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By Dr Dulcy Rakumakoe

Chief Executive Officer


Research: Men die at higher rates than women from top causes of death

Heart disease, stroke, suicide and depression, lung cancer and prostate cancer are some of these top causes of death.


Men are said to not take their health seriously.

According to the Men’s Health Network (MHN), men die at higher rates than women from the top causes of death – heart disease, cancer, stroke, chronic obstructive pulmonary disease, accidents, pneumonia and influenza, diabetes, suicide, kidney disease, and chronic liver disease and cirrhosis. Men also die younger than women.

All men over the age of 40 need to make sure they see a doctor at least once a year to screen for major health problems.

The biggest problem that men have is not so much a specific disease, but the diseases are the result of lack of health care monitoring earlier in life.

Society in general unfortunately is to blame. Men and boys are expected to be tough and ignore pain and this results in ailments that could have been detected earlier being detected much later when they have progressed.

Many of the top causes of death are preventable, and can be treated, if found early.

Let us look at the risk factors for five of the biggest killers of men: heart disease, stroke, suicide, prostate cancer, and lung cancer.

We will discuss why men are so vulnerable to these ailments.

HEART DISEASE

Although heart disease is the leading killer of both men and women, almost twice as many males die of conditions that affect the cardiovascular system.

According to the Centre for Diseases Control, one in four men has some form of heart disease. It is the leading cause of death.

Average annual rates of the first heart disease complication rises from seven per 1 000 men at ages 35-44 to 68 per 1 000 at ages 85-94.

For women, similar rates occur but they happen about 10 years later in life. The average age of a person having a first heart attack is 65 for men and 70 for women.

Basically for men, heart disease begins to manifest itself about 10 years earlier than women. This does not mean men have a free pass until they’re older.

The risk factors for heart disease include:

  • Increasing age.
  • Male sex.
  • Family history and race. People with family history of the disease have greater risk.
  • So do Black people.
  • Smoking.
  • High blood cholesterol.
  • High blood pressure.
  • Physical inactivity.
  • Obesity and overweight.
  • Diabetes. Your age and sex cannot be controlled but modifying lifestyle to eat right and exercise can reduce your risk of heart disease.

STROKE

Stroke is the third leading killer after heart disease and all forms of cancer.

The incidence rate of stroke is 1.25 times greater in men than in women, although there is really no difference between the sexes as people get older.

The most important risk factor for stroke is hypertension.

Other risk factors include:

  • Increasing age.
  • Race. Black men have the greater risk than whites.
  • Gender. Stroke is more common in men than in women until age 75.
  • Personal history of stroke or a transient ischemic attack (TIA, or ministroke).
  • Diabetes.
  • High cholesterol.
  • Heart disease.
  • Smoking, including secondhand smoke.
  • Physical inactivity.
  • Obesity.
  • Alcohol and substance abuse. Behaviours that can reduce the risk of stroke mirror those that can reduce risk of heart disease.

It is important to emphasise that a healthy lifestyle, dietary factors and exercise reduces the risk of people getting hypertension at all.

Picture: Supplied

Picture: Supplied

SUICIDE AND DEPRESSION

There are reports that men are four times more likely to commit suicide compared with women, which could be because of underdiagnosed depression.

Men are more prone to suicide because they are less likely to openly show depression and have somebody else recognise it early enough to treat it, or to have themselves recognise that they’re in trouble. Burnout and depression among men are hidden – and rising – afflictions in South Africa.

The number of men admitted to private psychiatric clinics for depression last year was nearly a third higher than in 2010 and absenteeism owing to stress among men, particularly executives, jumped between 2008 and 2013.

Men tend to leave it until later and the presentation is of a more serious nature.

The majority are depressed and not seeking treatment. When men get red-light signals from their bodies, they are more likely to take a substance, like alcohol and drugs, to make the signals go away. Men are less willing than women to say they are burned out and more likely to have other diagnoses like addiction or post-traumatic stress disorder.

A 2009 national survey shows that depression is undertreated in South Africa and that major depression occurs earlier in the younger generation.

The lifetime prevalence of major depression reaches 10% for people aged 18 to 29 and occurs seven years earlier than those aged 30 to 39.

If major depression – with an estimated prevalence of about one in 20 adults (4.9%, according to the South African Stress and Health Study) – is untreated, the downward spiral can be catastrophic.

More men are at risk of dying from suicide than women in a country that has about 23 suicides and 230 attempts every day, more than half of which are men.

Instead of sadness, depression may play out in the following ways in men:

  • Anger.
  • Aggression.
  • Work “burn out”.
  • Risk-taking behaviour.
  • Midlife crisis.
  • Alcohol and substance abuse.

Society around the men and the men themselves see the male symptoms of depression as “just being a guy”, or “having a hard time”, or “just going through a rough patch”.

The problem is that if they are signs of depression, and they’re getting bad enough, then many of these men are starting to form thoughts that life isn’t worth living.

To help men with depression and to reduce the risk of suicide, doctors, loved ones, and men themselves need to recognise that society’s model of masculinity – to ignore pain –can work against men.

Looking the other way may trigger depression and thoughts of suicide.

LUNG CANCER

Lung cancer is the leading cancer killer of both men and women, claiming more lives than prostate, colon, and breast cancer combined.

In men, there are expected to be about 213 380 new cases of lung cancer and some 160 390 lung cancer deaths this year. Tobacco products are responsible for 90% of lung cancer, which puts the weight of prevention efforts on smoking cessation.

According to the National Institute on Aging, as soon as you stop smoking, your chances of getting cancer from smoking begins to shrink.

Besides smoking, other risk factors for lung cancer are:

  • Exposure to secondhand smoke.
  • Exposure to asbestos or radon.
  • Personal history.
  • Air pollution.

PROSTATE CANCER

Prostate cancer is the most common cancer found in men.

It is the second leading type of cancer death in men, after lung cancer. There is not enough known about what causes prostate cancer and how to prevent it.

Yet the disease is treatable if found in early stages. This can be a challenge, since prostate cancer can show no symptoms until it has spread to other parts of the body.

This disease is one of those that shows the importance of early screening.

What is recommended is a prostate-specific antigen (PSA) blood test and digital rectal exam offered annually for healthy men starting at age 50 or older.

Men who are at high risk – such as those who have family history of prostate cancer or who are black – should begin testing earlier.

The risk factors include: family history, increasing age, diet with a lot of red meat and high-fat dairy products and not enough fruits and vegetables.

Although older age is a risk factor for prostate cancer, younger men should not be complacent.

Thirty percent of prostate cancers occur in men under age 65.

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