Men continue to live shorter lives than women – with experts singling out cancers, heart disease and stroke among the biggest killers. As part of Men's Health Week, we share five positive steps Kiwi men can take today to help themselves.
1. Get that blood pressure down
Been told you have high blood pressure? That's not something to ignore.
Blood gets pumped around the body when our hearts fill and contract, putting pressure on the arteries – and it's highest when leaving the heart and lowest when it returns.
Measuring and describing these gives your blood pressure, and ideally, you want to be sitting at 120/80 or lower.
Hypertension, in particular, develops when there's too much pressure in your blood vessels, which can damage them and cause health problems.
Anyone can develop high blood pressure, but it becomes more common as we get older, and can lead to strokes, heart attacks, heart and kidney failure.
If your reading is higher than 140/90, you need to start lowering it.
The first step is to get checked - and regularly, either at your local health clinic or pharmacy, or at home.
Your doctor might prescribe medications, but you can also make a difference yourself with moderate physical activity, eating plenty of fruit and vegetables, maintaining a healthy weight, cutting down on salt and alcohol - and avoiding processed meat and tobacco.
2. Help your heart
Many of those tips also apply for keeping your heart healthy.
Heart disease is the biggest killer in New Zealand, and accounts for one third of all deaths each year.
The most common one of these is coronary artery disease, or CAD. This happens when the arteries that supply blood to your heart muscle become hardened and narrowed due to the buildup of cholesterol and other material on their inner walls.
This build-up is called atherosclerosis and as it grows, less blood can flow through the arteries and the heart muscle can't get the blood or oxygen it needs.
A gradual blockage can result in angina, while a sudden or severe blockage can cause a heart attack or cardiac arrest.
Risk factors for CAD include age, ethnicity, gender, personal or family history of heart attack or stroke – but you can reduce that danger by not smoking, controlling blood pressure, exercising regularly, and keeping your blood cholesterol levels down.
Some easy dietary changes include eating more fruit and veges, switching to wholegrain, using herbs and spices instead of salt, and, of course, making healthy fat choices.
3. Get a prostate check
Prostate cancer is the most commonly diagnosed cancer among New Zealand men, with around one in nine Kiwi men developing it at some stage in their lifetime.
You're at higher risk if you're over 50, especially if you're over 60; if you have a family history of prostate cancer; or if you're overweight or obese.
Unfortunately, there might not be any warning signs: most symptoms relate to issues with passing urine, and many of these are due to prostate enlargement, rather than cancer.
That means men should annually get tested – either through a prostate specific antigen (PSA) blood test or a simple direct examination by their GP – after they pass their 50th birthday.
If found early, men with prostate cancer have a better chance of successful treatment.
4. Keep your mates close
Mental health isn't a trivial issue at all – and Kiwi men are particularly bad at addressing it.
Rather than talk about depression and anxiety, they're more likely to discuss the physical signs of, such as feeling tired all of the time.
Sadly, they're also more likely to take their own lives: in 2020, there were 444 suspected male deaths by suicide, compared with 147 among women.
Clinicians recommend eating well-balanced diets, staying physically active, avoiding turning to drugs and alcohol, staying connected and talking with loved ones – and perhaps most importantly, always asking for help.
If you're battling poor mental health yourself, reach out to a mate and talk about it.
And if you think your mate's in trouble, arrange a catch-up somewhere private, comfortable and neutral.
Make sure you won't be rushed, and if your mate wants to open up, that you have time to listen to him – and remember not to judge him, or think you can fix him.
Talking to a mate involves much more than a chat: it's a signal to him that he's not alone, he has someone to lean on, someone to offer hope.
5. Pick realistic goals, then stick to them
One in three Kiwi men are overweight – and it's estimated that, from the age of 20, left unattended the average man will put on between 500g and 1kg of fat per year up to the age of 50.
Put simply, gaining weight is the result of an energy imbalance: put energy into your body as food, and when you don't use up enough of that by exercise and daily movement, the excess energy gets stored as fat.
Being overweight majorly increases your risk of heart disease, stroke, diabetes and some types of cancer.
Clinicians encourage men to check their BMI (body mass index) - but waist size, as used by the World Health Organisation for metabolic risk, can also be a good guide.
Men with waist circumferences of more than 94cm show increased risk for metabolic syndrome, such as obesity, high blood pressure, high glucose levels, high blood fat levels, low good cholesterol levels.
All the above steps can help. And rather than try to go hard or go home, stick to small steps forward.
If you're overweight or obese, aim to lose a kilogram every fortnight, eat one healthier meal each week and cut back on the number of drinks you have. Take last week's gains and add a little this week.
On a day-to-day basis the gains may seem trivial, too small even to notice, but looking back over weeks, months and years, the gains can be enormous.
Why New Zealand needs a men's health policy
Why the focus on men?
Well, the figures aren't pretty. About 3000 cases of prostate cancer diagnosed a year; an average life expectancy four years' shorter than women; or the sad fact one in four Kiwi men won't live to retire.
Men are more likely to die of heart disease and to take their own lives.
These glaring statistics underscore why advocates are running a national mens' health week, now underway.
Rather than just being down to the common misperception that Kiwi men don't care about their own health - they do - the driving factors are complex, researchers say.
"The fact is that health services and health promotion programmes aren't specifically designed to support men to improve their own health," said Associate Professor Elaine Hargreaves, an exercise psychology expert who's part of Otago University's Centre for Men's Health.
"There are few opportunities for mens' health-centred for them to engage with."
Centre co-director Dr Ally Calder agreed.
"Once a guy has a health issue, they do want to seek help, and they do know about things like physical activity – but they just have so many barriers," she said.
"And that's not just men with disability, but men across the board."
Calder felt a sense of masculinity among some men – or a sense that seeking help for themselves might be seen as a sign of weakness – was a "tiny part of equation".
The factors were broad, and ranged from cultural reasons to a lack of tailored support, and socio-economic barriers.
That was particularly the case with Māori and Pasifika males, who had a life expectancies of just 73 years and 74.5 years respectively, compared with about 80.3 years for their non-Māori counterparts.
These men were more likely to be living with co-morbidities – but also faced long-standing health inequity.
One previous article in the New Zealand Medical Journal summarised men's health as "partly a product of biology, social expectations and systemic discrimination variable of access and quality of care, as well as a consequence of masculinity".
"To improve men's health," it continued, "it is beneficial to raise men's health awareness by enabling men to define what health means to them, improve access to healthcare resources, particularly avoiding environments, terminology or judgments that might be negative about masculinity."
When it came to what interventions could really make a difference, Hargreaves and Calders' work had suggested "by men, for men" programmes were particularly effective.
One such programme Hargreaves has been running through super rugby franchises to take advantage of men's love of sport to "hook them in".
And it wasn't about going on a diet or making radical changes to lifestyle behaviour, but making small achievable lifestyle changes.
The group nature of the programme had men supporting and motivating each other, Hargreaves said.
"It's about harnessing the power of social support between each man."
Overseas, Ireland's Farmers Have Hearts cardiovascular health programme has led to more than 80 per cent of participants successfully making some form of lifestyle behaviour change.
Empowerment was important, Otago mens health researcher and PhD candidate Hui Xiao said, given his work had identified a gap between awareness and motivation.
"Men have the awareness – but they often don't have the motivation."
While younger athletes and sportsmen were more likely to keep on top their health, men aged over 60 and 70 years old were often poor at seeking help.
"They have a kind of tolerance, in that they've accepted diseases come with their age, and that it's pretty usual to have them," Xiao said.
The researchers pointed out that, unlike Australia, Ireland, the UK and even Mongolia, New Zealand still didn't have a targeted men's health policy.
"We need a women's health policy – and it's great to see the Government are committed to a women's health strategy – but in addition, we need one that recognises some of the health inequalities that men have, too," Calder said.
"If New Zealand had a men's health policy, then our health service delivery and research could be better focused."
• For information, visit the Men's Health Week website.