Chapter 112

### Introduction

Call it the ‘M-factor’, call it maleness, call it what you like—but from infancy onwards, in every age group, males are more likely to die than females.

Andrew Pattison1

In recent years, increasing attention has been focused on men’s health, mainly because it became evident that the average male’s lifestyle was slowly killing him. As doctors we are beginning to understand that a great proportion of male ill-health is related to behavioural and social factors.

An important statistic is the constant discrepancy in average life expectancy (ALE) between the sexes. At present in Australia, the ALE is 79.9 years for males compared with 84.3 years for females.2

Since the beginning of the 20th century and even further back this discrepancy has continued. In 1900 the ALE for males was 55.2 years and 58.8 for females.2 This increased to a difference of 6 years for most of the last century. However, the significant increase in ALE for both sexes has been encouraging.

Men have a significantly greater incidence of medical conditions and problems, such as cardiovascular disease, obesity, alcoholism, HIV and hypertension, as well as having higher rates of accidental death and suicide. The following comparative statistics for Australian society highlight this difference.

### Men’s health at a glance1,2,3

• Up to 14 years, boys are at least twice as likely to die from accidental injury (e.g. motor vehicle accidents [MVAs] and drowning).

• In the 15–24 years age group, males are three times more likely to die in MVAs and four times more likely to commit suicide. The overall death rate is 3.65 times higher than for females.

• In the 25–65 years age group, males are four times more likely to die from coronary artery disease, three times more likely to die in MVAs, four times more likely to commit suicide, four times more likely to die in other accidents, and twice as likely to die from cancer. The overall death rate is two times that of females.

• The figures are worse in the lower socioeconomic groups. Low-income males are nearly three times more likely to state that their overall health is poor compared to men with higher incomes.

• At least four out of five heroin overdose deaths occur in males.

• Aboriginal males’ life expectancy is 17 years less than that of non-Aboriginal males. In the 35–45 years age group, the death rate is eleven times that of non-Aboriginals.

• Workplace deaths—93% occur in males (who constitute 56% of the workforce).

• Forty-six per cent of Australian marriages end in divorce. The majority of these are initiated by women.

• Ninety per cent of those convicted for acts of violence are males: 80% of the victims are males.

• In Australian schools, 90% of children with documented behavioural problems are males.

###### FIGURE 112.1

Source: Courtesy of Ron Tandberg

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