Meeting the

health needs of
men
Out lines:
Epidemiology of mens health
Diagnostic reasoning in the health care of men
Planning and implementation health care for
men
Evaluating health care for men

Epidemiology of mens health

1-Biophysical Considerations:
Men experience a variety of physical health
conditions, many of which can be prevented or
their effects ameliorated by effective community
health nursing intervention.
In 2002 the leading cause of death for men were:

heart disease
malignant neoplasm
unintentional injuries
cerebrovascular disease
chronic lower respiratory disease
D.M
pneumonia and influenza
suicide
nephritis,nephritic syndrome,nephrosis
chronic liver disease and cirrhosis

The overall age-adjusted male mortality rate for

2002 was 1,013 death per 100,000 men, compared
to only 712.2 per 100,000 women (CDC 2004a)
Erectile dysfunction:-**
Formally called impotence, when man cannot
achieve or maintain an erection sufficient for
satisfactory sexual activity
-The relatively high prevalence of ED was not
recognized until a landmark study in
Massachusetts in2004 indicated that 52% of men
between 40 and 60 years of age experienced some
level of difficulty (Solomon &jackson,2004)

Worldwide prevalence of ED is estimated at more

than 150 million men and is expected to double by
2025(kirby,2004)
The incidence of ED increase with age, with
approximately 39% of men aged 40 to 50 years
affected compared to 70% of those over aged 70
Research has indicated that both age and
atherosclerotic processes contribute to the
development of ED, but the diminished blood flow
due to atherosclerosis has greater effect on its
development than age (sololson& Jackson 2004)
-An estimated 35% of men 40 to 70 years of age
experience moderate to severe ED that may be
due to a number of factors are:1-chronic disease: DM, HTN and atherosclerosis.
2-Medecations used to treat this and other
conditions
3-Obesity
4-Renal failure and alcohol use
5-Smoking
6-Pharmacologic treatment
7-Infertility:male infertility is implicated in
approximately half of couples unable to conceive.
Approximately 25% of male infertility arises from
unknown causes. Possible causes include prior
surgery, pelvic trauma, sexually transmitted
disease, genetic causes ,medications.

8-Accidental injury: males have higher rates of

unintended injuries than females,

2-Psychological considerations:Several related elements of the psychological

dimensions are of concern to community health
nurses caring for men; these elements include
socialization, mental health problems, stress, and
coping abilities, as well as suicide as an outcome of
ineffective coping.
-socialization : men tend to value strength and
endurance more than women, they are more likely
to suppress or conceal pain and other perceived
indicators of frailty.
An example of this state of mind can be seen in the
male post myocardial infraction client who resumes
shoveling snow against the recommendation of
health care professionals and his family, and who
continues the activity despite the return of the
now-familiar angina. As a result of this need for
strength in his self-image, the male client
minimizes the importance of the problem.
Consequently, when shoveling snow causes further
angina, he may seek health care less readily and
use it less effectively than would a female client in
similar situation.
-mental health problems:
Men may be unable to express grief, sadness or
powerlessness,

Based on data from 1999 to 2009, men less

frequently reported frequent mental distress than
women, (7.2% versus 10.3%)
Men are also less likely than women to report
depression, physicians are also less likely to
diagnose depression in men than
women(monts2002b)
-suicide:
Claims more lives among men annually than many
of the diseases that health care professionals
combat so effectively, because suicide is such a
frequent cause of mortality for men, it's important
that community health nurses assess the male
population for the presence of suicide risk factors.

3-Physical environmental considerations:

Physical factors are structural elements of the work
place that influence worker health and
productivity, the various features that make up the
physical work environment include work space
,temperature, lighting, noise, vibration, radiation,
pressure, that may affect worker health.
For example, excessive noise can disrupt
concentration, or cause hearing loss

4-Sociocultural considerations:
Includes:

-family interaction, many men have little or no

children experience, married women with children
have been shown to spend 50% more time with
them than fathers do, many men may find
themselves single parents as a result to divorce or
a death of their wives,
-economic and occupational issues: in most
cultures men are the primary breadwinners for the
family, unemployment may be high in many
developing countries may lead young men to leave
their families for extended period of time to seek
employment where it can be found
Economic status is also associated to education
levels.

5-Behavioral considerations:
Seem to make greater contribution to mens health
status than to women, because men are generally
more likely than women to engage in high risk
behaviors.
Behavioral considerations to be addressed in
assessing mens health include consumption
patterns, exercise and leisure, sexual activity, and
other behavioral risk factors
Consumption patterns: includes diet as well as
substance use and abuse in US men are more likely
than women to be overweight but less likely to be
obese.
Exercise and leisure: men tend to be active in
competitive contact sports and choose leisure

activities involving some degree of physical risk

(skydiving, climbing mountain) participation in
athletic sports are closely linked with images of
masculinity and reinforce tendencies to
aggressiveness and violence increasing the
potential for injury.
-sexual activity: men are often unaware of
measures to prevent STDs.
Most men with multiple sexual patterns dont use
condoms, and those that tend to use them for
contraceptive purposes rather than STD
prevention.

6-Health system considerations:

Ability to be employed and to be economically
independent, and in some cases to have
adequate sexual function.
Factors may prohibit men from seeking health
care include, lack of trust in providers,
language barriers, lack of health insurance,
financial difficulties, and difficulty relating to
providers.
It is often difficult for men to obtain medical
coverage, but a depressed economy leads to
greater unemployment or employment in jobs
that dont provide health insurance benefits
and less employment-based coverage
Women routinely enter the health care system
through services related to pregnancy,
contraception, and routine screenings.

 men dont routinely access any health

primitive services that would provide a similar
door to other needed health care.
Health care services are not crafted to target
men, nor are many providers educated
specifically to address that health care needs
and motivations of men.
Assessing the health of the male population:The first important for effectively meeting the
health needs of men is an accurate assessment of
their health status and health needs.
In conducting and assessment of this population,
the community health nurse would gather data
related to factors in each of six dimensions of
health

Diagnostic reasoning in the care of men:

A positive diagnosis: might be high prevalence
of adequate physical activity due to presence
of multiple low cost opportunities for exercise.
A negative diagnosis: might be increased risk
of sexually transmitted diseases among young
adult men due to unprotected sexual activity.
Planning and implementing health care for men:-

Interventions to improve health status of men in

the population may occur at primary, secondary, or
tertiary level of prevention.
--Levels of preventions:
1- Primary prevention:

-preventing chronic illness:

Promoting health diet
Physical activity
Treat underlying conditions
-Providing immunization:
Educate men need for immunization
Provide immunization services
-Prompting safety
Educate men regarding the need to use safety
devices
Educate men regarding safe sexual practice
-Eliminate risk behavior
Educate men regarding smoking and drug use
Advocate for insurance coverage for smoking
and drug use

2-Secondary prevention
Involve earliest detection of health need through
effective screening
3-Tertiary prevention
Follow up and rehabilitation
The goals are to assist in coping with the
continuing manifestation of illness and reduce
future episodes of illness
Evaluating health care for men

 By determining the degree to which population

health goals have been met.
To determine whether intervention were
efficient or not.
The effect of intervention for men at the
aggregated level can be assessed in terms of
the accomplishment of national health
objectives.