Men’s health is often described in terms of male-specific, sexual and reproductive health problems, however, there are broader health issues and behaviours, including men’s engagement with health services, that impact overall men’s health.1 Risk-taking behaviours are seen more frequently in men, with men twice as likely as women to die in motor vehicle accidents2,3 and as a result of injuries from violence.2 Occupational injury and death is a major cause of male morbidity, and more than nine out of 10 people killed at work are men.4 Men are more likely to be homeless or involved in the justice system compared with women. Men also have higher rates of substance abuse and suicide,2 and unhealthy behaviours, including smoking tobacco and exceeding recommended drinking guidelines.5
Men have a life expectancy of 80.7 years, which is lower than women (84.9 years), however, this has improved over the last decade.5 In 2019, the leading cause of death for men was coronary heart disease followed by lung cancer and dementia including Alzheimer's disease.6 Men are less likely to have the necessary supports and social connections in place when they experience physical and mental health problems.3 Men visit their general practitioner (GP) less often than women and usually have shorter consultations resulting in missed opportunities for screening.2 They also may present when an illness is advanced, leading to increased morbidity and mortality.5
Socio-cultural barriers are more prevalent for Aboriginal and Torres Strait Islander men who have the highest morbidity and mortality rates and lowest rate of health service utilisation in Australia.7 This is in part due to the strict protocols in Aboriginal and Torres Strait Islander culture, known as Men's and Women's business, that determine what can and should be discussed or undertaken by men and women, which includes healthcare.8,9
Men who live in rural and remote Australia are more likely to have health risks and suffer chronic conditions than those who live in cities.10 Access to healthcare may be more difficult, and these men statistically are more likely to be involved in risky health behaviours, as well as live with social and economic disadvantage resulting in poorer health outcomes.10
Other barriers may include a view of healthcare which avoids preventive health measures, and the distorted notion of masculinity in Australian male culture that can deter men from admitting vulnerability and seeking help.7 Men may also be more comfortable seeing a male GP,2 which may be difficult in clinics with a majority female workforce.
GPs are well positioned to provide health checks for men and screen for relevant conditions. Cancer of the prostate is the second most diagnosed cancer and the second most common cause of cancer death in Australian men.11 Although screening for prostate cancer in asymptomatic men is not recommended, some men have individual concerns and see the benefits of prostate cancer screening as part of their regular check-up.12,13 It is important for GPs to engage men in shared decision-making when ordering prostate-specific antigen (PSA) testing.
GPs play a pivotal role in improving health literacy amongst men and need to embrace opportunities to engage early with boys and young men to develop meaningful relationships through to adulthood. GPs may negotiate and reduce barriers for men accessing healthcare. Dedicated men’s health services including those that are culturally safe for Aboriginal and Torres Strait Islander men may help enhance timely and effective access to care.14