Because it’s 2017 – it’s time for a new men’s health model

Have we become so accustomed to men dying earlier than women that it is just an accepted fact in our society? There is a recognized life expectancy gap between men and women in developed countries that favours women by 4 to 5 years. Although life expectancy for males and females are both increasing, the life expectancy gap has stayed the same.

What are the reasons for this gap? While we know that this is largely due to behavioral differences, with only 30% of a man’s overall health being determined by his genetics[i], attempts to effect change have proven difficult. Traditional masculine characteristics—competitiveness, stoicism, denial, and self-reliance—are all also believed to contribute to men’s reluctance to seek help.[ii]

In order to better understand the gender-related life expectancy difference, men’s health issues should be looked at based on male-specific and male-at-risk diseases.  Male-specific diseases are diseases that primarily effect men based on their physiological traits. While male-at-risk diseases are diseases that men have a higher associated risk of developing, largely contributing to the life expectancy gap difference. For example, men have a higher rate of cardiovascular disease and a higher risk of suicide as a result of mental health issues. In other words, men’s health care needs to be looked at through a lens specific to itself.

Urology is arguably a portal into the greater men’s health system. My vision is to have men’s health as another urological subspecialty, connecting it to a larger multi-disciplinary scope.  As a urologist I may be the first doctor a man has seen in years, for example if he comes into my office with a kidney stone or wants a vasectomy, and there is an opportunity to engage this man, and connect him to the larger health care sphere.

The Division of Urology at The Ottawa Hospital is getting closer to making this model a reality. The newly formed Men’s Health Centre will maintain its focus on the totality of men’s health by relying strongly on the collaboration of various specialties. The Men’s Health Care Delivery Model will introduce and treat male-specific disease care in the first two years of the Centre’s existence.  While collaboration with other specialties facilitating the treatment of male-at-risk diseases will occur in years 4 and 5.  It is the inclusion of the treatment of male-at-risk diseases within this model that will differentiate it from other models already in existence. By including “at-risk diseases” The Ottawa Hospital is working to address and improve the existing life expectancy gap.  

This delivery model needs to be innovative and deliver male-specific care that is meaningful and considers the various reasons for the life expectancy gap.  It will need to include multiple medical domains inclusive of urology, primary care, cardiology, endocrinology and psychiatry. It will facilitate this multidisciplinary approach to patient care by improving communication between specialties that exist in different locations with the unified goal of improving men’s health. 

We need to change the societal lens on men’s health, and focus on helping men feel more empowered in their self-care. By unifying and centralizing men’s health in a clinical setting, health professionals will be better equipped to help men to start living healthier lives as we all come to better understand how various health elements relate to each other. It’s time we start implementing this model and stop accepting the life expectancy gap, so that our fathers, partners, friends and neighbours can lead a long and healthy life too. 

Dr. J. Stuart Oake
Division Head, Division of Urology
Department of Surgery, The Ottawa Hospital
Chair, Division of Urology, Dept of Surgery
University of Ottawa


[ii] Goldenberg, Skeldon and Black.“Personalized messaging: Communicating with men about their health” Urology Times, July 2015.