After reading this piece, all of you will have a double-take on which is the stronger sex. If you look at the Philippine Statistics Authority monograph for Deaths in 2016, males still outnumber females across most age groups. The exception is in the oldest age groups (>70 years old), wherein there are many females. There are some differences in the causes of death among males compared to females in terms of prevalence. These may reflect the inherent differences in risk factors both sexes are exposed to. In this article, we will tackle the top five common diseases in men.
- Cardiovascular disease
Ischemic heart disease (those affecting the blood supply to the heart) and cerebrovascular disease (those affecting the circulation into the brain) are still the leading causes of death among males in the Philippines, not the angry wife as popular culture dictates. It is not completely clear why males are more predisposed to a heart attack compared to females, even if traditional risk factors are controlled (e.g. cholesterol levels). However, there are other usually preventable risk factors among males: a 2012 epidemiologic study showed that cigarette smoking was still more prevalent in them than in women. Hypertension and cholesterol problems were also more rampant in men. A sedentary lifestyle and bad eating habits continue to be common among males (think of the proverbial fatty pulutan). Stress, anxiety, and anger also play a big role, especially in a society that highly values machismo among men. All of these risk factors play a role in the incidence of stroke and its complications among males. The development of a stroke leads to more acute and chronic problems that complicate health care for males.
New cancer cases are generally higher among males. Preventable risk factors like smoking, alcohol consumption, and unhealthy diet are still more prevalent among them as well. The six most common sites of cancer among Filipino men were lung, liver, colon/rectum, prostate, stomach, and leukemia. Lung cancer is particularly connected with smoking, which remains relatively higher among males. This is despite government attempts to increase tobacco taxes in order to curb smoking. Liver cancer is intimately related to both alcohol intake and hepatitis B infections, which can be transmitted sexually. Colon and rectal cancer are heavily related to smoking and poor dietary habits (e.g. intake of carcinogenic substances in food). Prostate cancer is obviously a male-only malignancy as females do not have prostates. In all of these conditions, delayed screening and case-finding and lower utilization of possibly curative or remissive treatment contribute to higher death rates.
- Lung diseases
There are many lung diseases that are more prevalent in men. Chronic obstructive pulmonary disease (COPD) is caused by permanent and progressive damage in the lungs triggered by exposure to noxious stimuli. Again, the most common noxious agent that causes COPD is smoking. In the Philippines, other sources of noxious gases include pollution, especially from occupational exposure and smoke from agricultural or cooking fires. Smoking as a risk factor is notoriously difficult to stop despite the efforts of many agencies to prevent new smokers and reduce current smoking due to the inherently addictive characteristics of nicotine. Vaping presents its own unique dangers and may not necessarily be less harmful than tobacco smoking. The electronic allure of vaping gadgets also adds to its appeal, especially among the relatively younger male smokers.
COPD, which leads to lung damage, also predisposes males to other lung diseases and infections. Pneumonia still prevails as predisposing illness and the relatively lower uptake of vaccination against other diseases cause respiratory problems (e.g. influenza). These contribute to the persistently higher incidence of pneumonia in the country.
- Alcohol and its complications
Filipinos males love their alcohol – males older than 15 years old have a higher per capita consumption compared to females. Alcohol dependence was also higher among males. Alcohol intake is related to many of the aforementioned diseases, including heart disease and cancer. Liver cirrhosis, a known complication of long-term alcohol intake and a risk factor for liver cancer, is again higher among Filipino males. Cirrhosis occurs when the liver develops widespread fibrosis, leading to distortion of the liver architecture and function.
Traffic accidents related to alcohol intake and intoxication are more common in males. Recently, there are also deaths attributable to methanol poisoning due to intake of distilled spirits (like lambanog) from questionable cottage sources.
These are not diseases per se, but statistics show males are more likely to get into accidents. Males are more likely to engage in reckless or risky behavior, like driving while under the influence of alcohol or not taking safety precautions when working (e.g. in construction) or traveling (e.g. not using a helmet while riding a motorcycle). Use of alcohol, drugs, and the Filipino machismo attitude also increase participation in risky behavior. Males also generally have a shorter fuse and have a tendency to get into fights that put them in serious safety risks.
- Erectile dysfunction
I was tasked to write about five conditions only, but who can seriously ignore this? It would be hard to! (Pun intended.) Many of the conditions mentioned can lead to erectile dysfunction or ED. This is a sensitive issue among most males who value their potency as a measure of their overall manhood. The same risk factors for cardiovascular disease, diabetes, and smoking can lead to erectile dysfunction. In fact, ED may actually be an initial or early manifestation of cardiovascular disease as the same disease process may happen earlier in the circulation of the penis. Many men also mainly just focus on “getting the pole up” but ignore the underlying causes and seriousness of the condition.
It is important to have good health-seeking behavior to manage these conditions. Do consult your doctor, many of these can be prevented or controlled.