It’s been 20 years since South Africa underwent the transition from apartheid to constitutional democracy and although considerable social progress has been made toward reversing the discriminatory practices that pervaded all aspects of life before 1994, there are still many matters that are unsolved (Benator, 1986; 2004; Coovadia; Jewkes; Barron; Sanders & McIntyre, 2009). The health and well-being of most South Africans remain plagued by a relentless burden of infectious and non–communicable diseases, persisting social disparities, and inadequate human resources (Wideside, 2013)
Healthcare providers and politicians agree that although there are unique aspects to improving health in South Africa, the local challenges represent a microcosm of obstacles to improving population health globally (Benator, 2002).
In the Western world, the health of men is poorer than that of women, mortality rates are higher and men use health services less often than women, even when reproductive services have been accounted for. In fact, being male is a significant risk factor for early mortality in developed countries (Porter & Ku. Use of reproductive health services among young men, 1995. J Adolesc Health 2000; 27: 186-194).
Rates of morbidity and mortality are useful in establishing that men’s health should be monitored more closely. Men’s help-seeking behaviour and use of health services deserve increased attention. Although men’s help-seeking is known to be problematic, there is scant research to suggest how and why this is so (Mansfield, Addis, Mahalik. Why won’t he go to the doctor? The psychology of men’s help–seeking. Int J Men’s Health 2003; 2: 93-109; Lee, Owens. The psychology of men’s health. Buckingham: Open University Press, 2002.)
The equivalent use of terms such as doctor, health service, health service provider and healthcare system make comparisons between studies complex. Nevertheless, regardless of definitions, men consult doctors (specifically general practitioners) less often than women do (Seymour-Smit, Wetherell, Phoenix. “My wife ordered me to come!” a discursive analysis of doctors’ and nurses’ accounts of men’s use of general practitioners. J Health Psychol 2002; 7: 253-267).
Major health problems common amongst men
Heart disease comes in many forms. All its forms can lead to serious, fatal complications if undetected. The American Heart Association declares that more than one in three adult men have some form of cardiovascular disease. African-American men account for 100 000 more cardiovascular disease deaths than Caucasian men.
Stroke targets more than 3 million men. High blood pressure is common in males under the age of 45, according to the American Heart Association. Routine check-ups can help keep that heart beating. A doctor can calculate a persons’ risk for cardiovascular disease based on several risk factors, including cholesterol, blood pressure, and smoking habits.
Many respiratory diseases start with an innocent “smoker’s cough and over time, that cough can lead to life-threatening conditions, such as lung cancer, emphysema, or COPD. All these conditions interfere with your ability to breathe. COPD includes both chronic bronchitis and emphysema and you can have one or the other. Most patients have a combination of both. Chronic bronchitis involves the narrowing of the large and small airways and inflammation and emphysema involve damage to the air sacs (alveoli). The lungs are less able to exchange carbon dioxide for oxygen because of loss of their elasticity and air remaining trapped inside.
Rates of type 2 diabetes are soaring in the UK, in men, women and shockingly even children. Symptoms to look out for include increased thirst and urination, extreme fatigue and weight loss. Obesity, family history, high blood pressure and inactivity all increase your risk. Any man with any of these symptoms and risk factors should undergo blood testing for glucose levels and HbA1c (an indicator of longer-term glucose levels). The good news with type 2 diabetes is that it’s potentially reversible with committed lifestyle changes such as diet improvements, exercise and weight loss (Weng& Santeramo, 2018).
“In the UK, 1 in 7 men will develop cancer of the prostate (the gland between the penis and bladder) in their lifetime. Symptoms are mainly regarding urinating: difficulty starting, increased frequency, and difficulty emptying the bladder. Often, the prostate enlarges naturally with age anyway, known as benign prostate enlargement, producing similar symptoms. To investigate this, your doctor can perform a blood test and a prostate exam, and potentially refer you on to a specialist.”
The lifetime risk for Prostate Cancer in men in South Africa, is 1 in 19, according to the 2014 National Cancer Registry. Prostate cancer is the most common male cancer globally and locally and shows significant increases. International and local research indicates that the risk for aggressive prostate cancer is higher in black men (https://Cansa.org.za).
Often an embarrassing complaint to mention to a doctor, despite approximately 50% of men over 40 having experienced this to some degree. However, the inability to produce or maintain an erection (also known as erectile dysfunction) can be a sign of something more serious, such as heart disease or diabetes (https://Cansa.org.za).