Last Sun­day, from across the aisle in church, I saw the beam­ing smile of my friend Steve Reg­is, tow­er­ing over every­one, try­ing to get my at­ten­tion. As for­mer Guardian Me­dia work­mates, Steve and I hold a spe­cial bond, but that smile had an ex­tra gleam to it. More like mis­chief, to be hon­est.

He met me with a huge hug and start­ed, “I read your col­umn last week and was look­ing for­ward to talk­ing with you about it. The one about men liv­ing short­er lives and the caus­es.”

“Nice. Thank you,” I said.

“But you had me look­ing for the end of your col­umn,” he added quick­ly.

“I was turn­ing the page look­ing for the con­tin­u­a­tion. I say, ‘Like Car­o­line ar­ti­cle get cut’,” he joked.

“How come you left out the main rea­son men live less years than women? Where was the part about women be­ing a cause?”

And with that, we both fell apart with rau­cous laugh­ter!

Every time I speak on men’s life ex­pectan­cy, the re­sponse is the same. It is such a pop­u­lar po­si­tion sum­maris­ing the is­sue and one that has great comedic val­ue: that women dri­ve men to their deaths.

Dur­ing this past No­vem­ber, I did an ear­ly morn­ing pre­sen­ta­tion where I of­fered up the anec­dote to a group of re­tirees. They ful­ly ap­pre­ci­at­ed the hu­mour, and my usu­al dra­mat­ic de­liv­ery, of this non-fact, amid all the sci­en­tif­ic ev­i­dence pre­sent­ed on health­i­er liv­ing.

Still, was Steve mak­ing a valid ob­ser­va­tion, though?

Sci­en­tif­i­cal­ly, no. Noth­ing in the lit­er­a­ture shows that women in­flu­ence men’s mor­tal­i­ty. To my mind, the so­cial, bi­o­log­i­cal and hered­i­tary/ge­net­ic fac­tors to make this ar­gu­ment are dif­fi­cult to quan­ti­fy and es­ti­mate im­pact, if any, of as­sumed “haz­ards” in the so­cial in­ter­ac­tion be­tween men and women.

What the lit­er­a­ture sug­gests is that women should be at the oth­er end of the longevi­ty equa­tion, giv­en the so­cial in­equal­i­ties which char­ac­terise our ex­is­tence.

Women are known to ex­pe­ri­ence “high­er stress, more chron­ic dis­ease, more de­pres­sion, more anx­i­ety and are more like­ly to be vic­tims of vi­o­lence” (the­con­ver­sa­tion.com/if-men-are-fa­vored-in-our-so­ci­ety-why-do-they-die-younger-than-women).

“Women earn less than men, and in many coun­tries, they don’t have the same hu­man rights as men,” says the­con­ver­sa­tion.com, not­ing that women out­liv­ing men is a phe­nom­e­non in every coun­try, with­out a sin­gle ex­cep­tion.

The avail­able re­search gen­er­al­ly con­cludes that women out­live men be­cause men gen­er­al­ly en­gage in riski­er be­hav­iours that are detri­men­tal to health and life. Women, as well, take greater ad­van­tage of health in­no­va­tions, ac­cess­ing health­care and pay­ing more at­ten­tion to the so­cial de­ter­mi­nants of health (SDoH), like their liv­ing con­di­tions (sci­en­tifi­camer­i­ca.com).

The SDoH are the non-med­ical fac­tors that in­flu­ence health out­comes. The World Health Or­ga­ni­za­tion de­fines it as “the con­di­tions in which peo­ple are born, grow, work, live, and age, and the wider set of forces and sys­tems shap­ing the con­di­tions of dai­ly life. These forces and sys­tems in­clude eco­nom­ic poli­cies and sys­tems, de­vel­op­ment agen­das, so­cial norms, so­cial poli­cies, racism, cli­mate change, and po­lit­i­cal sys­tems” (who.int/health-top­ics/so­cial-de­ter­mi­nants-of-health).

Women have tra­di­tion­al­ly been dis­ad­van­taged in these sys­tems and gen­er­al­ly re­port worse health than men, de­spite out­liv­ing them. Many schol­ars con­clude that it may not nec­es­sar­i­ly mean women are un­health­i­er but that, be­ing more health aware, they are al­so the ones to re­port more health cir­cum­stances than their coun­ter­parts.

Ad­di­tion­al­ly, women are not­ed as bet­ter com­mu­ni­ca­tors and are more open to speak­ing about their prob­lems, which im­prove di­ag­no­sis. They are more com­mit­ted to their phys­i­cal and men­tal well-be­ing, while men are slow­er in ini­ti­at­ing health in­ter­ven­tions and are more like­ly to not ad­here to treat­ment.

Mas­culin­i­ty, says the con­ver­sa­tion.com, is a so­cial­ly learned con­struct that has un­healthy ef­fects.

“Many men de­fine un­healthy and risky be­hav­iours as mas­cu­line, while they see health care use and health-pro­mot­ing be­hav­iours as fem­i­nine.”

Now, the main idea be­hind this dis­cus­sion is not a de­fence of Steve’s pos­tu­la­tions, nor is it a pro­mo­tion of women’s help-seek­ing and health-seek­ing be­hav­iours as su­pe­ri­or. The mo­tive is to keep the con­ver­sa­tion open with the hope of get­ting our men to con­sid­er oth­er, or bet­ter re­spons­es to their health.

Our men must be­come com­fort­able about their health and more open to con­ver­sa­tions on the is­sues. You can­not know my joy that, like oth­er men who have emailed, Steve is read­ing and re­spond­ing, even if in jest.

My aim in my com­mu­ni­ty is to raise the vol­ume on men’s health. Let us all—men, women and chil­dren—ob­serve “Movem­ber.” Let there be cel­e­bra­tions every­where for In­ter­na­tion­al Men’s Day and let our ad­vo­ca­cy to make men health­i­er be dri­ven each day by the idea that our world would be health­i­er if they are.

Let us get to a place and a day when wish­ing a man hap­py In­ter­na­tion­al Men’s Day gets more ap­pre­ci­a­tion than the hur­ried hugs and pal­pa­ble brush asides with, “That is a re­al thing?” Or “When is that? To­day?” (ac­tu­al re­spons­es in 2023). Com­bat­ing such dis­com­fi­ture among men is a cam­paign in it­self!

For now, farewell Movem­ber. When we meet again, it will be with im­proved ad­vo­ca­cy and un­der en­hanced cir­cum­stances.

#Health­ier­men­health­ier­world

#Movem­ber2023

#Mo­Sista