Health and Maleness:

🕔Jan 31, 2011

Where are the men?
It’s not just northern BC’s single women who want to know. It seems even health-care providers are asking the question—not the least of which is David Bowering, chief medical health officer for the Northern Health Authority and, indeed, a man himself.

Although I haven’t taken his pulse or felt his brow, Bowering looks healthy enough. Seated across from me in a Smithers restaurant on his way to Haida Gwaii, he’s drinking tea and just ordered salad with his sandwich. But Bowering’s rosy complexion and healthy lifestyle might set him apart from the typical northern male.

Where are the Men: Chief Medical Health Officer’s Report on the Health and Wellbeing of Men and Boys in Northern BC is a report released by the Northern Health Authority in late November. The report reiterates a known truth: women, on average, live longer than men. It also reveals a shocking discrepancy in lifestyles and general health between men and women, particularly in the province’s northern region.

“Men just don’t do very well. That’s always been the case and there has always been an astonishing lack of attention paid to it,” Bowering says. “If men are healthy, the communities are healthy and the people they are partnered with and supporting will be better off.”

Researched through existing data and focus groups, the report starts with the difference between sex and gender: Sex is what you are born with, and brings with it its own health challenges. Gender is the societal expectation that’s layered on top.

For example, men tend to lead higher-risk lifestyles. They are more likely to work resource-industry jobs, which take them away from home on northern BC’s treacherous highways. While away, their diets are likely to suffer, their relationships struggle and they are more likely to partake in unhealthy lifestyles, such as drinking, smoking and drug abuse.

If you are a man born in northern BC, Northern Health estimates you’ll live slightly beyond your 75th birthday, whereas a woman is expected to live to 80. (For BC as a whole, add a few years for both sexes.) Assuming you survive your infancy (infant mortality is the only area where females outnumber males), you’ll be twice as likely as your female counterpart to die of heart disease or cancer, 50 percent more likely to die of respiratory disease, three times as likely to die of unintentional injuries, nearly twice as likely to die from tobacco use and nearly three times as likely for your death to be alcohol-related.

Inherent risks
Despite these statistics—and perhaps accounting for them—men seek medical help roughly half as often as females.

Also disturbing is the statistic that men in northern BC commit suicide three times as often as women, indicating stress and depression are also an issue. As primary income earners, they often feel greater pressure to be providers, making them less likely to take sick days or visit a doctor. As well, jobs away from home put additional pressure on families and marriages, increase the likelihood of substance abuse and make it harder to build a supportive social network.

“The choice to live and work in the North may, in itself, demonstrate a degree of tolerance for risk and a willingness to live on the edge,” Bowering adds. “I’m driving from Prince George to Prince Rupert with terrible weather and slippery roads, and that’s just what you do. Some of the risks are inherent with being up here.”

Bowering muses about the biological role of the man: to procreate, protect and provide. While, from an evolutionary perspective, it may have been more important for women to stay alive and raise the family, he notes that in today’s society, “Men can’t be effective, they can’t be good at support, if they die of a heart attack in their 40s.”

Over the past five years, 21.3 percent of workplace deaths in BC were in the North, despite the region having only seven percent of the province’s population. Of those 83 deaths, 81 were men and most were in forestry, mining or the commercial transport sectors.
Depressing as it sounds, the same timeframe saw an 80 percent drop in logging truck driver fatalities and injuries, in part due to MaryAnne Arcand’s work in raising awareness around road safety. Arcand is Executive Director for the Central Interior Logging Association and Northern Health’s RoadHealth coordinator. In November, she was awarded the Health and Wellness Advocate of the Year award in Prince George.

And she isn’t afraid to stand up to a bunch of loggers and tell them when they’re being stupid.

The Central Interior Logging Association represents 200 logging companies, or about 10,000 resource-industry jobs, and Arcand estimates 95 percent of those positions are filled by men.

“There’s a clear connection between workplace wellness, chronic diseases and injuries,” she says. “Truck drivers, for instance, generally have a higher rate of obesity than the rest of the population.”

The Road Less Healthy
Being overweight is often caused by lack of exercise and poor eating habits when on the road, and is a leading factor in sleep apnea, which causes abnormal pauses in breathing and leads to disturbed sleep patterns. Along with general ill health, sleep loss leads to drowsiness behind the wheel, which increases the risk for traffic collisions.

Add to that the long, lonely hours on the road away from family and friends and the financial stress that comes with seasonal jobs, and the prognosis for truckers doesn’t look good. In fact, the life expectancy of a truck driver in Canada is 61, Arcand says.

“The flip-side is the oil and gas industry, which pays really well and has a young demographic,” Arcand adds. In this case, large paychecks often lead to drug and alcohol abuse during days off, unsafe driving and sexually transmitted diseases.

“There’s been a push on industry for safety, but those habits don’t go home,” Arcand says, pointing to the chainsaw operator who follows safety procedures at work, but is likely to ignore them when bucking up firewood at home, or the truck driver who would never drink on the job, but drives home after a few at the pub on weekends.

“You can change the culture. It starts with that awareness. It starts with that person looking in the mirror and saying, ‘That was stupid. Why did I do that? I wouldn’t do that at work.’”

Bowering agrees, hoping that the recent report will raise awareness for issues surrounding men’s health and focus attention on prevention.

“We’re not going to change the whole culture with one report,” he says. “It just seems like there’s a number of aspects to men and boys’ health that really weren’t worked on before.”

Indeed, research has traditionally focused on health in women, children or aboriginal groups, with general men’s health largely overlooked. Instead of funding what Bowering describes as “big-picture issues” like road safety, health care dollars tend to focus on immediate concerns like the H1N1 virus.

He credits Northern Health with taking a pro-active approach to men’s health, and hopes the report will start a dialogue in communities throughout the region.

“I feel very lucky to be part of a health authority that would let me get this far. You won’t find it anywhere else.”

So where are the men?
Well, they’re often working jobs that don’t allow them to visit doctors during 9-to-5 business hours. They might avoid medical appointments because of stigma or embarrassment or because many preventative healthcare workers are female. Some feel more comfortable attending group medical appointments, where someone else might ask the embarrassing questions.

Or they’re out on adventures, exploring the mountains, driving the highways and living the northern life.

“We have a stereotype of men that works in some ways,” Bowering says, “but in some ways isn’t healthy.”