British Columbian men have a problem. Too many of them are dying too young.
Consider the following grim statistics: the life expectancy of the average male in this province is 76 years; that’s fully four years and five months less than the average female. More importantly, the “health expectancy” of the average male—the age at which a man becomes physically or mentally unhealthy, and dependent upon others—is a mere 65 years. In practical terms, that means men can look forward to 11 years of poor health and disability before finally passing away. Not a pleasant prospect.
Intolerable is the word that Dr. Larry Goldenberg would use to describe these statistics. “Having a Y chromosome should not be seen as possessing a self-destruct mechanism,” he says with conviction. As the founder and chief visionary behind the Men’s Health Initiative of British Columbia (MHIBC), Dr. Goldenberg is on a self-proclaimed mission to stop men from self-destructing—in essence, giving men the gift of life.
“What we want to do is apply a men’s lens, if you will, to population health,” Dr. Goldenberg explains. “To look at policy, health planning, health research, health education and perhaps more important than anything else, [health] awareness among the male population, in a male-friendly way.”
Dr. Goldenberg describes the MHIBC as an “umbrella initiative”—a rather diplomatic way to describe what amounts to a wholescale health care revolution. Strip away the professional charm and it’s clear Dr. Goldenberg’s real aim is to provoke: to get in the face of every man in the province and challenge the pervasive apathy that simply accepts ill health as a fact of nature. Along the way, if he can find a way to influence long-term government policy, change the curriculum of the country’s medical schools, found a hospital or two, and set up an internationally celebrated research centre for men’s health—well, so much the better.
“The old story of ‘eat your vegetables and exercise more and stop smoking’—men don’t want to hear that. I mean, enough,” Dr. Goldenberg says, stressing the word to drive the point home. “It’s a tired message. We have to get the messaging out there so that people will actually modify their behaviour in some way, so as to add 10 healthy years to the middle of their lives.”
A tall order, to be sure. But Dr. Goldenberg is exactly the kind of guy you want on your team in such an effort: Intelligent. Insightful. Charismatic. Tenacious. And utterly, absolutely confident that given enough resources—time, money, manpower—he will affect change. “If we can narrow that [health expectancy] gap in men, so it’s no longer 10 years, but nine years, eight years, seven years, eventually five years or even less … then the impact on the men, on their families, on society, on government, on our economy will be huge.”
While his focus is clearly androcentric, Dr. Goldenberg is quick to diffuse criticism that his efforts constitute a health-related battle of the sexes. “We’re not taking anything away from women’s health, or children’s health,” he says bluntly. “This isn’t about competing for dollars or resources. This is not men against women. This is: ‘Okay women, you’ve been smart for 20 to 30 years with the women’s health movement. It’s time that men smartened up and started to pay attention to themselves.’ ”
As Dr. Goldenberg explains, while women have long been the beneficiaries of a well-coordinated effort to address health issues specific to their sex, men have lacked such a program. “What we have in B.C. and across Canada and across the world is a lot of foci of excellence—areas where [professionals] have an interest in a particular area of [men’s] health,” he says. This compartmentalized approach has its limitations. “It’s like a matrix. You have a million little boxes, and we’ve got all these people who work in their little boxes who don’t know what’s going on in the next box over, or five boxes over and four down.”
Dr. Goldenberg aims to change that. “Education is a huge part of this initiative,” he says. “It’s not just doctors, either. It’s nurses and other health care providers across the spectrum—from community right through to acute care and chronic care facilities.”
“This isn’t about competing for dollars or resources. This is not men against women. … It’s time that men smartened up and started to pay attention to themselves.”
On that front, the Institute has indeed been busy: since it was founded back in November of last year, the MHIBC has built a 120-page website, sponsored full-day public fora in Vancouver and Kelowna, published a lengthy research report on the causes behind lower life expectancy in men, organized a continuing lecture series for the public and sponsored a number of development sessions for health care professionals working in the field of men’s health.
As innovative as all these activities may be here on the west coast, the idea behind the MHIBC it is by no means a new one. If anything, Vancouver is simply playing catch-up to other jurisdictions that long ago identified men’s health as a critical health care directive. “There are a couple of places in the world where they’re far ahead of the game,” Dr. Goldenberg says. He singles out Australia as a nation with a particularly well-developed men’s health policy. “Australia has declared that by 2020 or 2030, they’re going to have the healthiest population on earth, including males.” He goes on to catalogue the work already underway in Ireland, the United States, the European Union. Clearly, British Columbia has some work to do.
Of course, such work requires funding—and work of this scope requires a good deal of it. Here again, the doctor is on the case, bringing his considerable powers of persuasion to bear on well-heeled benefactors. “[The] networks like this around the world, they all face the same challenges,” Dr. Goldenberg says. “Much of it is based on volunteerism and funding from sources outside of government.”
But even when it comes to salesmanship, Dr. Goldenberg is relentlessly optimistic. “If I can get 20 guys who can afford to give us $100,000 a year for five years, this thing will happen,” he says, the enthusiasm rising from his sentences like bubbles in a champagne flute. “Then we will have enough critical mass and momentum that the government will have to pick it up. Right now, it’s a vision—a business case, a plan, very virtual. It’s sort of like, show me the money. And I want to.” He pauses for a beat and then declares with aplomb: “Give me a few more years, and I will show them the money.”
Despite his certitude, Dr. Goldenberg realizes the road ahead of him is not an easy one. “My goal here isn’t to change men overnight,” he admits. “That’s an impossible task.” But it’s only for a moment; then the realism subsides, the optimism returns, and the doctor transforms into prophet once more: “If I can impact 10 per cent of men, and save 10 years of ill health in 10 per cent of the population—you do the math.”
In the end, Dr. Goldenberg’s message of change is less of a call to action than it is a call to arms—a rallying cry for half the population to get off their collective behinds and take responsibility for themselves. “People will say you can’t change behaviour,” he says. “Well, you can change behaviour. It takes time, it takes repetitive action. But look at smoking: we changed smoking. Let’s get on with it.” We’ll see if men are ready to get started.
