In September, at the first UN General Assembly focused on universal health coverage (UHC), member states were urged to progress faster on health-related Sustainable Development Goals (SDGs) to achieve UHC by 2030—“leaving no one behind”. Despite major health gains over the past few decades, progress has been uneven when analyzed by subgroups and specifically by gender, which is a powerful determinant of health outcomes. The World Health Statistics 2019 report from WHO made a first attempt to disaggregate all indicators by sex, and revealed that, globally, boys born in 2018 could expect to live 68·6 years and girls 73·1 years, a difference of 4·5 years. Surprisingly, the life-expectancy gap between genders is larger in high-income countries than in low-income settings [ну, тогда РФ — страна с самым высоким доходом], which shows that although biology is important, the biggest drivers of life expectancy are linked to social determinants of health. In this context, there is less discussion on important differences between men and women and why men have worse health outcomes.
Strong beliefs, norms, attitudes, and stereotypes of masculinity are prevalent and harmful to men's health. These beliefs create social barriers that prevent men from seeking medical services and that exposes them to greater risks. Some health risks are behavioral, particularly tobacco and alcohol consumption, which contribute strongly to life-expectancy differences. Data from 2016 show a striking gender-based gap: 54% of men and 32% of women globally reported being current drinkers, and 34% of men and 6% of women reported smoking tobacco daily in populations older than 15 years. Additionally, mortality attributable to violence and road injuries is higher in men than in women. In Europe, about three-quarters of all road traffic deaths are in men younger than 25 years. Violence—whether self-harm or violence between men—is a particularly neglected and concerning public health issue that is growing among male adolescents. In the UK, suicide is the single biggest cause of death in men younger than 50 years [различия между странами, наверно, существенные].
Men more commonly exhibit some behaviors that put them at risk of conditions such as cardiovascular diseases (often associated with poor eating habits), cancer (often associated with smoking), tuberculosis (associated with non-adherence to medical treatment), and HIV/AIDS (associated with unsafe sexual practices). Additionally, men are more highly represented in higher-risk occupations such as construction, driving, mining, and the military, thus leading to higher rates of workplace fatalities and injuries.
Despite poor outcomes for men's health, only four countries (Ireland, Brazil, Iran, and Australia) have national health policies or strategies that specifically address men [!!!]. For example, in Brazil, by extending clinic opening hours, men are encouraged to accompany their partners to antenatal appointments, which include a medical consultation specifically for the men. Recognizing the value of health systems with gender-specific approaches, last year, the WHO–European Region published a strategy to address men's health that includes recommendations on how to build gender-responsive health systems.
Health conditions that affect both men and women can be addressed by gender-neutral policies, such as tobacco control and alcohol pricing, and by gender-transformative approaches that seek to encourage men to change their behaviors. However, gender equality will only be achieved by using integrated and tailored strategies to address the specific and overlapping needs of women and men. This aim will require an intersectional approach that includes new education programs at schools to break down harmful social gender norms and a redesign of health systems to make them more accessible to everyone, including men. Finally, more research is required, with the engagement of civil society and the public helping in decision making and feedback.
The message is clear: raising the profile of men on the political agenda is crucial to achieve gender equality and to accelerate progress on all SDG targets [sustainable development goals and targets].
Men more commonly exhibit some behaviors that put them at risk of conditions such as cardiovascular diseases (often associated with poor eating habits), cancer (often associated with smoking), tuberculosis (associated with non-adherence to medical treatment), and HIV/AIDS (associated with unsafe sexual practices). Additionally, men are more highly represented in higher-risk occupations such as construction, driving, mining, and the military, thus leading to higher rates of workplace fatalities and injuries.
Although men indeed need to care more about their own health, it is also true that, globally, public health systems are more easily accessed by women, even if universal access to quality health care for them is not guaranteed. For instance, in 2015, a research study in the rural areas of South Africa showed that the decline in HIV mortality for women substantially outpaced the decline for men, explained in part because of the easier access to anti-retroviral treatment for women in maternal and child health clinics and short opening hours of the clinics, restricting access for men. Disparities in men's health have substantial implications for women as well, whether in terms of HIV infection or the burden often incurred in caring for ill male family members.
Despite poor outcomes for men's health, only four countries (Ireland, Brazil, Iran, and Australia) have national health policies or strategies that specifically address men [!!!]. For example, in Brazil, by extending clinic opening hours, men are encouraged to accompany their partners to antenatal appointments, which include a medical consultation specifically for the men. Recognizing the value of health systems with gender-specific approaches, last year, the WHO–European Region published a strategy to address men's health that includes recommendations on how to build gender-responsive health systems.
Health conditions that affect both men and women can be addressed by gender-neutral policies, such as tobacco control and alcohol pricing, and by gender-transformative approaches that seek to encourage men to change their behaviors. However, gender equality will only be achieved by using integrated and tailored strategies to address the specific and overlapping needs of women and men. This aim will require an intersectional approach that includes new education programs at schools to break down harmful social gender norms and a redesign of health systems to make them more accessible to everyone, including men. Finally, more research is required, with the engagement of civil society and the public helping in decision making and feedback.
The message is clear: raising the profile of men on the political agenda is crucial to achieve gender equality and to accelerate progress on all SDG targets [sustainable development goals and targets].
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