1. Margareth Zanchetta, PhD, RN Ryerson University, Faculty of Community Services-Daphne Cockwell School of Nursing

2. 12 5065+950 Regular medical visits initiated by mothers Medical long term goals: Nourish good relationships with HCPs Men’s behaviours: self- medication, alcohol/drugs, suicide (successful!) Medical short term goals: Evaluate the health condition of occasional clients Colon cancer High cholesterol Diabetes Hypertension Eventual consultations: Private health insurance & check-up Increase of medical consultations due to chronic diseases Profile of medical consultations Critical period

3.  Restricted access and less men’s health & social services (Galand, 2001)  Immigrant men present high risk for chronic diseases (Hyman, 2007)  Lack of conceptual models and frameworks to inspire health policy respecting the diversity of men’s population (Doyal, 2000)  Lack of men’s health policy = Use of Health Canada sex & gender based analysis policy as a conceptual framework to explore health variations, health and illness experiences, within social sub-groups to better understand life diversity, and its impact on men’s health  Future should observe issues of domination and marginalization among sub-groups of men (Spitzer, 2005)  British Columbia’s Expanded Chronic Care Model (BC-ECCM) has inspired the conception of provincial plans (prevention & self-management of chronic diseases) that may support the development of men’s health programs.

4. 1. complex social / economic inequities 2. vulnerabilities 3. barriers to access health care 4. cultural differences between immigrant population / host society 5. health disparities endured by Francophone men when living as linguistic minority 6. sexual orientation diversity 7. aboriginal men  Re-conceptualization of masculine gender as a social determinant of health (or as vulnerability) is needed

5.  Margareth Zanchetta, PhD, RN- Daphne Cockwell School of Nursing (DCSON)-Ryerson University  Christine Maheu, PhD, RN- School of Nursing, York University  Sepali Guruge, PhD, RN- DCSON  Jalila Jbilou, PhD- University of Moncton  Roger Pilon, PhD cand, RN- Laurentian University Research Assistants:  Mohamed Mohamed, BScN, RN  Melissa Stevenson, BScN, RN- Anishnawbe Health Toronto  Olesya Kolinsyk, MN, RN- University Health Network- Toronto General Hospital & Centennial College  Terry Sizto, BScN student  Carole Lina SanJose, BScN  Diana Kinslikh, MA, RPT- West Park Healthcare Centre

6. 1. Cancers (prostate, lung, and colorectal) 2. Circulatory diseases (high blood pressure) 3. Respiratory diseases (chronic obstructive pulmonary disease and asthma) 4. Diabetes 5. Mental diseases & major depression episodes 6. Substance abuse & alcohol dependence  Source: Haydon, E. Roerecke, M., Giesbrecht, N., Rehm, J., & Kobus-Matthews, M. (2006). Chronic disease in Ontario and Canada: Determinants, risks factors and prevention priorities- Summary of Full Report. Available: http://www.ocdpa.on.ca/docs/CDP-SummaryReport-Mar06.pdf http://www.ocdpa.on.ca/docs/CDP-SummaryReport-Mar06.pdf

7.  In several qualitative studies, findings reported were not differentiated between men and women.  Less methodological rigor to compose a minimal sample of 3 men participants to allow internal comparison among them

8.  Barriers imposed by social vulnerabilities and health inequities over personal intentions to adopt self-management strategies  The use of humour to speak of diseases was important to manage the impact of threats to their masculinity

9.  Many studies target different cultural and ethnic men, however, there is no concrete comparison of whether one group is more adaptive than another  Little is explored about the influence of social and health services using a men- friendly approach to seek health care, and engagement in primary health care initiatives

10.  Research should aim to make explicit the issues men face within health care  Areas to be explored:  Preventative strategies  Comparison between cultural and ethnic groups  The influence of social and health services using a men-friendly approach to seek health care, and engagement in primary health care initiatives  Creation of a Canadian research group that includes Francophone and Anglophone researchers in the area of men’s health

11. 1. Men usually do not articulate what their communication needs are = Creation of innovative ways to communicate and respond to men’s interest in prompt action 2. It is not masculine to speak about emotions = Eliminate barriers that are formed through masculinity and gender shaped dialogue 3. Religion, culture, ethno-cultural background, SES, and sexual orientation diversity might affect perceived competence, safety and appropriateness of preventative and self-management behaviours= Cautions about gender overgeneralization 4. Create accessible and inclusive environments

12. Health Research: Evaluate population based initiative to address social and biological risk factors Compare effects of medical treatments Appraise the determination of health behaviours according to concepts of masculinities Include in studies the places of social interactions and masculine territories in health promotion campaigns Expand partnerships with community groups to reach out to groups of men who are not exposed to ideas of health promotion and prevention Investigate ways to mobilize men’s sensitivity and its effect in social relations

13.  Findings remain inconclusive regarding the following:  Health prevention strategies men find helpful to practice  Self-management barriers they face in their daily lives  The context men live in and how they manage their conditions  Needs of different men’s groups (e.g. age, culture, religion) are not addressed  Multicultural society  cultural, religious, cohort, gender identity, and socio-economic factors