Medicine:Men's health

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Symbol of Mars, representing men and symbol of the staff of Hermes, representing medicine
A symbol of men's health

Men's health is a state of complete physical, mental, and social well-being, as experienced by men, and not merely the absence of disease.[1][failed verification] Differences in men's health compared to women's can be attributed to biological factors, behavioural factors, and social factors (e.g., occupations).[2][failed verification]

Men's health often relates to biological factors such as the male reproductive system or to conditions caused by hormones specific to, or most notable in, males. Some conditions that affect both men and women, such as cancer, and injury, manifest differently in men.[3] Some diseases that affect both sexes are statistically more common in men. In terms of behavioural factors, men are more likely to make unhealthy or risky choices and less likely to seek medical care.

Men may face issues not directly related to their biology, such as gender-differentiated access to medical treatment and other socioeconomic factors.[4][5][6] Outside Sub-Saharan Africa, men are at greater risk of HIV/AIDS. This is associated with unsafe sexual activity that is often nonconsensual.[7][8]

Definition

Men's health refers to the state of physical, mental, and social well-being of men, and encompasses a wide range of issues that are unique to men or that affect men differently than women. This can include issues related to reproductive health, sexual health, cardiovascular health, mental health, and cancer prevention and treatment. Men's health also encompasses lifestyle factors such as diet, exercise, and stress management, as well as access to healthcare and preventative measures. [9]

Life expectancy

Despite overall increases in life expectancy globally, men's life expectancy is less than women's, regardless of race and geographic regions.[10][11] The global gap between the life expectancy of men and women has remained at approximately 4.4 years since 2016, according to the WHO.[12] Life expectancy is a statistical measure that represents the average number of years that a person is expected to live, based on the current mortality rates. It is typically calculated at birth, and can vary depending on factors such as gender, race, and location. For example, life expectancy in many developed countries is higher than in developing countries, and life expectancy for women is generally higher than for men.

However, the gap does vary based on country, with low income countries having a smaller gap in life expectancy.[13] Biological, behavioural, and social factors contribute to a lower overall life expectancy in men; however, the individual importance of each factor is not known.[14] Overall attitudes towards health differ by gender. Men are generally less likely to be proactive in seeking healthcare, resulting in poorer health outcomes.[15]

Y-axis is women's life expectancy, ranging 50–90 years old. X axis is men's life expectancy ranging 50–90 years old. On the graph plot there are different coloured circular bubbles representing different countries, as well as the world in grey. The size of these bubbles are proportional to the population of the countries they represent. The graph shows that women's life expectancy is consistently higher than men's world-wide.
Global comparison of life expectancy of men vs women in different countries

Men are difficult to recruit to health promotion interventions. The value of adopting a gender-sensitive approach to engage and retain men in health promotion interventions has been reported.[16]

Biological influences on lower male life expectancies include genetics and hormones. For males, the 23rd pair of chromosomes are an X and a Y chromosome, rather than the two X chromosomes in females.[11] The Y chromosome is smaller in size and contains fewer genes. This distinction may contribute to the discrepancy between men and women's life expectancy, as the additional X chromosome in females may counterbalance potential disease producing genes from the other X chromosome. Since males don't have the second X chromosome, they lack this potential protection.[11] Hormonally, testosterone is a major male sex hormone important for a number of functions in males, and to a lesser extent, females.[17] Low testosterone in males is a risk factor of cardiovascular related diseases.[18] Conversely, high testosterone levels can contribute to prostate diseases.[11] These hormonal factors play a direct role in the life expectancy of men compared to women.

In terms of behavioural factors, men have higher levels of consumption of alcohol, substances, and tobacco compared to women, resulting in increased rates of diseases such as lung cancer, cardiovascular disease, and cirrhosis of the liver.[11][19] Sedentary behaviour, associated with many chronic diseases seems to be more prevalent in men.[20] These diseases influence the overall life expectancy of men. For example, according to the World Health Organization, 3.14 million men died from causes linked to excessive alcohol use in 2010 compared to 1.72 million women. Men are more likely than women to engage in over 30 risky behaviours associated with increased morbidity, injury, and mortality.[21][22] Additionally, despite a disproportionately lower rate of suicide attempts than women, men have significantly higher rates of death by suicide.[23][24][25]

Social determinants of men's health involve factors such as greater levels of occupational exposure to physical and chemical hazards than women.[15] Historically, men had higher work-related stress, which negatively impacted their life expectancy by increasing the risk of hypertension, heart attack, and stroke.[11] However, as women's role in the workplace continues to be established, these risks are no longer specific to just men.[11]

Mental health

Stress

Although most stress symptoms are similar in men and women, stress can be experienced differently by men.[26] The American Psychological Association says that men are not as likely to report emotional and physical symptoms of stress compared to women.[26] They say men are more likely to withdraw socially when stressed and are more likely to report doing nothing to manage their stress.[26] Men are more likely than women to cite that work is a source of stress; women are more likely to report that money and the economy are a source of stress.[26]

Mental stress in men is associated with various complications which can affect men's health: high blood pressure and subsequent cardiovascular morbidity and mortality,[27] cardiovascular disease,[28] erectile dysfunction (impotence)[29] and possibly reduced fertility (due to reduced libido and frequency of intercourse).[30]

Fathers experience stress during the time shortly before and after the time of birth (perinatal period).[31] Stress levels tend to increase from the prenatal period up until the time of birth, and then decrease from the time of birth to the later postnatal period.[31] Factors which contribute to stress in fathers include negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth, and feelings of incompetence related to infant care.[31] This stress has a negative impact on fathers.[31] Higher levels of stress in fathers are associated with mental health issues such as anxiety, depression, psychological distress, and fatigue.[31]

Substance use disorders

Substance use disorder and alcohol use disorder can be defined as a pattern of harmful use of substance for mood-altering purposes.[32] Alcohol is one of the most commonly substances used in excess, and men are up to twice as likely to develop alcohol use disorder than women.[33] Gender differences in alcohol consumption remain universal, although the sizes of gender differences vary.[34] More drinking and heaving, binge drinking occurs in men, whereas more long-term abstention occurs in women.[34] Moreover, men are more likely to abuse substances such as drugs, with a lifetime prevalence of 11.5% in men compared to 6.4% in women, in the United States.[35] Additionally, males are more likely to be substance addicts and abuse substances due to peer pressure compared to females.[35]

Risks

Substance and alcohol use disorders are associated with various mental health issues in men and women.[36] Mental health problems are not only a result from drinking excess alcohol; they can also cause people to drink too much.[35] A major reason for consuming alcohol is to change mood or mental state.[37] Alcohol can temporarily alleviate feelings of anxiety and depression, and some people use it as a form of self-medication in an attempt to counteract these negative feelings.[38] However, alcohol consumption can worsen existing mental health problems.[35] Evidence shows that people who consume high amounts of alcohol or use illicit substances are vulnerable to an increased risk of developing mental health problems.[39] Men with mental health disorders, like post-traumatic stress disorder, are twice as likely as women to develop a substance use disorder.[40]

Treatment

There have been identified gender differences in seeking treatment for mental health and substance abuse disorders between men and women.[41] Women are more likely to seek help from and disclose mental health problems to their primary care physicians, whereas men are more likely to seek specialist and inpatient care.[42] Men are more likely than women to disclose problems with alcohol use to their health care provider.[43] In the United States, there are more men than women in treatment for substance use disorders.[43] Both men and women receive better mental health outcomes with early treatment interventions.[44]

Suicide

World Health Organization: Global Male-Female age standardized suicide rates (2015)

Suicide has a high incidence rate in men but often lacks public awareness. [45][46] Suicide is the 13th leading cause of death globally, and in most parts of the world, men are significantly more likely to die by suicide than women, although women are significantly more likely to attempt suicide.[46][47][48] This is known as the "gender paradox of suicidal behaviour".[47] Worldwide, the ratio of suicide deaths was 1.8:1 men per woman in 2016 according to the World Health Organization.[49] This gender disparity varies greatly between countries. For example, in the United Kingdom and Australia, this men/women ratio is approximately 3:1, and in the United States, Russia, and Argentina approximately 4:1.[50][51][52][53] In South Africa, the suicide rate amongst men is five times greater than women.[54] In East Asian countries however, the gender gap in suicide rates are relatively smaller, with men to women ratios ranging from 1:1 to 2:1.[55] Multiple factors exist to explain this gender gap in suicide rates, such as men more frequently completing high mortality actions such as hanging, carbon-monoxide poisoning, and the use of lethal weapons.[56][57] Additional factors that contribute to the disparity in suicide rates between men and women include the pressures of traditional gender roles for men in society and the socialization of men in society.[50][58][59]

Risk factors

Because variations exist in the risk factors associated with suicidal behaviour between men and women, they contribute to the discrepancy in suicide rates.[47][60][61] Suicide is complex and cannot simply be attributed to a single cause; however, there are psychological, social, and psychiatric factors to consider.[58][61][62]

Mental illness is a major risk factor for suicide for both men and women.[62][63][64] Common mental illnesses that are associated with suicide include depression, bipolar disorder, schizophrenia, and substance abuse disorders.[63][64][65] In addition to mental illness, psychosocial factors such as unemployment and occupational stress are established risk factors for men.[47][66][67] Alcohol use disorder is a risk factor that is much more prevalent in men than in women, which increases risks of depression and impulsive behaviours.[68][69] This problem is exacerbated in men, as they are twice as likely as women to develop alcohol use disorder.[33][70]

Reluctance to seek help is another prevalent risk factor facing men, stemming from internalized notions of masculinity.[58][66][71][59] Traditional masculine stereotypes place expectations of strength and stoic, while any indication of vulnerability, such as consulting mental health services, is perceived as weak and emasculating.[58][66][71][59] As a result, depression is under-diagnosed in men and may often remain untreated, which may lead to suicide.[59][72]

Warning signs

Identifying warning signs is important for reducing suicide rates world-wide, but particularly for men, as distress may be expressed in a manner that is not easily recognisable.[56][73][74] For instance, depression, and suicidal thoughts may manifest in the form of anger, hostility, and irritability.[58][73] Additionally, risk-taking and avoidance behaviours may be demonstrated more commonly in men.[58][71]

Common conditions

The following is a list of diseases or conditions that have a high prevalence in men (relative to women).

Cardiovascular conditions:

Respiratory conditions:

Mental health conditions:

Cancer:

Sexual health:

Other:

Organisations

In the UK, the Men's Health Forum was founded in 1994. It was established originally by the Royal College of Nursing but became completely independent of the RCN when it was established as a charity in 2001.[75] The first National Men's Health Week was held in the US in 1994. The first UK week took place in 2002, and the event went international (International Men's Health Week) the following year.[76] In 2005, the world's first professor of men's health, Alan White, was appointed at Leeds Metropolitan University in north-east England.

In Australia, the Men's Health Information and Resource Centre advocates a salutogenic approach to male health which focuses on the causal factors behind health. The centre is led by John Macdonald and was established in 1999.[77] The Centre leads and executes Men's Health Week in Australia with core funding from the NSW Ministry of Health.

The Global Action on Men's Health (GAMH) was established in 2013 and was registered as a UK-based charity in May 2018. It is a collaborative initiative to bring together men's health organizations from across the globe into a new global network. GAMH is working at international and national levels to encourage international agencies (such as the World Health Organization) and individual governments to develop research, policies and strategies on men's health.[78]

See also

  • Andrology
  • Gender disparities in health
  • International Journal of Men's Health
  • International Men's Day November 19
  • Movember
  • National Prostate Cancer Awareness Month

References

  1. ↑ WHO Definition of Health. "Archived copy". https://www.who.int/about/definition/en/print.html.  Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
  2. ↑ "Men's Health". https://medlineplus.gov/menshealth.html. 
  3. ↑ Almost Every Type of Cancer Kills More Men Than Women, Study Shows http://healthland.time.com/2011/07/13/almost-every-type-of-cancer-kills-more-men-than-women-study-shows Time, 13 July 2011
  4. ↑ Williams DR (2003). "The health of men: structured inequalities and opportunities". Am J Public Health 93 (5): 724–31. doi:10.2105/ajph.93.5.724. PMID 12721133. 
  5. ↑ "Men’s Health and Primary Care: Improving Access and Outcomes". http://www.ecoo.info/wp-content/uploads/2013/11/mens-health-and-primary-care-emhf-roundtable-report.2013.medium-res.pdf
  6. ↑ "The State of Men’s Health in Europe". http://ec.europa.eu/health/population_groups/docs/men_health_report_en.pdf ISBN:978-92-79-20167-7 doi:10.2772/60721
  7. ↑ "Gender Statistics Manual". United Nations Statistics Division. May 2015. http://unstats.un.org/unsd/genderstatmanual/HIV-and-AIDS.ashx. 
  8. ↑ "Is the US the only country where more men are raped than women?". The Guardian. 21 February 2012. https://www.theguardian.com/commentisfree/cifamerica/2012/feb/21/us-more-men-raped-than-women. 
  9. ↑ "Was ist Männergesundheit? Eine Definition" (in de). Gesundheitswesen 78 (7): e30–9. July 2016. doi:10.1055/s-0035-1564077. PMID 26492389. http://eprints.leedsbeckett.ac.uk/1352/7/Was%20ist%20M%C3%A4nnergesundheit%20-%20Eine%20Definition%20Upload.pdf. 
  10. ↑ "Life Expectancy by Country 2019". http://worldpopulationreview.com/countries/life-expectancy-by-country/. 
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 "Mars vs. Venus: The gender gap in health". Harvard Health Publishing. January 2010. https://www.health.harvard.edu/newsletter_article/mars-vs-venus-the-gender-gap-in-health. 
  12. ↑ "Global Health Observatory data on Life Expectancy". https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/. 
  13. ↑ Thornton, Jacqui (5 April 2019). "WHO report shows that women outlive men worldwide". BMJ 365: l1631. doi:10.1136/bmj.l1631. PMID 30952650. https://www.bmj.com/content/365/bmj.l1631. 
  14. ↑ Ortiz-Ospina, Esteban; Beltekian, Diana. "Why do women live longer than men?". https://ourworldindata.org/why-do-women-live-longer-than-men. 
  15. ↑ 15.0 15.1 Baker, Peter; Dworkin, Shari L; Tong, Sengfah; Banks, Ian; Shand, Tim; Yamey, Gavin (March 6, 2014). "The men's health gap: men must be included in the global health equity agenda". Bulletin of the World Health Organization 92 (8): 618–620. doi:10.2471/BLT.13.132795. PMID 25197149. PMC 4147416. https://www.who.int/bulletin/volumes/92/8/13-132795/en/. Retrieved 31 October 2019. 
  16. ↑ Nicolson, Gail Helena; Hayes, Catherine B.; Darker, Catherine D. (2 September 2021). "A Cluster-Randomised Crossover Pilot Feasibility Study of a Multicomponent Intervention to Reduce Occupational Sedentary Behaviour in Professional Male Employees". International Journal of Environmental Research and Public Health 18 (17): 9292. doi:10.3390/ijerph18179292. PMID 34501882. 
  17. ↑ "Testosterone — What It Does And Doesn't Do". Harvard Health Publishing. 16 July 2015. https://www.health.harvard.edu/drugs-and-medications/testosterone--what-it-does-and-doesnt-do. 
  18. ↑ Morris, Paul D; Channer, Kevin S (23 April 2012). "Testosterone and cardiovascular disease in men". Asian Journal of Andrology 14 (3): 428–435. doi:10.1038/aja.2012.21. PMID 22522504. 
  19. ↑ "World Health Report 2014". https://www.who.int/whr/2004/annex/topic/en/annex_2_en.pdf. 
  20. ↑ Nicolson, Gail; Hayes, Catherine; Darker, Catherine (22 August 2019). "Examining total and domain-specific sedentary behaviour using the socio-ecological model – a cross-sectional study of Irish adults". BMC Public Health 19 (1): 1155. doi:10.1186/s12889-019-7447-0. PMID 31438911. 
  21. ↑ Courtenay, W. H. (2000). "Constructions of masculinity and their influence on men's well-being: a theory of gender and health". Social Science & Medicine 50 (10): 1385–1401. doi:10.1016/s0277-9536(99)00390-1. ISSN 0277-9536. PMID 10741575. 
  22. ↑ Williams, David R. (May 2003). "The Health of Men: Structured Inequalities and Opportunities". American Journal of Public Health 93 (5): 724–731. doi:10.2105/ajph.93.5.724. PMID 12721133. 
  23. ↑ Freeman, Aislinné; Mergl, Roland; Kohls, Elisabeth; Székely, András; Gusmao, Ricardo; Arensman, Ella; Koburger, Nicole; Hegerl, Ulrich et al. (29 June 2017). "A cross-national study on gender differences in suicide intent". BMC Psychiatry 17 (1): 234. doi:10.1186/s12888-017-1398-8. PMID 28662694. 
  24. ↑ Moore, Fhionna; Taylor, Shanice; Beaumont, Joanna; Gibson, Rachel; Starkey, Charlotte; DeLuca, Vincenzo (23 August 2018). "The gender suicide paradox under gender role reversal during industrialisation". PLOS ONE 13 (8): e0202487. doi:10.1371/journal.pone.0202487. PMID 30138465. Bibcode: 2018PLoSO..1302487M. 
  25. ↑ Miranda-Mendizabal, Andrea; Castellví, Pere; Parés-Badell, Oleguer; Alayo, Itxaso; Almenara, José; Alonso, Iciar; Blasco, Maria Jesús; Cebrià, Annabel et al. (12 January 2019). "Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies". International Journal of Public Health 64 (2): 265–283. doi:10.1007/s00038-018-1196-1. PMID 30635683. 
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  27. ↑ Schneider, Robert H.; Alexander, Charles N.; Staggers, Frank; Rainforth, Maxwell; Salerno, John W.; Hartz, Arthur; Arndt, Stephen; Barnes, Vernon A. et al. (2005). "Long-Term Effects of Stress Reduction on Mortality in Persons ≥55 Years of Age With Systemic Hypertension". The American Journal of Cardiology 95 (9): 1060–1064. doi:10.1016/j.amjcard.2004.12.058. ISSN 0002-9149. PMID 15842971. 
  28. ↑ Oettgen, Peter. "Cardiovascular Disease Possible Risk Factors". https://www.dynamed.com/prevention/cardiovascular-disease-possible-risk-factors. 
  29. ↑ "Erectile dysfunction (impotence)". Nov 30, 2018. https://www.ebm-guidelines.com/dtk/ebmg/home?id=ebm00530. 
  30. ↑ Rove, Kyle. "Infertility in Men". https://www.dynamed.com/condition/infertility-in-men-19#POSSIBLE_RISK_FACTORS. 
  31. ↑ 31.0 31.1 31.2 31.3 31.4 Philpott, Lloyd Frank; Leahy-Warren, Patricia; FitzGerald, Serena; Savage, Eileen (2017). "Stress in fathers in the perinatal period: A systematic review". Midwifery 55: 113–127. doi:10.1016/j.midw.2017.09.016. ISSN 1532-3099. PMID 28992554. 
  32. ↑ "WHO | Substance abuse". https://www.who.int/topics/substance_abuse/en/. 
  33. ↑ 33.0 33.1 "CDC – Fact Sheets-Excessive Alcohol Use and Risks to Men's Health – Alcohol". 2018-09-18. https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm. 
  34. ↑ 34.0 34.1 Wilsnack, Richard W.; Wilsnack, Sharon C.; Kristjanson, Arlinda F.; Vogeltanz-Holm, Nancy D.; Gmel, Gerhard (September 2009). "Gender and alcohol consumption: Patterns from the multinational GENACIS project". Addiction 104 (9): 1487–1500. doi:10.1111/j.1360-0443.2009.02696.x. ISSN 0965-2140. PMID 19686518. 
  35. ↑ 35.0 35.1 35.2 35.3 "The Differences in Addiction Between Men and Women – Addiction Center". https://www.addictioncenter.com/addiction/differences-men-women/. 
  36. ↑ Melinda (2018-11-02). "Substance Abuse and Mental Health Issues - HelpGuide.org". https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm. 
  37. ↑ ABBEY, ANTONIA; SMITH, MARY JO; SCOTT, RICHARD O. (1993). "The relationship between reasons for drinking alcohol and alcohol consumption: An interactional approach". Addictive Behaviors 18 (6): 659–670. doi:10.1016/0306-4603(93)90019-6. ISSN 0306-4603. PMID 8178704. 
  38. ↑ Crum, Rosa M.; Mojtabai, Ramin; Lazareck, Samuel; Bolton, James M.; Robinson, Jennifer; Sareen, Jitender; Green, Kerry M.; Stuart, Elizabeth A. et al. (2013-07-01). "A Prospective Assessment of Reports of Drinking to Self-medicate Mood Symptoms With the Incidence and Persistence of Alcohol Dependence". JAMA Psychiatry 70 (7): 718–726. doi:10.1001/jamapsychiatry.2013.1098. ISSN 2168-622X. PMID 23636710. 
  39. ↑ Monahan, John; Steadman, Henry J. (1996-05-15). Violence and Mental Disorder: Developments in Risk Assessment. University of Chicago Press. ISBN 978-0-226-53406-0. https://books.google.com/books?id=v4oSb2Na4nQC&q=(substance+abuse+OR+alcohol)+AND+(mental)&pg=PA101. 
  40. ↑ "Men More Likely Than Women to Face Substance Use Disorders and Mental Illness". 3 June 2019. https://pew.org/2wB03Jr. 
  41. ↑ Abuse, National Institute on Drug. "Sex and Gender Differences in Substance Use Disorder Treatment". https://www.drugabuse.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use-disorder-treatment. 
  42. ↑ "WHO | Gender and women's mental health". https://www.who.int/mental_health/prevention/genderwomen/en/. 
  43. ↑ 43.0 43.1 "NIAAA Publications". https://pubs.niaaa.nih.gov/publications/arh291/55-62.htm. 
  44. ↑ Administration (US), Substance Abuse and Mental Health Services; General (US), Office of the Surgeon (November 2016). EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. US Department of Health and Human Services. https://www.ncbi.nlm.nih.gov/books/NBK424859/. 
  45. ↑ "The silent epidemic of male suicide | British Columbia Medical Journal". https://www.bcmj.org/articles/silent-epidemic-male-suicide. 
  46. ↑ 46.0 46.1 Ritchie, Hannah; Roser, Max; Ortiz-Ospina, Esteban (2015-06-15). "Suicide". Our World in Data. https://ourworldindata.org/suicide. 
  47. ↑ 47.0 47.1 47.2 47.3 Freeman, Aislinné; Mergl, Roland; Kohls, Elisabeth; Székely, András; Gusmao, Ricardo; Arensman, Ella; Koburger, Nicole; Hegerl, Ulrich et al. (2017). "A cross-national study on gender differences in suicide intent". BMC Psychiatry 17 (1): 234. doi:10.1186/s12888-017-1398-8. ISSN 1471-244X. PMID 28662694. 
  48. ↑ "UpToDate". https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults. 
  49. ↑ "WHO | Suicide rates (per 100 000 population)". https://www.who.int/gho/mental_health/suicide_rates_male_female/en/. 
  50. ↑ 50.0 50.1 "Men: A Different Depression". American Psychological Association. https://www.apa.org/research/action/men. 
  51. ↑ "Suicides in the UK – Office for National Statistics". https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2017registrations. 
  52. ↑ "Male:Female ratio of age-standardized suicide rates". 2016. http://gamapserver.who.int/mapLibrary/Files/Maps/Global_AS_suicide_rates_male_female_ratio_2016.png. 
  53. ↑ World Health Organization. Preventing suicide: A global imperative. Geneva: World Health Organization; 2014. 1–88 p.
  54. ↑ "#5facts: The sad extent of suicide in South Africa". https://africacheck.org/reports/5facts-sad-extent-suicide-south-africa/. 
  55. ↑ Chen, Ying-Yeh; Chen, Mengni; Lui, Carrie S. M.; Yip, Paul S. F. (2017). "Female labour force participation and suicide rates in the world". Social Science & Medicine 195: 61–67. doi:10.1016/j.socscimed.2017.11.014. ISSN 0277-9536. PMID 29154181. 
  56. ↑ 56.0 56.1 Hunt, Tara; Wilson, Coralie J.; Caputi, Peter; Woodward, Alan; Wilson, Ian (2017-03-29). Voracek, Martin. ed. "Signs of current suicidality in men: A systematic review". PLOS ONE 12 (3): e0174675. doi:10.1371/journal.pone.0174675. ISSN 1932-6203. PMID 28355268. Bibcode: 2017PLoSO..1274675H. 
  57. ↑ Beautrais, Annette L. (2002). "Gender issues in youth suicidal behaviour". Emergency Medicine 14 (1): 35–42. doi:10.1046/j.1442-2026.2002.00283.x. ISSN 1035-6851. PMID 11993833. 
  58. ↑ 58.0 58.1 58.2 58.3 58.4 58.5 "Men and Suicide". https://www.suicideinfo.ca/resource/men-and-suicide/. 
  59. ↑ 59.0 59.1 59.2 59.3 Seidler, Zac E.; Dawes, Alexei J.; Rice, Simon M.; Oliffe, John L.; Dhillon, Haryana M. (2016). "The role of masculinity in men's help-seeking for depression: A systematic review". Clinical Psychology Review 49: 106–118. doi:10.1016/j.cpr.2016.09.002. ISSN 0272-7358. PMID 27664823. 
  60. ↑ Ibrahim, Norhayati; Amit, Noh; Din, Normah Che; Ong, Hui Chien (2017-04-28). "Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia". Psychology Research and Behavior Management 10: 129–135. doi:10.2147/prbm.s125176. PMID 28496374. 
  61. ↑ 61.0 61.1 Donker, Tara; Batterham, Philip J; Van Orden, Kimberly A; Christensen, Helen (2014). "Gender-differences in risk factors for suicidal behaviour identified by perceived burdensomeness, thwarted belongingness and acquired capability: cross-sectional analysis from a longitudinal cohort study". BMC Psychology 2 (1): 20. doi:10.1186/2050-7283-2-20. ISSN 2050-7283. PMID 25815191. 
  62. ↑ 62.0 62.1 Platt, Stephen (2017). "Suicide in men: what is the problem?". Trends in Urology & Men's Health 8 (4): 9–12. doi:10.1002/tre.587. ISSN 2044-3749. 
  63. ↑ 63.0 63.1 Brådvik, Louise (2018-09-17). "Suicide Risk and Mental Disorders". International Journal of Environmental Research and Public Health 15 (9): 2028. doi:10.3390/ijerph15092028. ISSN 1660-4601. PMID 30227658. 
  64. ↑ 64.0 64.1 Too, Lay San; Spittal, Matthew J.; Bugeja, Lyndal; Reifels, Lennart; Butterworth, Peter; Pirkis, Jane (2019). "The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies". Journal of Affective Disorders 259: 302–313. doi:10.1016/j.jad.2019.08.054. ISSN 0165-0327. PMID 31450139. 
  65. ↑ Breet, Elsie; Goldstone, Daniel; Bantjes, Jason (2018). "Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review". BMC Public Health 18 (1): 549. doi:10.1186/s12889-018-5425-6. ISSN 1471-2458. PMID 29699529. 
  66. ↑ 66.0 66.1 66.2 Boettcher, Nick; Mitchell, Jennifer; Lashewicz, Bonnie; Jones, Erin; Wang, JianLi; Gundu, Sarika; Marchand, Alain; Michalak, Erin et al. (2019). "Men's Work-Related Stress and Mental Health: Illustrating the Workings of Masculine Role Norms". American Journal of Men's Health 13 (2): 155798831983841. doi:10.1177/1557988319838416. ISSN 1557-9883. PMID 30880590. 
  67. ↑ "The Effect of Unemployment on Suicide Risk". https://www.mentalhealth.va.gov/suicide_prevention/docs/Literature_Review_FSTP_Unemployment_FINAL_508_8-19-2019.pdf. 
  68. ↑ Gilman, Stephen E; Abraham, Henry David (2001). "A longitudinal study of the order of onset of alcohol dependence and major depression". Drug and Alcohol Dependence 63 (3): 277–286. doi:10.1016/S0376-8716(00)00216-7. ISSN 0376-8716. PMID 11418232. 
  69. ↑ Norström, Thor; Rossow, Ingeborg (2016). "Alcohol Consumption as a Risk Factor for Suicidal Behavior: A Systematic Review of Associations at the Individual and at the Population Level". Archives of Suicide Research 20 (4): 489–506. doi:10.1080/13811118.2016.1158678. ISSN 1381-1118. PMID 26953621. 
  70. ↑ "Why Are Men More Susceptible to Alcoholism?". https://www.elsevier.com/about/press-releases/research-and-journals/why-are-men-more-susceptible-to-alcoholism. 
  71. ↑ 71.0 71.1 71.2 Goyne, Anne (2018). "Suicide, male honour and the masculinity paradox: its impact on the ADF". Australian Defence Force Journal. https://www.defence.gov.au/adc/adfj/Documents/issue_203/ADF%20Journal%20203_Article_Goyne.pdf. 
  72. ↑ Call, Jarrod B.; Shafer, Kevin (2018). "Gendered Manifestations of Depression and Help Seeking Among Men". American Journal of Men's Health 12 (1): 41–51. doi:10.1177/1557988315623993. ISSN 1557-9883. PMID 26721265. 
  73. ↑ 73.0 73.1 Rochlen, Aaron B.; Paterniti, Debora A.; Epstein, Ronald M.; Duberstein, Paul; Willeford, Lindsay; Kravitz, Richard L. (2010). "Barriers in Diagnosing and Treating Men With Depression: A Focus Group Report". American Journal of Men's Health 4 (2): 167–175. doi:10.1177/1557988309335823. ISSN 1557-9883. PMID 19477750. 
  74. ↑ Kilmartin, Christopher (2005). "Depression in men: communication, diagnosis and therapy". The Journal of Men's Health & Gender 2 (1): 95–99. doi:10.1016/j.jmhg.2004.10.010. ISSN 1571-8913. 
  75. ↑ "More About Us". https://www.menshealthforum.org.uk/more-about-us. 
  76. ↑ "Men's Health Week". 2014-05-26. https://gamh.org/mens-health-week/. 
  77. ↑ Macken, University of Western Sydney-Michael. "Men's Health Information and Resource Centre". https://www.westernsydney.edu.au/mhirc/mens_health_information_and_resource_centre. 
  78. ↑ "About Us". November 2013. http://gamh.org/about-us/. 

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