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Men's Health: What's that all about?

I Introduction

When asked if I was interested in writing something about men's health for this bulletin, I wondered about the best way to approach the subject.

Being the director of Canada's first non-profit health organization focussed on promoting the health of men and boys has given me the unique opportunity to learn about the health issues and behaviour of males.

Given that Men's Health is conceptually pretty new in Canada, I figured that rather than load up on statistics illustrating how men die or areas where they are unhealthy, I would instead try to describe what Men's Health means to me in my own words.

II It's about Prostate Cancer, right?

At first glance, the term Men's Health means dramatically different things to different people.

For some, it is about prostate or testicular cancer. Perhaps erectile dysfunction. Certainly something sexual or having to do with male sexual parts. Men's Health magazine in the United States, for example, is filled with images and stories about hard bodies and great orgasms.

Others are certain it is about men's rights, angry men challenging feminism. This then leads to the standard, adversarial gender politics with lots of finger pointing.

Some think it is only for gay men, while others think it is about men who are homeless and at the end of their rope.

I am always struck at how two simple words -- men and health -- can engender so many different perceptions. Certainly I have learned that when it comes to issues about health and gender, nothing is simple and politics comes with the territory.

For me, Men's Health should aim to follow the example of the Women's Health Movement, which takes a broad, multi-dimensional, determinants of health approach to gender analysis. While the issues for males may be different, the approach can be similar.

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III Beyond Stereotypes

I've been involved in exercises with men and women where they are asked to quickly toss out words to describe the two sexes. Almost without fail, and regardless of the background of the participants, it tends to go something like this:

Women are Nurturing, Caring, Warm, Supportive, Loyal, Capable, Kind, Selfless, etc. Men are Violent, Controlling, Aggressive, Competitive, Tough, Independent, 'Have all the Power', etc.

After this exercise they are asked, "Now describe the men or women in your life. What are they like?"

Curiously, the same group then describes the other sex in a completely different way. This time as being more multi-dimensional, more complicated and less stereotypical. In short, they describe them as real human beings.

The implication is clear to participants in these exercises. The more we know someone, the more we are able to appreciate their uniqueness. The less we know a person, the easier it is to deny this uniqueness, label them according to our own bias or prejudice and then lump them into a group.

For Men's Health to make a significant impact in improving the health of men, their families and communities, it will need to promote the understanding that there is no one 'way' of being, living a healthy life or being male, that health is found in diversity rather than mono-culture and that it is about being human, rather than a caricature.

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IV Hockey Night in Canada

One of the fondest memories I have from growing up in Canada is hockey: playing hockey, watching hockey, anything hockey.

In Canada, hockey holds a quasi-religious status. When we talk about the players, we use the same words we give to soldiers returning from war. In fact in Canada, hockey often seems our replacement for war.

We refer to 'battles along the boards' and 'killing penalties.' We speak about players as gritty warriors. In reality, most hockey players never play professionally and for those who do their careers are usually short, with post-hockey lives filled with chronic pain and injury.

When we examine the messages males receive from a Canada's national 'game' we hear:

* real men ignore pain and injury

* real men are tough and strong

* real men sacrifice their bodies

* real men hurt other men

* men who are not these things are gay, fags, wimps, pussies, women

* real men don't need help

For males, taking care of their health is not high on the list of priorities for a 'real' man. In fact, the opposite seems true. Real men are supposed to flaunt their health and welcome self-destruction.

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V Nelson Mandela & Bruce Springsteen

For me, Nelson Mandela has always stood out as a positive role model.

The former president of South Africa, is an international symbol of peace, a metaphor for the struggle to achieve social justice and confront racism.

However Mandela's life has also followed much the same trajectory as other men.

In his autobiography, 'Long Walk to Freedom,' he describes his circumcision at age 16, a traditional ceremony in which boys are delivered into manhood. In Mandela's words, "circumcision is a trial of bravery and stoicism; no anaesthetic is used; a man must suffer in silence. A boy may cry, a man must conceal his pain."

When boys in Mandela's Xhosa clan were circumcised they would cry out loudly, and without any sign of pain or fear, "'Ndiyindoda' - I am a man."

Through spending almost 30 angry years in prison, Mandela would later learn that concealing pain, feeling angry and appearing manly simply turns an angry young man into a bitter, broken older man. Mandela made an amazing transformation in prison. Of all the people who could rightfully feel bitterness and rage, Mandela became more forgiving and compassionate, eventually receiving the Nobel Peace Prize.

In his song 'Living Proof,' Bruce Springsteen describes this same struggle for men:

"I went down to the desert sand

Trying so hard to shed my skin

I crawled deep into some kind of darkness

Looking to burn out every trace of who I'd been

You do some sad, sad things

When it's you you're trying to lose

You do some sad and hurtful things

I've seen living proof"

"Shot through my anger and my rage

Showed me my prison was just an open cage

There were no keys, no guards

Just one frightened man

With some old shadows for bars"

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VI Learning from Women

So how do we get men to live healthier lives when just getting them to see a doctor is hard enough?

There is a wonderful little book titled "Why Women Live Longer than Men...and What Men Can Learn From Them" written by Dr. Royda Crose. In the book, Dr. Crose looks at why women live on average 7 years longer than men do and why, as Satistics Canada shows, men have higher mortality rates in most major categories of death, including homicide and suicide.

Among her observations, she notes four qualities that seem to encourage longer, healthier lives, including:

1. Flexibility

2. Resiliency

3. Connectedness

4. Sense of engagement with life

For many men, these are qualities that go against traditional masculine values of self-reliance, certainty, dominance, competition and control.

From my own experience and observations, I believe that men are ready and willing to make dramatic changes in their lives but simply don't have the skills to do so. They know 'something' is wrong but aren't sure what to do. There is a sense of not knowing where to turn for help, what to look for, who to ask.

The message I have received from women is, "We are supportive of men taking greater interest in their health. But don't expect us to make it happen. We can be supportive, but not take the responsibility."

I believe that an important way in which women can support men to live healthier lives is as teachers and advisors. Instead of doing the work for men, they can share skills and tools.

I have heard many men and women who think men should do it alone. But for me, these suggestions ignore the simple reality that not enough men currently have these skills. As well, even among those men who do have the skills, many are often reluctant to work with other men.

The competitive nature of male relationships and the insidious strength of homophobia makes the idea of supporting or helping other men problematic even for the most 'liberated' of men.

So while we need to get many more men, especially health professionals, to take greater interest in learning how to promote the health of males, we need to promote the important involvement of women.

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VII A Healthy Vision

As I travelled across Queen Street East in Toronto recently, looking out my streetcar window at faces of men walking along the sidewalk, I recognized that same lost expression and sense of disconnection I've felt all of my life.

The tragedy is that so many of us feel it and yet we don't seem to have the skills or, seemingly, the permission to do anything about it. Talking publicly will be a good first step.

Men's Health has the opportunity to positively impact the lives of everyone because it offers a hopeful vision, encouraging men and boys to give greater value and priority to health. This will promote improved health for everyone as men attempt to change unhealthy behaviours and attitudes.

Most importantly, it will offer a positive alternative to the destructive and unsatisfying role expectations that too many males accept in silence.

VIII References

Long Walk to Freedom: The Autobiography of Nelson Mandela. Bay Back Books, Little, Brown and Company, New York, 1994.

"Living Proof," from Lucky Town. Bruce Springsteen, Sony Music, 1992.

Why Women Live Longer Than Men...And What Men Can Learn From Them. Royda Crose, Ph.D., Jossey Bass Publishers, San Francisco, 1997.

"Selected Leading Causes of Death by Sex." Stats Canada, 1997,