Bad health linked to low life expectancy in men

By Nilma DOLE

The Sri Lankan male mentality is such that they think they’re invincible to disease and the culture of patriarchy has given rise to the male perception of being ‘strong’. The problem is by having this kind of mentality, it means that they hardly go to the doctor and only seek medical attention once it’s too late. Regular checkups are not part of the routine with Sri Lankan men as they hardly have any relationship with their doctor and more often than not, some don’t even go to a doctor.

As a result, men have become more prone to conditions such as diabetes, obesity, heart ailments and cancer which affects them badly in the late stages.

Prof. Lakshman Dissanayake of the Department of Demography at the Colombo University told the Sunday Observer that addictions such as smoking, alcohol consumption in addition to unhealthy eating habits have contributed to Sri Lankan men living much less than women. “The sad plight is the loss of husbands contributing to a long widowhood in women and children losing their fathers at an early age. So we should aim to increase the longevity of men so that elderly couples can age gracefully together,” said the professor.

Life expectancy at birth for men was 32.7 and women was 30.7 in the 1920s but in 2002, female life expectancy at 77.2 years surpassed the male life expectancy which was 68.8 years.

The projected figures show that male life expectancy is expected to reach 72.3 years while female life expectancy will be 82.5 years by 2026 (Gunasekera, 2008).

Annual gain

According to the professor, the total as well as average annual gain in life years was more than double for females. Therefore, men seem to be increasingly exposed to high risk mortality factors.

“In relation to the diseases of the circulatory system, nervous system, respiratory system, endocrine, nutritional and metabolic diseases and external causes of morbidity and mortality, men are in a more hostile position in promoting their survival chances,” said the doctor.

Although most of these causes are amenable to medical intervention, sex differentials of mortality can be attributed to factors other than such interventions.

The research paper titled, ‘Avoidable mortality and men’s health status in Sri Lanka’ done by Prof. Dissanayake has stated that the focus on men’s health in Sri Lanka is rarely visible and can be regarded as a largely neglected health aspect. “Although there are general discussions about the gender gap in life expectancies, a serious attempt has not been taken so far to provide a rational explanation for such a significant difference.

Therefore, an awareness of the actual disparity that exists with men’s health still remains ignored,” he said.Age and sex-specific death rate due to diseases of the circulatory system show that there is a considerable difference of its prevalence between men and women, especially after 40 years of age.

After the age of 40, the death rate of men than women is higher at each age and the gap becomes wider, especially between 60 and 75. Among the diseases of the circulatory system, ischemic heart diseases, other heart diseases, hypertensive diseases and cerebrovascular diseases are the greatest killers of men during those ages in Sri Lanka.

Deaths

According to the professor, the proportion of male deaths to total deaths of all these four causes during the ages 50 to 74 demonstrates that these causes constitute 56 percent of total deaths due to the diseases of the circulatory system.

He said, “It is quite interesting to observe that the widening gap between the sexes emerges only after the menopause is reached and hence women no longer have the same immunity like what they experience during the childbearing years against these diseases.

In such a situation, we need to expect that the morbidity status of both men and women to be not different if other factors affecting are equal.”

Therefore, the only theory that can rationally explain these statistics is that metabolic syndrome, mental depression and smoking are related to behaviourial patterns which are determined by factors outside the medical care system.

“This causes the difference of the prevalence of diseases of the circulatory system between men and women,” said the professor.

About 71 percent of the change in temporary life expectancy between men and women can be attributed to the difference in deaths due to these diseases. Different occupational conditions and specific lifestyle patterns have played key roles in making a significant difference between life expectancies of men and women.

“Health awareness given to women through exceptionally successful maternal and child health program available throughout Sri Lanka have played a key role in making women more health conscious than their male counterparts,” said Prof. Dissanayake.

Public health midwives or family health workers in the country play a significant role in addressing reproductive health related issues which also suggests that women are in a more beneficial position to be health conscious during and also even after child-bearing span.

Deaths due to malignant neoplasm of lip, oral cavity and pharynx recorded highest number of deaths among neoplasms category and it accounted for 9.3 percent of all deaths in that group.

Addictions

It is a commonly known fact that tobacco and alcohol consumption are the two leading risk factors for those diseases and thus linked to specific lifestyle patterns.

According to Prof. Dissanayake’s study, the selected causes for this study are significant as Sri Lanka could have added 2.8 years to men’s life expectancy between birth and 75 years of age if those diseases were prevented at least to the levels of women’s mortality.

“In Sri Lanka, these risks are related more to men than women since prevalence of smoking and drinking is higher among men,” said the professor.

“Sri Lanka’s maternal and child health program could have had a significant impact on the reduction of women’s overall mortality level because of their more awareness of health issues,” said Prof. Dissanayake.

Lack of special programs for men’s health unlike the former together with cultural beliefs about masculinity may also have had considerable effect on deterioration of men’s health.

He said that an additional effort has to be taken to improve the health status of men to be par with women in order to advance their health standing and thus diminution of their vulnerability position to the above causes of death.

So, healthy lifestyles for men should be promoted in addition to eating right food plus regular checkups and healthy relationships with doctors should be promoted to make the Sri Lankan man live longer.

According to the professor, preventive programs are needed to decrease both morbidity and mortality due to such causes.

“One way of tackling this major public health issue would be introduction of successful interventions from the developed world,” said the professor.

Analysis

As outlined in the methodological section of his paper, a life table analysis was performed in order to find the contribution made from each cause of death category to the gap between life expectancies of men and women. Such an analysis provides a unique opportunity to understand the relative significance of each cause of death category in the reduction of survival chances of men.

The total difference between temporary life expectancies of men and women were four years in 2006. Prof. Dissanayake said, “When major causes of death categories selected for this study are adjusted for both men and women, the difference becomes 2.8248 years.”

He said that this shows that if both sexes are not exposed to the six categories of causes of death, the difference is reduced by 1.1752 years.

“This research will allow us to examine how much contribution that each cause of death category made for men to have 2.8248 life years less than women.

Alcoholism leads to higher rates of general and cancer-related deaths

Alcohol consumption causes approximately four percent of all deaths worldwide and is responsible for roughly five percent of global diseases. A study of alcohol consumption in Tuscany, Italy has found that alcoholics have significantly higher rates of both general and cancer mortality when compared to the general population.

Results will be published in the February 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“[We conducted this study of] mortality rates [among] this relatively large group of alcoholics because of our interest in better understanding the risk profile of alcoholism,” explained Domenico Palli, head of the Nutritional and Molecular Epidemiology Unit at the Cancer Research and Prevention Institute (ISPO) in Florence, and corresponding author for the study. “The higher number of male alcoholics in our group reflects the distribution of alcohol consumption in the Italian population.”

“There have been other studies of the relationship between alcohol and mortality but not with so many addicted people and particularly those with cancer,” added Emanuele Scafato, director of the World Health Organisation Collaborating Centre for Research & Health Promotion on Alcohol and Alcohol-Related Problems at the Istituto Superiore di Sanità.

“From an epidemiological point of view, this is a unique opportunity to examine health experiences and outcomes due to long-term hazardous and harmful consumption of a toxic and well-known carcinogenic that has resulted in alcohol dependence. This is relevant from a public-health perspective in order to formulate caution messages to the public to increase levels of awareness about the need for a healthier lifestyle and really moderate alcohol consumption.”

Palli and his colleagues gathered data on 2,272 alcoholics (1,467 males, 805 females), predominantly middle-aged, who were treated at the Alcohol Center of Florence during the period of April 1985 through September 2001, for a total of 21,855 person-years. Expected deaths were estimated by using age, gender, and calendar-specific regional mortality rates.

“Our study has provided strong evidence that alcohol addiction significantly increases the risk of death from several causes in comparison to the general population in a Mediterranean country,” said Palli. “The alcoholics seemed to be at greater risk of mortality for specific diseases such as infections, diabetes, diseases of the immunological, nervous, cardiovascular, respiratory, and digestive systems, as well as violent causes.

Alcohol’s role as a ‘dietary’ carcinogen emerged quite clearly. The highest risks were found for cancers of the pharynx, oral cavity, liver, and larynx, but also the risk of other cancers - esophagus, rectum, pancreas, female breast “ was increased.”

“This research is certainly a step in the right direction in order to foster awareness not only for addicted people but for the general population as well,” said Scafato. “It is also important for health professionals to increase levels of valid information and competent actions aimed at prevention, early identification, advice, and helping people change.

It is furthermore one more tool for better dealing with a counter productive and misleading information spread mainly by commercial interests that always give a positive image of drinkers, portraying drinking as a ‘must’ behaviour. Those who are advised or believe that one glass could be good for the heart, they should also be aware that WHO councils that for many people, females and the elderly for example, just a bit more than a glass increases the risk of 60 diseases and 14 cancers.

This is what prevention needs to address in terms of informed choices, keeping in mind that hazardous alcohol use always produces more harm than benefits at the population level.”

The results also showed that female alcoholics reported higher survival rates than male alcoholics. “Perhaps female alcoholics are more likely to obtain help and achieve remission, tend to benefit more than men from continued participation in treatment programs, and/or tend to be referred to specific alcohol centre earlier than men, who often are admitted with advanced disease or only when severe symptoms emerge,” said Palli.

“Women usually live longer than males on average,” added Scafato, “and are much more keen to control their health status; they also tend to have a higher probability of receiving medical interventions due to a different social networking and mutual gender support.”

Clearly alcohol abuse can compromise the structure and functionality of several human organs, thus directly increasing the risk of death,” said Palli.

“Other aspects of the characteristic life-style of alcoholics - smoking, drug abuse, promiscuity and a poor diet - may contribute to this high-risk pattern together with reduced health-consciousness.”

Medicalxpress.com

Researcher examines how the brain perceives shades of grey

How the brain perceives colour is one of its more impressive tricks. It is able to keep a stable perception of an object’s colour as lighting conditions change.

Sarah Allred, an assistant professor of psychology conducted the research with Alan L. Gilchrist, a professor of psychology at Rutgers-Newark, and professor David H. Brainard and post-doctoral fellow Ana Radonjic, both of the University of Pennsylvania.

“Although we recognise easily the colours of objects in many different environments, this is a difficult problem for the brain,” Allred says. “For example, consider just the grey scale that goes from black to white. A white piece of paper in bright sunlight reflects thousands of times more light to the eye than a white piece of paper indoors, but both pieces of paper look white. How does the brain do this?”

The process of seeing an object begins when light reflected off that object hits the light-sensitive structures in the eye. The perception of an object’s lightness (in terms of color shade) depends on the object’s reflectance. Objects that appear lighter reflect a larger percentage of light than those that appear darker.

Differences

Allred says the brain processes perceptual differences between black and white objects even when illumination of the object changes.

If the brain did not do this, it would fail to distinguish colour shade in different light.

In general, white objects reflect about 90 percent of the light that hits them, and black objects reflect about three percent, a ratio of 30-to-1, she explains.

“However, if you look at the intensities of light that enter the eye from a typical scene, like a field of lilies, that ratio is much higher, usually somewhere between 10,000-to-1 and a million-to-1,” Allred says.

This happens because in addition to having objects with different reflectance, real “scenes” also have different levels of illumination. One example might be a shadowed area under a tree.

- Psypost.com