“Changing the Face of Men’s Health”: Breaking Down Stigma One Moustache at a Time

By Zach Cantor

“Changing the Face of Men’s Health” – this is a familiar call to action, one that has gained popularity since the launch of the Movember movement in 2003[1].

The Movember mandate is simple – grow a moustache and raise awareness and money for three important health issues that impact men: prostate cancer, testicular cancer, and mental health/suicide prevention.

Started by Australia’s Travis Garone and Luke Slattery, Movember has grown from 30 donors in 2003 to over 6 million in 2020, and has collectively has raised over $1 billion. That’s a lot of zeros!

This begs the question: why does Movember care, and why should we care? Well, we know that men die on average, 6 years earlier than women. And yes, some if it is because of this….

…but the real reason is due to preventable health concerns.

If we look at Movember’s first mandate, prostate cancer, the second most common cancer in men, the rates are rising worldwide, with more than 1.4 million men diagnosed each year [2]. Nationally, there are more than 200,000 men living with prostate cancer, and 1 in 9 Canadian men will be diagnosed in their lifetime [2].

The testicular cancer numbers are equally concerning. Globally, testicular cancer is the number one cancer diagnosis in young men – those aged 15-39. Overall, survival rates are high, but one in 20 men will ultimately die from the disease [3]. Though survivability is high, this often comes with a cost…

Lastly, the third mandate of Movember is to tackle mental health and suicide prevention. In the spirit of the Hatching Lab, let’s dissect this a little bit more and get comfortable with being uncomfortable. One can argue there’s nothing more uncomfortable than having an open discussion surrounding mental health. So, let’s do it :)

Death by suicide is very much a gendered phenomenon. Looking at the big global picture, we know that, on average, one man dies of suicide every minute [4] – that’s a half million men every year who die from a preventable cause. In Canada, death by suicide ranks as the 8th most common cause of death among men (compared to 14th for women) [5]. Based on numbers alone, men die by suicide at a rate three times as high as women, accounting for approximately 75% of Canadian suicides [4]. This is consistent regardless of age and, while the methods may change, this trend holds true.  

 Death by suicide is a major public health crisis.

 This isn’t a surprise – we know that there are several high-risk factors for suicide, such as: a) being male, and b) being a first responder. Interestingly, women have higher rates of self-harm, which is also a notable risk factor for suicide.

 As a male first responder, this resonates with me on a personal level. There is an established link between experiencing PTSD and rates of suicide [6]. Among the first responder community, rates of PTSD are elevated compared to the general Canadian population, with past year prevalence rates of 2.4% and lifetime prevalence rates ranging from 8-32% (compared to 2.4% and 9.2%, respectively). Beyond this, we also see higher rates of depression, anxiety, and alcohol abuse/dependence among this population.

We see similar trends among first responders in terms of suicide. Previous research has compared suicidal ideations, plans, and attempts in Canadian public safety personnel (police, fire, paramedic) to those in the general public, and the differences are striking [7]. In this study, public safety personnel reported past-year and lifetime suicidal ideation of 10.1% and 27.8%, respectively; past-year and lifetime rates of suicidal planning of 4.1% and 13.3%, respectively; and, past-year and lifetime rates of suicide attempts of 0.3% and 4.6%, respectively. Rates of suicidal ideation and planning are higher than the general population, ranging from 12.5%-14.1% and 4.1%-5.1%, respectively. Self-reported suicide attempts were, generally, on par with rates in the general population, which range from 3.1%-4.0%.

Adding to this risk is the issue that both men and first responders are less likely to speak up and ask for help when they need it. Now, we know there’s a problem, so what do we do? Like any good medical intervention, we come up with an acronym.

As an example, the F-A-S-T acronym is famous for identifying strokes. For suicide prevention, we can look to A-L-E-C [8]:

Ask: Start by mentioning that you’ve noticed a difference, and ask if they’re ok. Don’t be afraid to ask more than once – the common response to are you ok is “I’m fine” even when we’re not.

Listen: I know it’s hard but put away the phone – listen with intention and without interruption. Give them your full attention. Use follow-up questions. “That can’t be easy. How long have you felt this way?”

Encourage Action: Help focus on things that might improve their wellbeing (sleep, exercise, nutrition). Encourage them to seek out professional help (see the resources at the end of this post).

Check-In: Suggest a check-in soon, ideally in person (in a COVID-friendly way), but a phone call or text goes a long way. If you’re worried, that someone is in danger, call 911.

Though Movember’s main fundraising campaign has become synonymous with November and growing a mustache, let’s spend more than a month bringing attention to these important topics.

I’m probably in the minority on this one, but do we really need an excuse to grow a moustache…

Let’s keep the conversation going, and let’s keep changing the face of men’s health.

References:

[1] About us. (2021). Movember. Retrieved October 29, 2021, from https://ca.movember.com/about/foundation

[2] Prostate cancer. (2021). Movember. Retrieved October 29, 2021, from https://ca.movember.com/about/prostate-cancer

[3] Testicular cancer. (2021). Movember. Retrieved October 29, 2021, from https://ca.movember.com/about/testicular-cancer

[4] Mental health and suicide prevention. (2021). Movember. Retrieved October 29, 2021,  https://ca.movember.com/about/mental-health

[5] Statistics Canada. Table 13-10-0394-01 Leading causes of death, total population, by age group. DOI: https://doi.org/10.25318/1310039401-eng

[6] Gradus, J.L., Qin, P., Lincoln, A.K., Miller, M., Lawler, E., Sørensen, H.T. & Lash, T.L. (2010). Posttraumatic stress disorder and completed suicide. American Journal of Epidemiology, 6(15), 721-727. https://doi.org/10.1093/aje/kwp456.

[7] Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., LeBouthillier, D. M., Duranceau, S., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., … Asmundson, G. J. G. (2018). Suicidal ideation, plans, and attempts among public safety personnel in Canada. Canadian Psychology, 59(3), 220–231. https://doi.org/10.1037/cap0000136

[8] Give support. (2021). Movember. Retrieved on October 29, 2021, from https://ca.movember.com/mens-health/give-support