Movember
The Numbers Behind Men's Health
The Numbers Behind Men's Health
Dylan Knowles
November 14, 2022
This blog discusses death, suicide, historical inequality, and other sensitive topics.
Movember is all about mustaches, mental health, and cancers of various organs down there. Focused efforts are great. But what do the numbers say about men’s health more broadly? What else should you keep in mind for the men in your life (and/or yourself?)
(And before you go “stay in your lane Dylan,” here’s my publicly-available public health work. “That simulation guy” is actually short for “that directing-millions-of-public-health-dollars-using-simulation guy.”)
So what kills men?
Before I get into the actual reasons for death and disability, let’s look at a few root causes. You will notice a theme here: these are really hard things to do anything about. In other words, appreciating someone’s life circumstances is critically important when trying to help them. As Michael Marmot says, don’t be born poor or disadvantaged.
Location. Living in the right postcode gives you better access to exercise, healthy food, and quality medical care. An urban, walkable location with lots of amenities reduces chronic health issues that cause a plethora of issues, like obesity, and by extension, improves both your life expectancy and quality of life years.
Age. Different health problems emerge in different age brackets; young men have more substance abuse issues, for example.
Socioeconomic status. Like location, the amount of money and societal power you have impacts your well-being. Low income (or being time-poor) means restricted health choices (e.g. food options). Being in a minority group (e.g. racialized group) can gatekeep opportunities and healthcare; in my opinion, the latter is particularly abhorrent because your background shouldn’t impact whether people, especially healthcare providers, take your health concerns seriously.
Early life history. Much like socioeconomic status, early life experiences dramatically increase your risk of poor health outcomes. Some studies suggest that, on average, people can tolerate about three adverse childhood events before it disproportionately messes with your long-term well-being. This sharply changes the equation on the type of support someone may need or want.
OK, so what actually kills them (and reduces their quality of life)?
The above factors (e.g. location with low walkability) lead to the causes of poor health outcomes (e.g. obesity) that then lead to morbidity and disability (e.g. diabetes). With that context in mind, here are the top items that affect men in Canada according to the global burden of disease study. Note that we are focussing on DALYs – disability-adjusted life years – which accounts for both deaths and reduced quality of life. Looking at deaths only changes the order slightly.
Men between 15 and 49
DALYs per 100,000 people: Canada, Males, 15-49 years.
(You can also get the above stats for females (or simply explore it yourself))
The top five causes of death and disability in adult men under 50 are as follows:
Drug use. Drug use (excluding alcohol, which is #2) is the leading cause of harm for men under 50. It leads to and correlates with suicide (a Movember topic) and causes a host of issues, including cancers (also a Movember topic), brain damage, organ damage, and dental issues.
Alcohol use. In addition to “other” drugs, alcohol is a big killer. Suicide, vehicle accidents, and cancer are the big outcomes of chronic use (even at low levels) and/or binge alcohol use.
Occupational injury. Young men get hurt on the job, and it causes lifelong frustration and pain. For programmers, RSIs are a big one.
High body mass index. Being overweight or obese is a causal factor in just about everything you can imagine. It’s particularly bad for your heart, joints, and leads to diabetes. It also leads to surgical complications, making emergency situations more dangerous.
Smoking. Cancer is a leading cause here, but it also causes cardiovascular disease (e.g. heart problems, blood pressure, etc.)
PSA: Check your dang house for radon. The second leading cause of lung cancer behind smoking is radon exposure. Saskatchewan has exceptionally high radon levels due to our geography, and the tests are free.
Suicide in men: A note on recessions, job loss, and means of suicide
Suicidal ideation disproportionately increases in men when they lose their job: recessions are killers. One theory suggests that this is because income and providing for your family are traditionally tied to male self-worth.
Men attempt suicide less than women but have a substantially higher death rate due to using more lethal means. If you know someone with firearms, ask if they keep them stored securely: this physical barrier matters a lot in the heat of the moment.
Men between 50 and 69
DALYs per 100,000 people: Canada, Males, 50-69 years.
Smoking. This is disproportionately high in the older age bracket. This is partially due to higher smoking rates in older generations but can also be due to accumulated damage over time.
High body-mass index. As per the younger age bracket. Heart and kidney disease, in addition to diabetes, are big harms here.
High blood pressure. Unsurprisingly, this causes a lot of heart damage and stroke.
High fasting plasma glucose. This one surprised me; I think it is new since I last looked at this data. It’s a precursor to diabetes.
Alcohol use. This leads to organ damage and cancer at later ages, often but not exclusively through accumulated damage. Cirrhosis is an example: chronic alcohol use essentially scars the liver and makes it harder and harder for it to function, and eventually causes liver failure.
So what do I do to help the men in my life?
These also apply to the non-male people in your life.
Movember exists to reduce stigma around the causes of men’s ill health, especially mental health and socially sensitive cancers. This said, there are other everyday things you can do to help the men in your life lead healthier, longer lives:
Watch for and flag excessive alcohol and cannabis use. We’re pretty good at keeping the drinking controlled at Vendasta, but if you see someone who isn’t, that can be a red flag for future problems. Helping them slow the pace can make a big long-term impact. The same goes for other substances we don’t use (shouldn’t be using!) in-office. “Drink less” is shit advice, especially since alcohol can be really enjoyable, so here are a few practical ideas:
If you have a regular event with alcohol, encourage lighter options that take longer to consume. For example, less alcohol consumed over a long period can prevent several cancers.
If you spot someone who is drinking (or consuming/smoking) well above the group norm, have a conversation or help them keep a slower pace.
Always ensure your coworkers and friends have a safe way to get home. Impaired driving leads to many transport issues, and inebriated people have a high rate of hurting themselves on the walk home.
2. Eat better together. Men often compete for big, high-calorie meals; in my experience, this can be due to social pressures (e.g. getting the weekly extra-large deep friend wings and fries). “Eat better” is shit advice, so here are some better ideas:
If you and your friends have regular lunch outings, aim for locations with lower fat, lower sugar options and make it normal to have them – pick them yourself or pick them for shared plates. People eat the same amount but eat better if it’s not on the plate (or is less on the plate).
Vendasta: Put healthy options at eye level. Study after study shows that we disproportionately choose what’s immediately available and at eye level. Brands pay enormous sums to get these locations on shelves. Keeping the soda machine in an awkward spot is actually a good strategy, and simply putting the vegetables at eye level in the fridge upstairs will make people eat better. You can literally put water in a shared fridge at eye level, and people will frequently ignore their usual coca cola on the bottom shelf that they can still see.
Vendasta: Healthy lunch options matter. The kitchen here has way more influence over your health than you think. Small choices – bigger sizes of the healthy side, low fat and low sugar options, leaner meats and sauces, etc. – can significantly impact men’s health. Some insurance companies pay businesses to do this because it reduces health costs.
3. Support the men in your life who want to stop smoking. This is a hard one. “Just quit a substance that is one of the most addictive on the planet” is shit advice, but if you’re a smoker and have friends who are smokers, you can challenge each other to cut back. If you’re not a smoker and you know someone wants to quit, see if they want an accountabilibuddy 😉.
4. Make your meetings walking meetings and go for walks during breaks. One of the easiest ways to cut down obesity rates is to walk more. This is shit advice when it is unpleasant to walk due to weather or poor urban planning (hence location mattering), but an active group effort can make a difference. Walk to the further coffee shop in winter and take a daily walk by the river in summer.
Fun fact: Adding a nature strip to sidewalks (that little bit of grass and trees between you and the road) remarkedly increases the number of people walking due to improved (and perceived) safety and comfort.
5. If a man in your life loses their job, be supportive. Suicidal ideation (i.e. thinking about it) increases in men when they lose their jobs far more than it does in women. If you know someone who’s recently lost their job, reach out.