the wife plays an important role in making her husband go for health screening or consult a doctor.

3. Healthcare SystemA lack of male-friendly health services deters men from visiting doctors. The clinics or hospitals tend to focus on children and women. For example, the posters on children, pregnancy and women’s health may make men feel awkward and out of place.

A Matter of Life and DeathRecent statistics show that about 60 Malaysian men die from heart attacks everyday. Regular health screenings will go a long way toward improving

men’s health and protecting them from various preventable diseases.

By Joan Fam

Dr Ng Chirk Jenn, Professor of Family Medicine

Mr Teo Chin Hai, Men’s Health Researcher

Health Screening Schedule for Adult Male Tests recommended for male Frequency Notes Reference

page Age

18 20 25 30 40 50 60 65 70 75 80

Cardiovascular (CV) risk

Global CV risk assessment

low risk 2 -5 years

2

B B B B B B B intermediate 6/12 -1year

high Individualised

Smoking or nicotine addiction

Opportunistic Should be done as part of clinic vital sign recording

A A A A A A A A A A A

Hypertension Yearly More frequent for individual with higher CV risk

A A A A A A A A A A A

Diabetes Mellitus Yearly Earlier for individual with

DM risk A A A A A A A A A A A

Dyslipidaemia Yearly At any age for individual with CV risk A A A A A A A A A A A

Family history of premature CVD

Once at first presentation B

Obesity 2-yearly More frequent for individual with higher CV risk

B B B B B B B B B B B

Unhealthy diet 2-yearly

More frequent for individual with higher CV risk

B B B B B B B B B B B

Physical inactivity 2-yearly

More frequent for individual with higher CV risk

B B B B B B B B B B B

Colon cancer

average Yearly (FOBT)

47

A A A A A A

high 5-yearly (colonoscopy)

10 years earlier than the age of first diagnosis of CRC in the family

A A A A A A A

HIV infection Opportunistic At any age for high risk

individuals 70 A A A A A A A A A A A

Alcohol misuse Opportunistic Among at risk individual 65 B B B B B B B B B B B

Depression Opportunistic

Screening is appropriate in setting with support for treatment

83 C C C C C C C C C C C

Fall risk assessment Yearly Among at risk individual 104

C C C C C

The alphabet in each cell denotes the grade of recommendation.

Colour coding: Offer to all patients Offer to patients with risk factors

4. The Doctor FactorIn order to encourage men to see them, doctors need to be trained to be more ‘male-sensitive’ and learn how to communicate with men. Doctors play an important role as a motivating factor for men to come into their clinics. Men in Malaysia generally trust doctors and would listen to their advice.

Regular health screeningProf Ng stresses that it’s important for men to understand what health screening is and that it should be done regularly.

He explains that health screening is not only about detecting underlying diseases, it should also identify health risk factors such as smoking and sedentary lifestyle so that appropriate actions can be taken. Statistics have proven that health screening greatly helps to reduce morbidity and mortality. This means that if you detect and treat a disease at an early stage, you can live longer, have a better quality of life and save money!

For instance, if a man found out that he has hypertension at an early stage, with lifestyle changes such as eating less salt, exercising

weight, he can maintain his blood pressure and protect himself from stroke, heart attacks and kidney failure. Without regular health screenings, he will not know that he

attack or stroke!

Not all screening tests are necessaryTeo shares that health screening should be done once a year. There is no need for men to undergo a long battery of tests. It is only necessary to go for screening tests that are evidence-based, such as screening for high blood pressure, high cholesterol level, diabetes and colon cancer (Refer table).

It is important to note that health screening is done when one is asymptomatic, not when he has symptoms. Some of the available tests are carried out for diagnostic purposes. This means the tests are done only when the medical expert suspects the patient has a

out that more tests are not necessarily better.

Start youngStatistics show that men start to develop diseases at the age of 40. Experts are advising men to start going for health screening as early as 18 years old since more and more young men are now being diagnosed with common diseases such as diabetes and high blood pressure.

UMMC and the MOH have started public campaigns to encourage more men to go for regular health screening. They are looking into ways to make it easier and more accessible for men by having screening done at their workplace as well as offering incentives and screening packages at hospitals and clinics throughout Malaysia.

Understanding why men avoid health screening is a big step towards improving the status of men’s health. When men become more knowledgeable about taking care of

their families, the communities and the nation at large.

Note to graph: ‘A’ means highly recommended, means it has substantial impact. ‘B’ means it’s more moderate. ‘C’ means less evidence but it depends on the context and situation.

• Blood pressure* • Blood sugar test for diabetes* • Blood cholesterol test for

hypercholesterolaemia*• Colonoscopy – after 50 years old.

However, if there is a family history of colon cancer, screening should be done 10 years before the age when the relative was diagnosed.

• Depression using a simple questionnaire

• HIV / sexually transmitted diseases – government health clinics (Klinik Kesihatan) offer anonymous health screenings for this.

Take These Tests!

Here is a list of basic health screenings that men should go for:

*Hypertension, diabetes and high cholesterol are risk factors for cardiovascular diseases.

Source: Asian Men’s Health Report by the Malaysian Men’s Health Initiative, ‘Barriers and facilitators to health screening in men: A systematic review’ by Teo et al 2016. Also

For Health Metrics And Evaluation.

Over the last 100 years, the state of human health has moved forward thanks to great achievements in

public health, advances in medical science, changes in labour law, safety legislation,

effective environmental campaigns for clean and healthy surroundings. Over the last decade, health experts are increasingly focused on the importance of gender medicine as the natural next step in improving both male and female health.

Globally, reports on men’s health show a lower level of overall health for men compared to women. This includes life expectancy, susceptibility to communicable and non-communicable diseases, injuries and suicides. The Asian Men’s Health Report

Life expectancy varies across regionsThe AMHR reveals that there is a demographic difference in life expectancy and it varies greatly across 49 Asian countries and regions. However, with the exception of Qatar and Kuwait, it has been found that men have a shorter life span compared to women.

Data reveals that the male-to-female ratio is high in UAE (2 male: 1 female) and in Qatar (3 male: 1 female) while in Georgia, Armenia and Hong Kong, the ratio of male is lower

than female, that is, men have a lower life expectancy than women. Death rates, for men, due to non-communicable disease are three times higher in poorer countries like Afghanistan, Kazakhstan and Turkmenistan, compared with countries like Singapore and Qatar.

The study also shows that in most Asian countries, 35 to 50 percent of all smokers are male. The prevalence of type 2 Diabetes Mellitus is particularly high in the Middle East while the prevalence of hypertension in men is the highest in Mongolia (51.5 percent). Cancer mortality is also much higher for men in developing nations like Mongolia and Armenia while the male suicide rate ranges from 36.2 to 53.9 deaths/100,000 in Japan, South Korea and Kazakhstan. The death rate

men/100,000 population in the Maldives to an astronomical 73.9 men/100,000 population, in Thailand.

Higher income countries show a lower mortality rate in communicable diseases compared to the other income categories. Between 1980 and 2009, the trend for systolic blood pressure was on the decline for men in higher income countries. However, the trend for fasting blood glucose and BMI showed a steady increase for all income countries.

A shining exampleThere is clearly an urgent need to elevate men’s health, not only in Asia but also worldwide. Besides the need to sustain socio-economic productivity, there is a huge demand and expectation for an active life

from the aging male population, and this can only be achieved with marked improvement in men’s health.

Improving a man’s health, from adolescence to old age, will help to sustain productivity because doing this will control healthcare expenditure and expand the economy by retaining a higher number of healthy, active retirees. The Japanese model in achieving the world’s best health status as well as the largest aging workforce is certainly a shining example for a rapidly aging Asia, as well as the aging world, to emulate.

Based on these facts and data there is no doubt that in aging Asian nations, both rich

effective ways to slow the decline of socio-economic conditions and ensure a healthy workforce, is by improving the health and wellbeing of men in Asia.

Are Asian Men

Healthy?The results are in. The Asian Men’s Health Report reveals that the standard of health

for men in Asia needs to be elevated to ensure a healthy workforce and better

socio-economic conditions.

Dato’ Dr. Tan Hui Meng FRCS (Edin) FRCPS (Glasg)

About The Asian Men’s Health Report

systematically and comprehensively documents the status of health for Asian men. The databases on the status were obtained from the World Health Organization (WHO), Economic and Social Commission for Asia and the

Department of Health of Taiwan and Hong Kong and relevant individual studies covering 47 Asian countries and two regions, namely Hong Kong and Taiwan.

By Dato’ Dr. Tan Hui Meng

Men’sHealth

in MalaysiaRecent statistics show that Malaysian

men lag behind women when it comes to taking care of their health.

Facts on Life Expectancy for Men in Malaysia

Common Diseases That Affect Malaysian Men

How to Keep Your Health in Check

1. Men die 5 years earlier than women.2. The number of men who die in a year is double than women.3. The highest death rate in men happens between age 15 – 65. 4. The three leading causes of death:

- Heart disease - Stroke - Road traffic injury

1. The prevalence of undiagnosed Diabetes Mellitus in men is 8.8 percent and the prevalence of undiagnosed hypertension is 21.8 percent.

2. The proportion of current smokers is 30 times higher among males compared to females - Everyday, 9 men are diagnosed with lung cancer and 8 men die from it.

3. Colorectal cancer is the second most common cancer among men - Everyday, 7 men are diagnosed with colorectal cancer and 4 men die from it.

Exercise 5 times a week for 30 minutes each time

Check your blood pressure, sugar and cholesterol annually

Reduce sugar, salt and fat

Stopsmoking

Keep a healthy weight

Go for regular health screening at your nearest clinic

(Nagaraj et al. Journal of Population Research 2008, Disease burden 2012, Health statistics & Health Information system)

(NHMS 2011 & 2015, WHO: Globocan 2012)

This special educational report is brought to you by Family Health Development Division, Ministry of Health Malaysia.

ED can be treated. Talk to your doctor. Don’t let ED ruin your life.

(Source: Khoo et al, 2008, journal of sexual medicinel Feldman HA et al 1994, Journal of Urology)

No “HARD” Feelings7 out of 10 men above the age of 40 suffer from some

degree of erectile dysfunction (ED).

Cardiovascular disease

Sedentary lifestyle

Smoking

Diabetes

Obesity

High Cholesterol

Risk factors for ED

This special educational report is brought to you by Family Health Development Division, Ministry of Health Malaysia.