Less than 50% of male population dies from old age- Most common health concerns for males

According to the Australian Institute of Health and Welfare (AIHW), in the year 2000 the top ten leading causes of death for males in Australia included ischaemic heart disease (21% of all deaths), cerebrovascular disease (7.3%), lung cancer (6.9%), chronic obstructive pulmonary disease (4.9%), prostate cancer (4.0%), colorectal cancer (3.8%), suicide (2.8%) and diabetes (2.4%). Land transport accidents (2.0%), shared equal place with pneumonia and influenza (2%). Together these conditions represented over 50% of all causes of death within Australia’s male population1.

Coronary or ischaemic heart diseaseIn the year 2000 Coronary heart disease (CHD) represented the biggest single cause of death for males in Australia. However, while a steadily increasing trend for death rates from such disorders was observed from 1940-1968, a more recent trend (from 1996-2000) showed an annual decline in deaths caused by ischaemic heart disease by 6.3% in the male Australian population¹. This observation may be due to both better prevention strategies and improvements in treatment of the disease¹.Cerebrovascular diseaseAlthough second on the list, cerebrovascular disease (CVD) is a significant contributor to mortality rates for Australian males. However, as for ischaemic heart disease death rates due to CVD have climbed during the first part of the last century, while the opposite trend emerged since 1970 showing an annual decline of cerebrovascular disease-linked deaths by 4.5% for the male population of Australia¹. As for ischaemic heart disease this may also, at least in part, be attributed to lifestyle changes and improvements in disease management¹.Malignant neoplasmsOverall death rates due to malignant neoplasms peaked during the 1980s and started to slowly decline since then¹. For males a decrease of 15% in the standardized death rate was observed between 1993 and 2003². However, increases in the standardised death rate for particular types of cancers in the male population between 1993 and 2003 have also been observed and include: Oesophageal cancer (+5.1%), liver cancer and intrahepatic bile duct neoplasms (+37.5%) and melanoma of the skin (+2.5%)². During 1993 to 1998 incidence rates for various forms of cancer in the Australian male population increased. Such cancers include melanoma (2.1%), testicular cancer (3.4%) and kidney cancer (1.6%). On the other hand, lung cancer showed a decreased incidence (-1.8%), as did stomach cancer (-2.7%) and pancreatic cancer (-1.0%)¹. Based on 1998 cancer incidence rates, it has been estimated that one in three Australian males may likely be diagnosed with some form of cancer within their first 75 years of life^1,3. One estimate attributes 30% of cancers to tobacco smoking, with a further 30% due to dietary influences, 2% to radiation exposure, between 5-15% to infectious agents and the rest to miscellaneous risk factors^1,4. Excessive sun exposure is a likely cause for increased rates of melanoma-related deaths.According to AIHW figures for the year 2000, lung cancer is the leading cause of cancer related male deaths in Australia (22.8%)¹. As for CHD and CVD annual rates were found to increase up until 1982, but since then a steady decline in the annual death rate due to lung cancer has been observed for the male population. Unfortunately, the robust encouraging trend observed for lung cancer is not mirrored by other cancers such as colorectal cancer, which represents the second most common cause of overall cancer deaths in Australia, with death rates somewhat higher in the male population¹. The male death rate has fluctuated (which was observed to climb between the early 1940s up until 1983). However, cautious optimism may greet the observation that between 1996 and 2000 the rate of decline of colorectal cancer-related deaths for males was 2.5% per year¹. Prostate cancer, is the second most common cause of death for Australian males over the age of 70¹. The period between 1921 up to the early 1990s saw a slow increase in deaths due to prostate cancer. Alarmingly, a marked increase occurred in the early 1990s, but since then an annual decrease in prostate cancer deaths has been observed between 1993 and 2000¹. Effective treatment strategies are an urgent imperative to combat prostate cancer deaths in males.DiabetesLifestyle factors are likely to influence prevalence and incidence of type 2 diabetes mellitus. In 2001, AIHW studies showed 42.9% of Australian men to be overweight (Body mass index [BMI] of ≥ 25, as classified by the World Health Organization^5,6). Obesity (BMI ≥ 30) was observed at similar rates in both sexes⁵. Such findings were considered similar to results from studies in the United States of America^5,7,8 and Canada^5,9. A large scale, cross-sectional, multicentre study in Australia revealed that prevalence of obesity in Australia had more than doubled over the last 20 years and found strong positive associations between obesity and television viewing time as well as lower physical activity time¹⁰. This highlights the need for increased physical activity to combat obesity and related pathological conditions.Mental healthMental health issues are have emerged as an important consideration for Australian men. Over the last century male suicide rates have fluctuated between 15 and 25 deaths per 100,000, a figure three to five times higher than that for the rest of the population¹. This alarming finding is further placed into perspective by one study which observed that, apart from road crash deaths, male suicide deaths in 1997 exceeded those from all other injuries combined^1,12. Such observations prompted government health initiatives to address the problem of youth suicide. While this may have contributed to a decline in suicide rates among young males (15-24 year olds), the suicide rate for males aged 25-39 years continued at an increasing trend, and though, fluctuating from year to year remained higher than for younger and older age groups by the year 2000¹. This underlines the importance of further research into causes of mental health problems in various age groups in order to enable development of effective preventative initiatives.References

1. AIHW (Australian Institute of Health and Welfare) 2002. Australia’s health 2002. Canberra: AIHW.
2. ABS (Australian Bureau of Statistics) 2001. Causes of death, Australia, 2003. ABS Cat. No. 3303.0. Canberra: ABS.
3. AIHW and Australasian Association of Cancer Registries (AACR) 2001. Cancer in Australia 1998. Cancer Series No. 17. AIHW Cat. No. CAN 12. Canberra: AIHW.
4. Trichopolous D, Frederick PL and Hunter DJ 1996. What causes cancer? Scientific American 275 (3):50-57.
5. AIHW 2003. Are all Australians gaining weight? Differentials in overweight and obesity among adults, 1989-90 to 2001. Canberra: AIHW.
6. WHO (World Health Organization) 2000. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. WHO Technical Report Series 894. Geneva: WHO.
7. Flegal KM, Carroll MD, Ogden CL and Johnson CL 2002. Prevalence and trends in obesity among US adults, 1999-2000. Journal of the American Medical Association 288 (14):1723-1732.
8. Schoenborn CA, Admas PF and Barnes PM 2002. Body weight status of adults: United States, 1997-98. Advance Data from vital and health statistics; no. 330. Hyattsville, Maryland: National Centre for Health Statistics.
9. Torrance GM, Hooper MD and Reeder BA 2002. Trends in overweight and obesity among adults in Canada (1970-1992): evidence from national surveys using measured height and weight. International Journal of Obesity and Related Metabolic Disorders 26(6):797-804.
10. Cameron AJ, Welborn TA, Zimmet PZ, Dunstan DW, Own N, Salmon J, Dalton M, Jolley D and Shaw JE 2003. Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Medical Journal of Australia178(9):427-432.
11. ABS 2001. National Health Survey: Summary of Results, 2001. ABS Cat. No. 4364.0. Canberra: ABS.
12. Steenkamp M and Harrison JE 2000. Suicide and hospitalised self-harm in Australia. AIHW Cat. No. INJCAT 30. Adelaide: AIHW Injury Research and Statistics Series.