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Federal Government announces action plan to improve men's health



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Dr Carmen Lawrence M in ister for H u m an S ervices and H ealth M in ister A ssistin g the P rim e M in ister for the Statu s o f W om en

CL 19/96 ·

18 January 1996

F E D E R A L G O V E R N M E N T A N N O U N C E S A C T IO N P L A N T O IM P R O V E M E N 'S H E A L T H

An innovative education campaign and extensive research are the key elements of the first stage of the Federal Government's national action plan to improve the health of Australian men.

Launching the draft Men's Health Policy in Melbourne today, Federal Minister for Human Services and Health, Carmen Lawrence, said a radical new approach was needed to address serious health problems facing Australian men and their underlying causes.

"The draft policy recommends a concerted approach by Federal, State and Territory governments and community groups to tackle the high levels of preventable deaths, injuries and illnesses which characterise the health profile of Australian men,” Dr Lawrence said.

"As a first step, an education campaign and community based programs will get underway during the year to take key information on men's health into schools, the workplace, service clubs and health centres.

"We will also embark on a major media campaign to directly address male stereotypes that contribute to excessive risk taking behaviour and poor use of health services."

In preparation for this national education campaign, and for the final policy, extensive research will be conducted to identify men's specific needs from health services.

"The conventional approach to men's health is to deal with injuries, diseases and conditions in isolation from other factors," Dr Lawrence said.

"This draft policy establishes a more holistic approach to men's health and recommends broad responses to specific problems."

Dr Lawrence said that for change to occur, health services need to consider the impact of masculinity and male socialisation on a range of outcomes.

"For example, we need a better understanding of why so many men, particularly young men, engage in high levels of risk taking behaviour," she said.

"Underlying structural factors could also help explain why preventable problems such as suicide, heart disease, lung cancer and occupational accidents, affect men at much higher rates than women. ( .

"Unless the nature of men's work, their socioeconomic status and pressures such as unemployment are taken into account, the health system will struggle to come to terms with targeting men."

Federal Government commitment to a National Mens' Health Policy was announced by Dr Lawrence in August last year at the first National Men's Health Conference. In addition to input from more than 500 delegates at the conference, forums were held in Sydney, Brisbane, Adelaide, Perth and Hobart to formulate the draft policy.

A major consultation process is planned, with distribution of the draft policy to State Governments, community groups, key stakeholders and interested individuals for comment.

"We are encouraging all interested parties to have their say, to ensure that we develop a responsive, innovative policy that fits the bill," she said.

"The special needs of Aboriginal and Torres Strait Islander men, men from non- English speaking backgrounds and other groups must also be addressed and the consultation process has been designed to incorporate their views."

Other strategies announced today include the creation of an Indigenous men's reference group; a national electronic database of existing men's health initiatives; and plans for a series of issues papers to stimulate debate on key topics.

Dr Lawrence said the final draft of a National Men's Health Policy would be submitted to the Australian Health Ministers' Council towards the end of the year as the basis for comprehensive national action.

Media Contact: Brenda Conroy 0412 414781

M en’s Health - a framework for the future

BACKGROUND

The Draft National Men's Health Policy underpins an important shift in thinking in the way Australia tackles men's health. In essence, the Federal Government has devised a blueprint aimed at fostering a broader, more holistic approach.

This revised approach is founded on key recommendations from Australia's first National Men's Health Conference last August, and a subsequent series of community forums. Progress towards a national policy, expected to be in place by the end of this year following extensive

consultation, will be supported by interim initiatives outlined in an action plan released by the Minister for Human Services and Health, Carmen Lawrence, today.

A ctio n plan

Education, community information and research initiatives will feature heavily in the first phase of a national action plan to improve men's health.

Last year’s national conference and community forums highlighted the need for action, particularly in relation to the impact of masculinity and male socialisation, as well as structural issues such as the nature of work, unemployment and socio-economic status on men's health outcomes.

The three-point action plan commits the Federal Government to initial measures to improve men's health and their access to health services, and paves the way for longer term measures when a National Men's Health Policy is finalised.

Education

The action plan commits the Federal Government to a national men's health education strategy targeting schools, workplaces and a range of community organisations and facilities.

Issues to be addressed range from challenging stereotypes and violence which have a negative impact on young men's health, to encouraging more positive masculine behaviours.

Information

National co-ordination of skills and information will be a priority under the action plan. An electronic data base will be developed and regularly updated. Best practice initiatives, many of which are already in place, will be identified and promulgated. Benchmarks and indicators will set standards to gauge progress.

Research

Research on targeting health services for men will pave the way for improvements; The action plan also commits the government to developing a men's health research strategy to help guide decisions by existing research organisations such as the National Health and Medical Research Council. *

T o w a r d s a N a tio n a l M e n 's H ealth P olicy

The Draft National Men's Health Policy was founded on advice from community organisations, researchers and men's health experts, starting with the national conference in Melbourne last August and refined through consultation at a series of forums around Australia. .

The policy will be further developed through the input of State and Territory governments, the community sector, professional medical organisations and other key stake holders, as part of an exhaustive consultation process this year.

The implementation of the national action plan will also create opportunities for consultation, reshaping both the action plan and the progress towards a final policy.

Consideration of the special needs of groups such as Aboriginal and Torres Strait Islander men, men from non-English speaking backgrounds, rural men and gay men will be built into the consultation process. This should ensure that the action plan and the National Men's Health Policy promote services which are applicable to all men.

The draft policy will ultimately go before the Australian Health Ministers Conference, probably later this year.

Men's Health - a framework for the future

F A C T S A N D F IG U R E S

Despite significant improvements in health outcomes generally, statistical research highlights a continuing disparity between Australian men and women.

Australian Institute of Health and Welfare research shows:

• A boy bom in 1993 has a life expectancy of 75 years, six years less than a girl bom in the same year.

• Young men (aged 15 to 24) are three times more likely to die in a car accident and four times more likely to suicide.

• Working aged men (25 to 64 years) have a death rate nearly twice as high as women the same age.

• Working aged men are disproportionately affected by several major killers - their deaths rates from heart disease and suicide are 3.5 times higher, three times higher for lung cancer, and 2.5 times higher for motor vehicle accidents.

• Boys (aged 14 and under) have a death rate 35 per cent higher than girls and are 42 per cent more likely to have a serious chronic illness.

• Prevalence rates for disability, handicap and severe handicap are approximately 40 per cent higher for boys than for girls.

• Older men (aged 65 and over) die at a rate 61 per cent higher than women, with lung cancer deaths almost four times as high and suicide deaths almost three times as high.

The same research shows that working aged men have significantly higher levels of risk taking behaviour such as smoking, obesity and risk drinking, yet are far less likely to visit doctors, hospitals and dentists.

Other factors suggest a greater likelihood of poor health outcomes, such as:

• Men's over-representation in prisons, where they make up 95 per cent of inmates.

• Their greater propensity to commit acts of physical violence.

For Aboriginal and Torres Strait Islander men, the picture is worse (as it is for all Indigenous Australians). For example:

An Aboriginal male child bom in 1992 is three times more likely to die before the age of five than a non-Aboriginai male.

This boy's life expectancy is just 57-60 years, around 15-18 years less than his non­ Aboriginal contemporaries.

• Mortality rates are significantly higher for young and middle aged Aborigines than for non-Aborigines overall, with males in the 35-44 year age group dying at a rate more than 11 times higher.

• Aboriginal and Torres Strait Islander men are also around 30 times more likely to be in prison or custody than other men. ..

Men's Health - a framework for the future

THE CHALLENGES FACING MEN'S HEALTH

BOYS WILL BE BOYS: SOCIALISATION AND STRUCTURAL FACTORS %

Traditionally, biology was to blame for gender differentials in mortality and morbidity. The approach adopted in the t Federal Government's national action plan and proposed for the National Men's Health Policy, will be to factor in a „ range o f other considerations.

Identifying and responding to underlying structural factors such as socio-economic status, and linking these with male socialisation, may help explain the disproportionate impact o f some diseases, conditions and trauma on men.

For instance, the lack o f gender analysis in mainstream health services limits our understanding o f how underlying structural factors affect men's access to these services. Nor are the mixed effects o f socialisation, particularly notions s of masculinity, clearly understood in a health context.

Closer scrutiny of underlying causes may help explain outcomes such as men's propensity for significantly higher risk taking behaviour such as smoking, reckless driving, obesity and risk drinking. Research and education campaigns under the national action plan such as developing curricula for schools which address stereotypes, violence and bullying, and targeting services to male-dominated workplaces, will address these issues, and lead to longer term strategies.

A better understanding o f the impact o f socialisation and underlying structural factors will also enable mainstream services, such as substance abuse and mental health services, to reorientate their programs to better target their male clients.

$ ABORIGINAL AND TORRES STRAIT ISLANDER MEN

Aboriginal and Torres Straight Islander men have consistently poorer outcomes across a range o f health indicators. Under the national action plan, an Indigenous men's reference group will be convened to ensure that the proposed * National Men's Health Policy targets the specific needs of Aboriginal and Torres Straight Islander men in a culturally sensitive way.

The state of Indigenous health generally, and Indigenous men's health in particular, starkly illustrates the need to foster initiatives at a community level which address underlying causes o f ill health including racism, dispossession, lack o f f basic infrastructure (housmg, sewerage and water), and unemployment.

MEN'S HEALTH FOR ALL: NESB. GAY & RURAL MEN

The national action plan and Draft National Men's Health Policy will also target the needs o f men from other specific population groups, particularly men from non-English speaking backgrounds, gay men and rural men.

For instance, the needs o f men from non-English speaking backgrounds differ from other groups, particularly in $ relation to the delivery of health promotion material and culturally appropnate medical services. Significant differences in the rates o f disease incidence and mortality among different ethnic groups (eg. across a range o f cancers) pomt to y the importance of lifestyle factors that need to be considered to improve the health of all men.

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Gay men and other men who have sex with men often need access to health services which are sensitive to their lifestyles and can deliver effective, confidential treatment and advice free o f stigma or assumptions.

Rural men often suffer the double disadvantage o f remoteness from services and frequent exposure to hazardous machinery or chemicals. The socialisation process that inculcates male roles and behaviours can be particularly strong in rural areas too. _

The national action plan includes initiatives to identify and promulgate best practice at all levels o f health education and care. The gay community's success in developing multi-tiered education and treatment responses to HIV/AIDS illustrates the need for governments to work in partnership with the community sector. The Draft National Men's Health Policy recommends a cooperative approach to foster men's health initiatives across all sectors o f the community, and community consultation will be central to this year's push to develop a final National Men's Health Policy.

STAG E BY STAGE: THE IMPORTANCE OF LIFESTAGES

By far the biggest changes recommended by the Draft National Men's Health Policy focus on the need to adopt broader, more holistic approaches to improving health outcomes. Instead o f just focusing on illnesses, strategies will consider how a man's stage o f life influences the issues that impact on his health.

For boys and young men. socialisation is particularly influential on health and risk behaviours, both in their youth and in creating long-term habits. As the national action plan recognises, this is an important time to be working in schools to overcome some o f the pressures behind these behaviours and thinking.

For working aged men. issues around work are often of paramount importance. For unemployed men, issues o f mental health, self-esteem and access to services can impact on their health. For those with jobs, occupational stresses and behaviours can affect their health and access to services. The national action plan includes programs to target workplaces, which can be a medium for disseminating health services and information, and seeks to encourage

innovation in the delivery o f such programs to increase their effectiveness.

For older men. retirement is a key health influence. Many are ill-prepared to take on a different role in society. Many others have grown up in traditional roles, and the death of a spouse can leave them ill-equipped to deal with basics like cooking and creating social networks. The national action plan will seek to promote and develop a role for existing service organisations (such as RSL. Rotary and other clubs) to promote initiatives that are making a qualitative difference to older men's lives. This will include provision o f information and encouraging discussion across a range o f health issues such as prostate problems, including prostate cancer, heart disease, disability and sexuality.

Prostate cancer is a major men's health issue of concern to older men with considerable debate and controversy as to the value and efficacy o f screening and treatment technologies. The Federal Government has commissioned the Australian Health Technology Advisory Committee (AHTAC) to review evidence on the benefits, risks and costs o f screening for prostate cancer. AHTAC, a standing committee o f the NHMRC, is expected to report to the Minister

in the next few weeks. Recommendations from this review will be taken up as part of the men's health policy.