Men's 'head-in-the-sand approach' to health must stop

At the end of Tamborine, Chris Rock's 2018 comedy special, the comedian dishes out “man lessons” he learnt through his divorce. One is that, “There's a coldness you have to accept when you're a man, especially a black man. The world is cold as a motherf****er and one thing I learnt is that only women, children and dogs are loved unconditionally. A man is only loved under the condition that he provides something.”

Rock was stressing the point that society isn't compassionate towards men. It may seem like bad timing, pleading for a focus on men's wellness when men are the perpetrators of most abuse, but the reality is that men are suffering and dying too.

“Currently the focus is to provide support to victims and families who experience abuse. If we expect to address issues of abuse and stop the cycle with boys growing up to become men who abuse, we need to address boys and men through outcomes-based programmes,” says Garron Gsell of the Men's Foundation SA.

The health department recently released the South African National Integrated Men's Health Strategy, with findings that show that men's health isn't prioritised.

Men also generally don't take care of themselves, especially those who are between the ages of 20 and 34. Young men are going through key transitional phases from adolescence to manhood and older males in their 40s and 50s have entrenched beliefs of what being a man is but both groups shoulder societal expectations of manhood.

Tuberculosis remains the top killer among men, accounting for 57%, but the findings reveal a sharp rise in non-communicable diseases, which can be attributed to bad lifestyle choices. Diseases like type 2 diabetes, cancer and cardiovascular disease catch up with men as they age.

“Men's head-in-the-sand approach to their physical and mental health issues, coupled with the 'big boys don't cry' and patriarchal mindset leads to men suffering in silence, feeling isolated and not taking action. Often men avoid questioning their mortality, ignoring health issues and believing they will resolve themselves,” says Gsell, who's been working with key issues affecting men for over a decade.

Gsell uses the example of how the breast cancer pink ribbon reflects women's unity in addressing health issues.

“Men lack acknowledging their vulnerability, whether physical or mental, and by having men identify with the fact that other men are dealing with the same issues. This has been exacerbated since the Covid-19 pandemic where job losses, isolation, loss of identity and financial uncertainty strike at the core of how men see themselves.”

As the findings point out, in general men have a problem with booze: 29% of men aged 15-49 have had five or more alcoholic beverages at least once in the past 30 days, and binge drinking has grown among 25- to 34-year-olds.

“Alcohol abuse is the most prevalent form of abuse and can be attributed to cost and access in relation to other forms of substance abuse. Men often resort to substance abuse as an emotional crutch and coping mechanism to deal with other psychological issues — this harmful behaviour often perpetuates in violent, external forms of abuse like gender-based violence,” says Gsell.

The Men's Foundation, which also manages the Movember campaign in SA, is part of the Cancer Alliance — a group of non-profit organisations and advocates for the prevention and control of cancer. The alliance released a report last month titled “Access to Cancer Medicines in SA”.

“We're heading for a crisis — but with careful planning we can avoid it,” says Gsell.

South African men have a seven-year lower life expectancy than women, attributed to several reasons. Men are more prone to risky behaviour. Also, globally, one man dies “every minute from suicide — in SA, four out of every five suicides are men”, says Gsell.

Prostate cancer will become the most prevalent cancer in SA by 2023 — already “the preliminary report indicates that prostate cancer makes up 22% of all cancers affecting men”. This, Gsell says, should reinforce the need for awareness and education.

The Department of Health discovered that, compared with 10 years ago, more men are depressed and are being admitted to psychiatric hospitals. Men also tend to wait until they're sicker before seeking medical help.

One of the delivery models of the 2020-2025 strategy to reach the goal of an all-round healthy man is health-seeking behaviour. Before the global Movember campaign launched in 2003, there was little awareness surrounding the key mental and physical health issues affecting men.

The government's strategy is fine on paper, like our constitution. But it's the implementation part that trips our leaders. Yet Gsell is confident that through awareness, education and men becoming responsible for their wellbeing and their actions, the goals the government and civil society have set will have a positive impact on society.