We hope that the articles in this collection will whet readers’ appetites for Ten to Men. The first article, by Currier et al. [6], sets the scene by providing an overview of the study. It describes the process that led us to our 15,988 males. We knocked on the doors of all of the households in areas selected via a stratified random sampling technique, and invited all of the eligible males within each household to participate. We deliberately over-sampled in areas of Australia outside major cities (referred to as inner and outer regional areas) to ensure that we had sufficient numbers of participants in these areas to undertake meaningful analyses. We collected data on a range of constructs (physical health, mental health and wellbeing, health behaviours, social determinants of health, and health service utilisation and health knowledge), using self-complete questionnaires for participants aged 15 to 55 and the parents of boys aged 10 to 14. We also conducted interviews with the boys themselves. We achieved a 35 % response fraction and high questionnaire/interview completion rates.
The article by Spittal et al. [7] provides more detail about the sampling strategy used in Ten to Men, exploring the implications of four of its key elements (stratification, multi-stage sampling, clustering and sample weights) for the analysis of Wave 1 data. This article notes that estimates of prevalence will be biased if the hierarchical nature of the data and sample weights are ignored, whereas estimates of association will be less likely to be affected. They use the examples of weight and smoking status in the cohort to illustrate these points.
The next seven articles draw on the Wave 1 data to answer a range of important research questions. Kavanagh et al. [8] profile men with and without disabilities on a range of socio-demographic and health-related variables and show that the former are much more likely to experience social and economic disadvantage. For example, they are more likely to live in tenuous circumstances and find it difficult to make ends meet. They are also less likely to have a job, and, if they are employed, are less likely to be performing skilled roles and more likely to be working fewer hours than they would prefer to be. They have lower levels of social support and community participation, and worse physical and mental health. As Kavanagh et al. [8] point out, these results underscore the need to ensure that health and social policy supports men with disabilities.
LaMontagne et al. [9] take a different angle on employment and working conditions, focusing particularly on psychosocial job quality. They observe that men who have low levels of control over their jobs, find their work too demanding or complex, have minimal job security, are faced with unfair payment practices, work long hours and/or do shift work have significantly poorer mental health and wellbeing than men who do not work under these conditions. The more of these adverse conditions men confront in their working lives, the worse they fare. This has significant implications for workplace reform; improvements in psychosocial job quality would undoubtedly benefit working men themselves, and there is evidence that employers would also benefit from having an emotionally healthier workforce.
Currier et al. [10] consider a broader range of life stressors and examine the extent to which these are related to suicidal thinking in men. More specifically, they consider whether life stressors exert an influence on suicidal thinking independently of mental disorders. They find that certain stressful life events (e.g., serious family conflict, difficulty finding a job, legal troubles, major loss of property, break-up of a relationship and serious personal injury) significantly increase the risk of suicidal thinking in the absence of mental disorders, but when these events take place in the context of such disorders (particularly depression) the risk is amplified. This suggests that suicide prevention strategies, whether they are delivered in clinical or population settings, should not only focus on mental health problems but should also address what is happening in men’s lives.
Senaratna et al.’s [11] article shifts the focus to sleep apnoea. They demonstrate that the prevalence of this condition increases as men age. They also show that it is associated with indicators of poorer self-rated physical and mental health and wellbeing, and it clusters with a number of other chronic conditions. It is also associated with unemployment. Senaratna et al. [11] suggest that preventive efforts might capitalise on the fact that sleep apnoea occurs co-morbidly with a number of other conditions, and that interventions designed to modify lifestyle-related factors (e.g., smoking, alcohol consumption, low levels of physical activity and overweight) might not only reduce sleep apnoea in men but other chronic conditions as well.
Koelemeyer et al. [12] consider one such chronic condition, namely diabetes. They show that diabetes is relatively common in adult males, and that those who have been diagnosed with diabetes are more likely to be socio-economically disadvantaged than their peers who have not. The former group also fare worse when it comes to other physical and mental health conditions, and are more likely to rate their own health as poor. Koelmeyer et al. [12] suggest that their findings may have implications for how to improve the targeting of diabetes screening in men.
Schlichthorst et al. [13] explore an issue that is often hidden, namely sexual difficulties in men. They note that this issue is more common than many people might expect; over 50 % of men experience at least one sexual difficulty that lasts at least 3 months in a given year. Sexual difficulties present in young men as well as older men, and are associated with health factors (e.g., poor self-rated health, having a disability, having a mental health condition) and lifestyle factors (e.g., smoking, consuming alcohol at harmful levels, taking drugs). Schlichthorst et al. [13] reflect on their findings and conclude that discussions about sexual health and sexual functioning should constitute part of a routine health check for men of all ages.
In the final paper, Schlichthorst et al. [14] move away from looking at particular conditions, and consider instead men’s health service use. In particular, they consider the likelihood of men consulting with a general practitioner (GP) in a given year or having an annual health check-up. They report that 81 % of men consult with a GP annually, but only 39 % have an annual health check. An interesting mix of factors is predictive of both types of health service use. On the one hand, low levels of use are associated with indicators of good health (e.g., those who rate their own health as excellent are less likely to visit a GP). On the other hand, low levels of use are also associated with indicators of poorer health (e.g., those who consume alcohol at harmful levels are less likely to have an annual health check). Either way, it would seem to be the case that there are missed opportunities for proactive discussions about health promotion and disease prevention.
