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A need to close gaps in men’s health across Asia

Rachel Soon
Medical Writer
31 Aug 2019
Professor Dato’ Dr Tan Hui Meng

More work needs to be done by Asian healthcare stakeholders to reduce disparities in men’s health between regions and the sexes, says an expert.

According to Professor Dato’ Dr Tan Hui Meng, consultant urologist and adjunct professor at Universiti Malaya, data from the second Asian Men’s Health Report (AMHR 2) indicated that the number of disability-adjusted life years (DALY) lost to communicable diseases (CDs) was up to 15 times higher in developing countries versus developed countries.

“As for non-communicable diseases (NCDs), the difference between developed and developing countries isn’t as wide due to the growing issue of ageing populations in developed countries such as Japan and Singapore,” said Tan. “However, developing countries still have overall higher DALY rates; two to three times more than in developed countries.

DALY refers to the number of years of life lost due to ill health, disability, or death. According to Tan, DALY is a favoured measure in the field of public health policy as it provides an economic view of a country’s healthcare burdens.

Speaking at the recent 17th Urological Association of Asia Congress (UAA) 2019 in Kuala Lumpur, Tan added that in most Asian countries, men also lost a greater proportion of DALY compared to women whether due to CDs or NCDs.

“In only nine countries out of 52 surveyed was the reverse true for CDs, and five countries for NCDs,” said Tan. “In most areas, the burden of disease is still primarily weighted towards men … there is a dire need to equilibrate health and life expectancy in Asian countries, and between men and women.”

Data points from AMHR 2 data on DALY disparities between countries and sexes.

Data points from AMHR 2 data on DALY disparities between countries and sexes.

According to Tan, the healthcare profession needs to rise to the challenge of contributing to the maintenance of physical and mental health; prolonging working lifespans; minimizing risk factors for disabilities and diseases, particularly with ageing; and fostering healthy lifestyles through government policy, new strategies for healthcare management, and public education.

“The goal is to push back those years of disability [and] to delay the inevitable as long as possible,” said Tan. “When we urologists see younger men, especially those still below 30, we can certainly contribute to primary prevention. Secondary prevention can be brought in at any age.”

Released in 2013, the first Asian Men’s Health Report (AMHR 1) examined morbidity and mortality across diseases, regions and income groups in 49 countries. The results prompted the launch of a Delphi survey among men's health stakeholders “to determine whether any dedicated men's health policies in Asia existed and to reach a consensus on the recommendations of men’s health policies.” [Nat Rev Urol 2017;14:630–636]

According to Tan, AMHR 2—which covers 52 countries—took a more focused approach by identifying key men’s health topics for situational analysis. These included the changing patterns of prostate cancer, sexual dysfunction, population sex ratios, ageing, HIV infection, and testosterone deficiency in Asia.

The full text of AMHR 1 can be publicly accessed at menshealthmalaysia.org/wp-content/uploads/2016/03/Asian_Mens_Health_Report.pdf. AMHR 2 is targeted for release at the end of 2019.

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Roshini Claire Anthony, 11 Sep 2019

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