6 steps to improve men’s health literacy
The Australian Government is currently developing a National Men's Health Strategy that aims to make it easier for all Australians to get the information and support they need to stay healthy.
During the consultation process, AMHF surveyed the men’s health community and developed a submission to the Government calling for the Strategy to include a specific focus on “men’s health literacy”.
In this article we outline 6 key recommendations we made to the Government but first, let’s look at what we mean by “men’s health literacy”.
What is men’s health literacy?
There is more than one definition of health literacy, however the model we find most useful for the overall improvement of men’s health considers three levels of health literacy:
1. Functional Health Literacy: This is primarily focused on improving men's knowledge of health risks and health services with the aim of educating individual men to be healthier consumers who actively engage with the health system (e.g. taking part in health screening programs) and comply with prescribed actions (e.g. taking medication or modifying behaviours such as smoking and physical activity).
Example: A man in his 50s receives information about the risk factors for heart disease. He books a Medicare-funded heart health check with his GP who advises him to take action to reduce his blood pressure. He follows his GP's advice and his risk of heart disease is reduced.
2. Interactive Health Literacy: This builds on functional health literacy and includes improved motivation and self-confidence to act independently on health information. This level of health literacy requires supportive and collaborative environments, including the health system and support groups. Men who develop interactive health literacy have the capacity to engage in health conversations within social groups and community settings and can gain support and knowledge from their peers and influence social norms.
Example: A man in his 30s joins a weekly men's-only "walk and talk" group, where men often share experiences of dealing with mental health challenges. At an individual level, the man's physical activity levels and social wellbeing increase through regular group attendance. Collectively, the group's capacity to cope with mental health challenges through self-help, peer support and proactive engagement with health services also increases over time.
3. Critical Health Literacy: This builds on functional and interactive healthy literacy and requires improved knowledge of the social factors that shape men's health (sometimes referred to as the social determinants of health). When men advocate effectively for their health it leads to changes in policy and practice and funding that ultimately lead to the improvement of men's health at a community level.
Example: men's groups and men's health advocates in Tasmania work together to persuade Government to consult with on the development of the State's Suicide Prevention Strategy, leading to more focus on initiatives that are designed to help prevent male suicide.
Source: Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, [online] 15(3), pp.259–267.
Overall, improving men’s health literacy requires a balanced focus on improving the health literacy of individual men, reforming the health system to make it more “literate” about men’s needs and preferences, and empowering different groups and communities to take collective action to improve men and boys’ health.
Here we outline 6 key steps to help achieve these goals:
1. Name men and boys as a priority population
The development of the National Health Literacy Strategy is one of eight immediate priorities under the National Preventive Health Strategy (NPHS)
During the consultation process for the NPHS, the Australian Men's Health Forum made the case for men to be identified as a priority population. We welcomed the fact that the NPHS states on Page 1 that it “presents a powerful opportunity for Australia [to reduce] health inequity” and we highlighted the following facts:
- Men account for 2 in 3 potentially avoidable deaths
- There are around 27,000 potentially avoidable deaths a year in Australia. On a typical day, 50 men and 25 women die from preventable causes.
- Addressing this gendered health inequity would save the lives of more than 7,000 men a year
Unfortunately, our calls to target men as a priority population in the Strategy were overlooked. As a result, the final version of the NPHS includes a focus on seven different priority populations, excluding men and boys.
The knock-on effect of this decision is now seen in the draft National Health Literacy Strategy, which takes its lead from the NPHS and so does not consider the specific health needs of men and boys to be a priority.
We are now recommending that this oversight is corrected and that the specific needs of men and boys as a priority population are incorporated into the National Health Literacy Strategy. Overall, our survey of the men’s health community found that:
- 67% agree making men a priority population in the National Health Literacy Strategy will improve male health (with 58% strongly agreeing)
- 94% say that taking account of the different cultural needs of men and women will improve men’s health (with 44% strongly agreeing)
2. Take action to improve boys’ literacy
Basic literacy skills are the foundation upon which health literacy is built. As such, boys’ literacy is a fundamental building block of men’s health literacy.
In 2022, NAPLAN reported that boys' literacy level hit record lows in 2022. Nearly one in seven Year 9 boys (13.5%) do not reach the national minimum standard for reading. This rate is nearly twice as high as the figure for Year 9 girls (7.1%).
While improving boys’ education is not within the scope of the National Health Literacy Strategy, the consultation document does highlight the role of “Advocacy Groups” in providing “strong and continued leadership and commitment” to ensure that the “overall vision and aims of the Strategy” are delivered.
With this in mind, one of the essential steps that we need to take to improve men’s functional health literacy is to advocate for Government action to improve boys’ literacy.
Financial Review Article: It’s the gender literacy gap that warrants the greatest attention
3. Support the health system to take action
The health system can play a vital role in improving men’s functional and interactive health literacy.
With this in mind, the key principles of the National Men's Health Strategy need to be integrated into the National Health Literacy Strategy, i.e., that the health system should provide male-centred information and apply a gendered lens to health by consciously considering the needs and preferences of men in the design, delivery, promotion and continuous improvement of health literacy initiatives.
Put simply, we need to take action to make the health system more male friendly.
We asked the men’s health community whether they support this principle of providing “male-centred information, programs and services and apply a gendered lens to health by consciously considering the needs and preferences of men in the design, delivery, promotion and continuous improvement of programs and services”.
81% strongly agreed that taking this approach will improve men’s health. Furthermore, 86% strongly agreed that the National Health Literacy Strategy should take account of the needs and preferences of men and boys.
To achieve this, we can’t just focus on improving men’s knowledge of their own health, we need a more literate workforce that is educated on how to engage men effectively.
Read: AMHF’s 10 step guide to developing male-friendly services
4. Fund projects focused on diverse groups of men
As well as targeting men and boys as a priority population in general, initiatives also need to focus on specific male groups at different ages, stages of life and in various settings.
In addition, men and boys within other priority population groups will also benefit from a gender lens, e.g. men and boys in rural and remote communities, Aboriginal and Torres Strait Island males, Culturally and Linguistically Diverse men and boys.
The development of a National Men's Health Literacy strategy presents a good opportunity to fund organisations with a long-term commitment to working with men and boys to develop sustainable men's health literacy initiatives.
Consideration should also be given to funding men's health literacy initiatives that support some of the goals of the National Preventive Health Strategy. For example:
- Reducing the rate of male suicide in support of the Towards Zero Suicide target
- Increasing bowel cancer screening participation rates in men from 42% to 53% by 2025 *
- Increasing HPV immunisation rate in boys from 76% to at least 85% by 2030
- Reducing harmful alcohol consumption in males 14 and over by 10% by 2030
5. Make the strategy gender specific
The new National Health Literacy Strategy will place a strong focus on tackling health inequity.
Unfortunately, the health inequality that men clearly face when compared to women, is not generally recognised by the Government or the health system as health equity issue and references to “gender equity” tend to refer exclusively to the health and social issues that impact women and girls.
This may help explain why the men’s health community is somewhat divided on the issue of equity and men’s health.
While 61% strongly agree that applying “an equity lens” could help improve men’s health, when asked if they think a focus on “gender equity” will help improve men’s health, only one third (33%) strongly agree.
At the same time 17% strongly disagree that a focus on “gender equity” could improve men’s health, a larger proportion than the 8% who strongly disagree that “an equity lens” is good for men’s health.
As with all priority populations currently identified in the National Health Literacy Strategy, it is important to recognise that men and boys “have specific priorities and face special challenges and purpose-built solutions will be necessary". Men and boys "also bring assets and strengths that can be enablers of health literacy."
The Consultation Paper for the National Health Literacy Strategy notes that “the challenges faced by priority populations in improving health literacy and accessing health information” need to be addressed and states that “partnerships and co-design processes are of particular importance to addressing the needs of priority populations”.
If these principles are not applied to men and boys as a priority population – in addition to the priority populations already identified - then the Strategy’s vision that "all Australians are enabled to make informed decisions about their health" will not be realised.
Our survey also found that 92% of respondents are concerned that the “gender blind” approach of the National Health Literacy Strategy, which ignores the differences between men and women, will not be effective at improving men's health.
In stark contrast, 94% of those surveyed agree that “taking account of the different cultural needs of men and women will help improve men's health”.
With this in mind, we have recommended that “Gender Specific” be added as a key “Principle for Action” of the National Health Literacy Strategy
If applied appropriately, “Gender Specific” is an inclusive “Principle for Action” which can be applied to address the different needs of men and boys, as well as being applied to women and girls, and gender diverse people in general. It can also be applied within different populations, such as the 9 priority populations named in the National Men’s Health Strategy.
6. Fund advocacy for men health
Critical Health Literacy is characterised by the ability to advocate collectively for actions that will improve the health of your community. As such, men’s health advocacy is a fundamental aspect of men’s health literacy.
One of the major barriers to men’s health is the lack of administrative structures at State, Federal and Territory level to provide advocacy and advice on men’s health and social issues.
In contrast, there are offices for women and women’s strategies at every level of Government with Six National Women’s Alliances funded to collaborate with Government on the development of initiatives to tackle gender equality issues that impact women and girls.
Advocacy groups are noted in the Consultation Paper on the National Health Literacy Strategy as one of the key groups that are expected to provide “strong and continued leadership and commitment” to ensure that the “overall vision and aims of the Strategy” are delivered.
To achieve this, it is essential to building the capacity of Advocacy Groups to take collective action for priority populations, such as men and boys.
Men’s health literacy isn’t just about giving men information to help them be better health consumers who follow advice (functional health literacy); it’s also about creating healthy and supportive environments that develop men’s ability to act independently on health information (interactive health literacy) and building men’s collective capacity to advocate for better health for men and boys.
With this in mind, the need for men's health advocacy groups to be funded to operate at local, state, territory and national levels needs to be called out in the National Health Literacy Strategy.
Further reading:
Time to put men's health literacy on the map (AMHF Oct 2022)
Learning about men's health literacy (AMHF May 2021)
Men's Health Literacy Check-Up: 10 to Men releases final insights report (Nov 2020)