The Healthy Male. issue 47. National Male Health Policy: Three years on CONTENTS. Winter Male Health Policy. 2 From the Director

Transcription

1 The Healthy Male NEWSLETTER OF ANDROLOGY AUSTRALIA Australian Centre of Excellence in Male Reproductive Health Winter 2013 issue 47 CONTENTS 1 Male Health Policy Three years on 2 From the Director 2 Letters Andrology Australia s outgoing Chairman reflects 2 Health Spot The Foreskin 3 Focus On The National Male Health Policy 5 Community Development Men s Sheds: Here, there and everywhere 5 Research Round-up Ten To Men: The Australian Longitudinal Study on Male Health 6 Latest News Learning about screening 6 News in brief National Male Health Policy: Three years on We have just celebrated another International Men s Health Week (IMHW). Community groups around Australia continue to lend their support to men s health advocacy efforts through IMHW events. What we may not remember is that IMHW was first recognised in Australia in 2002, which prompts us to stop and think what has changed in the men s health landscape in that decade. Certainly, the phenomenon that is Movember has gone a long way towards changing the face of men s health in Australia and overseas. Men s Sheds is also a great example of a grass-roots movement that has expanded nationally and internationally over the years. Such initiatives suggest that men s health is indeed receiving greater recognition in the broader community. Arguably the most significant change in the last ten years was the development of the first National Male Health Policy, launched in May 2010 by the Australian Government in response to extended calls from men s health advocacy groups and a 2007 pre-election commitment by the Labor Government. The release of the Policy, together with nine supporting documents, provided a comprehensive analysis of male health issues and a framework for action to improve male health outcomes for all males across Australia. In addition, a total of $16.7 million over four years was committed to male health programs that supported the Policy. Despite the release of the Policy, advocacy efforts still need to continue so that changes in health outcomes are seen for all males across Australia. Three years on since the Policy was introduced, it s a good time to reflect on what s been achieved and to look ahead to what remains to be done over the next decade.

2 From the Director The National Male Health Policy s aim to improve the health of all males and achieve equal health outcomes for population groups of males at risk of poor health is a bold longterm vision, and we won t know how effective it has been for years or perhaps even decades. But three years on we can still reflect on achievements to date and ask if the foundations for longer-term change have been established. My thanks go to all contributors to this issue of The Healthy Male who provided insights into key Policy activities and opportunities that still exist to ensure that the Policy makes a lasting difference to the health outcomes of all Australian males. I also take this opportunity to reflect on the significant contribution that our recently retired Chairman, Mr Mark Rayner, has made to the Andrology Australia program during his twelve-year appointment. Mark has been an integral part of Andrology Australia since the start. We have always valued his commitment and business acumen, and his unwavering support of the program over many years. We are fortunate to have an equally talented and experienced new Chairman in Mr David Crawford, and we welcome him to the program. Professor Rob McLachlan Letters Health spot - The foreskin In my time as Chairman of Andrology Australia, I have seen significant increase in both community awareness of men s health and desire for reliable information from authoritative, independent sources. Highlights of my time with Andrology Australia include the Men in Australia Telephone Survey (MATeS), development of the online information resources and the extent to which they are now utilised, and the progress achieved in health awareness and action for Aboriginal and Torres Strait Islander men. I hope that we will see further development of Andrology Australia s information base and distribution systems for the community at large, expansion and greater penetration of professional education, driven by the early general adoption of the proposed medical curriculum module, and significantly increased funding, both government and private sector, particularly to help drive expanded research and education efforts. Finally, I urge all Australian men to talk openly to your doctor about health issues, sooner rather than later and as often as they arise! Mark Rayner Andrology Australia Chairman It is now uncommon, except for religious or cultural reasons, for boys to be circumcised as babies. It is important therefore that boys and men take care of their foreskin to avoid certain penis problems. At birth, the foreskin and the glans penis (head of the penis) are joined. As boys start growing, an increase in hormones helps the foreskin and glans to separate and the foreskin can then be pulled back. In most boys, this happens at around three years of age. The foreskin of an uncircumcised boy should not be forcibly pulled back as this can cause bleeding and injury. If force is used to pull back the foreskin, scarring can happen. This scarring can cause problems in the future with retracting (pulling back) the foreskin, a condition called phimosis. If the foreskin cannot be pulled back, it is hard to keep the inside of the foreskin clean and this can lead to inflammation of the glans penis, sometimes due to infection, a condition called balanitis. All uncircumcised adult men should have a periodic genital examination by their doctor and have their foreskin retracted to check for signs of infection or penis cancer. If there is an infection, the doctor may prescribe antibiotics or antifungal medication. In severe cases of balanitis, circumcision may be recommended. To avoid balanitis, do not use strong soaps and chemicals, and pull back the foreskin and clean it daily. For more information, see fact sheet Penis Problems at or call

3 Focus on: The National Male Health Policy Where are we at with the National Male Health Policy? The following overview highlights key activities targeting male health and identifies opportunities that still exist to ensure that the Policy makes a lasting difference to the health outcomes of all Australian males. Statistical bulletins on male health Governance Minister s Male Health Reference Group An important initiative instigated by the Minister responsible for male health, the Hon Warren Snowdon MP, was the establishment of an expert advisory group, comprising leading academics, health professionals and key stakeholders in male health. The Reference Group meets about three times a year to provide advice on male health issues and oversee the implementation of key Policy initiatives. The Reference group has also provided advice on specific program activity made available through the Policy, and is developing a strategic framework to ensure that identified Policy action areas can be effectively implemented. The work of the reference group is complemented by meetings between representatives of Australian Government Departments that manage programs which impact on men s health. These meetings aim to enable a more co-ordinated approach to male health across Departments; identify opportunities for potential collaboration; and share learnings about effective programs relating to male health. Supporting national infrastructure Building the male health evidence-base Importantly, for any policy to be effective and to appropriately align resources to identified need, strategies need to be informed by robust evidence. An important Policy area is the attention to building the male health evidence-base and providing the infrastructure that will allow researchers, health professionals and policy-makers to better understand the impact of sex, age and gender on attitudes, behaviours and outcomes and understand the behavioural, economic and social determinants that put some groups of males at greater risk of poor health. The Australian Longitudinal Study on Male Health known as Ten To Men was commissioned in 2011 by the Australian Government Department of Health and Ageing as a key element of the Policy to build the evidence base on male health and ensure that evidence will be a key factor in shaping male health policy over time. The longitudinal nature of the study is crucial to this task not only does it allow the identification of the lifestyle and environmental factors that play a role in determining health outcomes (both good and poor outcomes) in the future for males, it will also generate knowledge of risk and protective factors associated with health outcomes over time, and thus identify potential targets for policy intervention. Moreover, the longitudinal approach, particularly one that follows participants from a young age, allows an examination of the key transition points in men s lives and the impact of these on lifestyles and health, for example, entering the workforce, establishing relationships and becoming a father. This life-course approach will present policy opportunities for supporting the health and wellbeing of Australian males at such key life stages. The Ten to Men study is an important national resource with data collected being made available, upon application, to the broader male health research community. More on the Ten to Men study is included in the Research Round-up column in this newsletter. Commonwealth support was also provided to the Australian Institute of Health and Welfare (AIHW), the government agency that collects and analyses health and welfare data for all Australians, to develop regular statistical bulletins on male health. Drawing on a wide range of national data sources, the AIHW publish up-to-date snapshots of the health and wellbeing of Australian males for health professionals, academics, policy-makers and the broader community to discuss and debate current issues and future trends in male health. Launched in June 2011, the first in the series of four male health bulletins, The Health of Australia s Males, provides a summary of the health and wellbeing of the Australian male population. The first bulletin sets the scene by outlining the lifestyle factors influencing male health, the health status of Australian males and their access to health services. The Health of Australia s Males: A focus on five population groups was the second in the series of male health bulletins, released in June This bulletin starts to break down the data into distinct health profiles of five population groups, namely Aboriginal and Torres Strait Islander males, males living in regional and remote areas, males living in socioeconomically disadvantaged areas, males born overseas and older males. Bulletins can be accessed directly from the AIHW website, Supporting population groups Programs to alleviate social isolation A key determinant of health is social isolation. People who are more isolated tend to demonstrate poorer health outcomes across a range of measures. Recognising the impact of social isolation, the Australian Men s Shed Association (AMSA) was funded to develop national infrastructure aimed at ensuring the future sustainability of men s sheds. At the time of the Policy launch, there were approximately 300 men s sheds nationally in various stages of operation: today there are over 940 with an estimated 200 sheds in many other countries such as Ireland, New Zealand, Canada, United States and the United Kingdom. Through the Policy initiative, the AMSA also administers the Australian Government Shed Development Program that provides direct financial assistance to Men s Sheds, by way of small grants. Another organisation, Mensheds Australia, has been funded to undertake and support health initiatives targeting Men s Sheds with Aboriginal and Torres Strait Islander participants. More on the Men s Sheds program is included in the Community Development column of this newsletter. Programs to support Aboriginal and Torres Strait Islander Fathers It is well-recognised that Indigenous males are the most disadvantaged population group in Australia in terms of physical health and wellbeing. A key element of the Policy is the National Aboriginal Islander Male Health Framework Revised Guiding Principles, which recognises the interconnectedness between individuals, families and communities and the need for a holistic approach when addressing the health needs of Indigenous males. As part of the Policy, funding was made available for The Strong Fathers, Strong Families Program which aims to build on and complement other Department of Health and Ageing initiatives addressing Indigenous child and maternal health. The program is designed to specifically promote the role of Aboriginal and Torres Strait Islander fathers, partners, grandfathers and uncles, and encourage them to actively participate in their children s and families lives, particularly in the antenatal period and early childhood development years. Where to next? As a result of the Policy, male health initiatives have been established that start to lay the foundation on which to build future policy and programs specifically for Australian males. It is hoped that as we move into a final year of a four-year commitment, resources are directed to develop key, relevant and measurable male health indicators and an independent evaluation of Policy actions is undertaken. Such initiatives will help ensure that limited resources are aligned to evidence-based and integrated programs and services and the effectiveness of the Policy actions can be appropriately measured. The Policy spoke of much promise: building on the foundations that have been established will help ensure optimal health outcomes of all Australian males is an achievable goal. Andrology Australia would like to thank Dr Dianne Currier (Ten to Men), David Helmers (Australian Men s Shed Association) and Professor Rob Moodie (Chair, Ministers Male Health Reference Group) for their contributions to this Focus On article.

4 Community Development Men s Sheds: Here, there and everywhere IT IS easier to state what a Men s Shed is not rather than to describe what it is. Men s Sheds are not places full of lonely, clinically depressed, social outcasts or suicidal men. Nor are they a referral agency that provides comprehensive counselling that will make everything better. And they are definitely not a place that society should look upon with pity for suffering occupants. Men s Sheds are vibrant places full of good, well men participating in meaningful projects for the benefit of themselves and their communities. The Australian Men s Shed Association (AMSA) views Men s Shed facilities as providing a comfortable place of belonging for men, where they can work together and be an inclusive part of the community, where they can talk comfortably on issues to do with their lives and also their health, and in this sense can be seen as another health preventative measure. They also provide an ideal platform from which to launch future men s health initiatives. But over the years they have become so much more than this, Men s Sheds have become key social hubs within their community, the men of the sheds have developed a strong sense of belonging to and ownership of their sheds, their community and to their Association, AMSA. Sheds have become community service organisations contributing valued support to many other community groups and facilities. They have achieved so many objectives it is now harder than ever to clearly define or summarise exactly what is a Men s Shed and what does it do. Although Sheds existed before the National Male Health Policy, it is clear that with the support of the Policy and the energy of the shedders, Men s Sheds have made a significant difference for the betterment of men and the wider community. Our thanks to AMSA for providing this article. For more information please visit Research round-up Ten To Men: The Australian Longitudinal Study on Male Health THE MELBOURNE School of Population and Global Health at the University of Melbourne is overseeing the establishment of the Ten to Men study and coordinating the first wave of data collection. The chief investigators are Professor Jane Pirkis (Director of the Centre for Health Policy, Programs and Economics) and Professor Dallas English (Director of the Centre for Molecular, Environmental, Genetic and Analytic Epidemiology) supported by four advisory groups of more than 30 researchers from across Australia. The aims of Ten to Men are to: Examine male health and its key determinants including social, economic, environmental and behavioural factors that affect the length and quality of life of Australian males, Address a range of key research questions about the health of Australian males, including their health behaviours and risk factors (including risky behaviours), key life transition points, social and economic environments in which they work and live together with their use of health and other services, and Identify policy opportunities for improving the health and wellbeing of males and providing support for males at key life stages, particularly those at risk of poor health. The study will recruit three cohorts of males between 10 and 55 years from across Australia (boys aged years; adolescent males years; and adult males years). It is anticipated that follow-up surveys will be conducted every three years to gather data on health and lifestyle changes and outcomes over time. Wave 1 data collection will occur in the second half of The first of its kind, the Ten to Men study is providing an important resource for improving the health and wellbeing of Australian men and boys. Our thanks to Ten To Men for providing this article. For more information please visit

5 In brief Expressions of Interest: PhD Scholarship in Aboriginal and Torres Strait Islander male health As part of Andrology Australia s program to build research capacity in men s health, expressions of interest (EOI) are being called for a scholarship for an Aboriginal and Torres Strait Islander student to undertake full time research towards a PhD degree. It is proposed that the project will focus on health service access and primary health care for Aboriginal and Torres Strait Islander males. Applicants will need to negotiate their candidature with an Australian University. Details about the PhD scholarship and EOI application process are available at We need your help As the end of the financial year approaches, we invite you to contribute to our annual gift-giving program. Andrology Australia rarely appeals for donations but with broader restrictions on Government funding and the growing need for our work, your tax-deductible donation will help us continue our community, professional and research programs in men s health. You may choose to support a specific project, such as helping to sponsor a PhD student and sustain our research program in male reproductive health. To donate online please visit Annual Report available Download our 2012 Annual Report at or request a printed copy by info@andrologyaustralia.org or phone Latest News Learning about screening A SCREENING TEST is one carried out on a population of apparently healthy people intended to find out who is likely to have a specified disease and who probably does not. It is not meant to be a diagnostic test and usually further testing is needed. Factors that make a good screening test include: the nature of the disease itself (e.g. its severity and how often it occurs), the effectiveness and risk of sideeffects of available treatments, and the cost, safety, convenience, and the sensitivity and specificity of the test. The sensitivity of a test shows how reliable it is based on the proportion of people with the disease who get a positive result to the test: the higher the sensitivity, the better the test is at detecting people who have the disease. On the other hand, specificity shows how well a test excludes people who do not have a particular disease: the higher the specificity, the fewer false positives (a false positive is where a positive screening test indicates a person may have the disease but further testing shows they do not have the condition). In general, a good screening test has high sensitivity and high specificity but most tests work in such a way that increasing sensitivity reduces specificity, and vice versa. Clinical adviser to the National Prescribing Service (NPS) Dr Andrew Boyden says there is complexity for GPs in deciding which tests are appropriate. There is a great opportunity to identify people who are at increased risk of developing chronic conditions and give them the opportunity to make lifestyle changes that will benefit them into the future, he says. However tests are just one part of the story and are not infallible. Taking a good clinical history and physical examination and considering family history and lifestyle issues will best determine which patients are most likely to benefit from which tests. NPS is providing a new educational program that encourages GPs to prioritise the use of evidence-based risk assessments and tests and avoid inappropriate testing. Harm can be caused through overdiagnosis for example a test may identify a condition that if left alone would not impact on a person s health, but once identified could lead to further investigations and treatments with harmful side effects, says Dr Boyden. Helping patients understand the risks and benefits of tests in relation to their individual health needs will help them to make informed decisions in partnership with their doctor. NPS has launched an information hub ( that provides a more detailed appraisal of the latest evidence on a range of tests used during preventive activities, such as prostate-specific antigen (PSA), faecal occult blood test for colorectal cancer (FOBT), vitamin D, thyroid, diabetes risk assessment and the absolute cardiovascular disease risk assessment. Look for the article Testing Times, for a detailed comparison of the PSA and the FOBT. Subscribe Today! Andrology Australia extends an invitation to all to take advantage of the FREE SUBSCRIPTION offer. Call, fax or us to register on our mailing list and receive this regular quarterly publication and other items from Andrology Australia. NEWSLETTER OF ANDROLOGY AUSTRALIA Australian Centre of Excellence in Male Reproductive Health The Andrology Australia project is supported by funding from the Australian Government under the Health System Capacity Development fund, and is administered by Monash University. Postal Address: Andrology Australia, c/o Monash Institute of Medical Research PO Box 5418, Clayton, Victoria, Australia, 3168 Street Address: Wright Street, Clayton, Victoria 3168 Telephone: Web: info@andrologyaustralia.org Facebook: AndrologyAustralia DISCLAIMER: This newsletter is provided as an information service. Information contained in this newsletter is based on current medical evidence but should not take the place of proper medical advice from a qualified health professional. The services of a qualified medical practitioner should be sought before applying the information to particular circumstances.