Movember: Bringing men’s health to the forefront
Monday, November 21, 2016
The Pulse on Global Trials by Matthew Howes
Globally, men’s health outcomes are significantly worse than women’s—a paradox, given that more men participate in clinical trials than women. Across the world, men die an average of six years younger than women.
November has become the month for turning the public’s attention to the unmet health needs of men. Dubbed “Movember,” this is the time of year where men grow moustaches for 30 days in solidarity for bringing awareness to the goal of reducing the number of men who die prematurely for reasons that are largely preventable.
In recent years, the gap in health outcomes between women and men has increased in awareness worldwide. The World Health Organization (WHO) published a paper detailing the men’s health gap in the global health agenda. Co-written by authors from Belgium, England, Malaysia, South Africa and the U.S., the report provides data from a number of studies that quantify the gap.
During the period from 1970 to 2010, female life expectancy at birth increased from 61.2 to 73.3 years, and male life expectancy rose from 56.4 to 67.5 years. While life expectancy for both sexes has improved over the last 40 years, it has improved slightly less for men.
The disparity in outcomes is explained, in part, by the fundamental biological makeup of men—genes, hormones, reproductive anatomy and metabolism. But social norms, attitudes and behaviors, coupled with occupational hazards, may provide a better understanding of why, for instance, men are 60% more likely to die from cancer. Medical consultation rates are lower for men, often resulting in missed or delayed diagnoses. Women are more likely than men to have health insurance and a regular source of healthcare. About a quarter of men say they wait as long as possible before seeking help.
Work environments can also have a negative impact on men’s health. Men are more than seven times more likely to die from occupationally related causes. In Europe, 95% of fatal accidents and 76% of non-fatal accidents at the workplace are experienced by men. In Japan, karoshi, “death from overwork,” is a recognized diagnosis, and it triggers compensatory payments to survivors.
From adolescence onward, the main reason that men fall ill sooner and die off faster than women is high risk behaviors like smoking, alcohol and substance abuse, aggression and violence, poor diet and lack of exercise.
Raising public awareness of men’s health issues is not just a matter of closing the outcomes gap. It is a matter of economics. In Denmark, for example, underuse of primary care by men equates to overuse of more expensive hospital and emergency services. In the U.S., premature mortality and morbidity is estimated to cost over $450 billion annually.
Importantly, reducing the burden of disease on men could have a positive impact on women’s health. Men’s physical illness has a direct, negative impact on their female partners and families in terms of loss of income and high, diagnosable levels of stress. Moreover, if we reframe men’s health in this way, it changes how we strategically approach women’s health issues.
Birth control, for example, has long been seen as a women’s health issue. A recent study published in the Journal of Clinical Endocrinology & Metabolism indicates hormonal birth control shots for men may change our notion of birth control for men.
In a phase II clinical trial, a combination of synthetic testosterone and progesterone were found to reduce pregnancy by 96%. Compared to using condoms, which are 98% effective when used correctly, this could represent a significant shift in how we think about birth control.
Awareness of men’s health outcomes gaps has a few important implications for clinical research.
First, as payers and policy-makers nudge healthcare systems around the world to value-based models, it is not far-fetched to imagine a future in which prescriptions for male cancer treatments and heart disease will be accompanied by prescriptions for individualized diet and exercise regimens.
Second, understanding co-morbid conditions will become an increasingly important area of investigation. A new study at the University of Maryland School of Medicine observed a correlation between testicular cancer and increased risk of intermediate to high-risk prostate cancer. As the spotlight shines on men’s health, more studies like this will be necessary to help predict and prevent morbidity in men.
Lastly, and perhaps most importantly, research into biomarkers and better diagnostics remains a critical need in men’s health research. The demand for earlier detection—as early as childhood—opens the door for funding new and innovative studies that could have a far-reaching impact.
Matthew Howes is executive vice president, Strategy & Growth for PALIO, an inVentiv Health company. A leader in digital strategy, he has provided the fuel for digital businesses visited by more than 100 million people every month. Email firstname.lastname@example.org.
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