Alaska News

Violence and public health in the North: What about the men?

Much ink has been spilled in Canada the past month on the merits of a federal inquiry on missing and murdered aboriginal women.

Without detracting from the need to better understand why Aboriginal women are three times as likely to be murdered as non-aboriginal women, it is worth wondering why the even more disproportionate violence exacted upon Aboriginal men has been absent from the national conversation.

A recent sensationalist U.K. Daily Mail article similarly focused on "Why the US and Canadian Arctic is one of the world's most dangerous places to be a woman." Not for nothing, but statistically, men in the North have it worse. Men die sooner, with a life expectancy in the three territories of 72.5 years, compared to 78.2 for northern women and 78.8 for Canadian men as a whole. They are four times more likely to commit suicide than women. And they are more likely to be injured or killed through workplace incidents, diseases, unintentional injuries and intentional violence. In spite of the social, political and economic advantages men seemingly enjoy, their health outcomes are surprisingly poor.

‘Where are the men?’

A 2011 report, entitled "Where are the Men," from the Chief Medical Officer of Northern British Columbia Health, does an excellent job of describing the myriad reasons for this and I can recommend it unconditionally to anyone interested in public health or northern development. Among the factors it identifies are the usual risky behaviors, such as alcohol consumption and involvement in vehicle accidents. But men's reluctance to use the health care system also contributes. Men are less likely to have annual physicals and regular check-ups, or get treated for minor infections, which means that they more likely to die from illnesses that are preventable or treatable. It is well worth noting that this is broadly true for men around the globe. But like many things, it is exacerbated in the North.

One of the more interesting findings of the report was that: "Preventive public health services are offered almost exclusively by female staff and are focused primarily on mothers and their children. Men often report feeling uncomfortable in health units and clinic settings and avoid contact with these settings as much as they can."

I think that, with the benefit of hindsight, we can all recognize this to be true. Pretty much every health clinic I have ever visited has children's toys in the lobby, posters encouraging breastfeeding, and a primarily female staff. This has been purposeful, since we know the period between conception and age five is particularly significant in achieving good health outcomes. But the unintended consequence has been the de facto exclusion of an entire category of the population.

Cycles of violence

The Northern B.C. men's health website takes a different approach, looking more like a beer ad than a public health campaign. This is not to suggest that northern men should drink more beer, but that public health agencies should know their audience. This triumph of public health communications reveals how poorly, if at all, its predecessors and counterparts have thought about connecting with men.

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A men's wellness group on a First Nation in Saskatchewan figured out much the same thing. Public events advertising talks on domestic abuse or curbing drinking attracted very few participants. But a guy's social night, with 10 to 15 minutes of health promotion slotted in surreptitiously, brought in dozens of men on an ongoing basis.

All of this is by way of saying if we are to address the shocking rates of violence and sexual abuse of northern and aboriginal women, we must at the same time address it for men, and paying attention to their physical and mental health is an important place to start. One elder I spoke to who used to counsel at a prison asserted that every one of his clients had suffered sexually abuse. But this is rarely addressed and almost never discussed. In general, research on and knowledge about northern and aboriginal men's perspectives on health, sexual orientation, their roles as fathers and caregivers, and incidence of physical and sexual abuse is lacking.

The high rates of murdered and missing aboriginal women is an issue that deserves our attention. But knowing what we know about cycles of violence, men need to be considered in the equation as something more than just the abusers.

This story is posted on Alaska Dispatch News as part of Eye on the Arctic, a collaborative partnership between public and private circumpolar media organizations.

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