The “DUDES Club” started in August 2010 when 70 men in the Downtown Eastside of Vancouver attended a community forum asking for more services specifically for men. DUDES is an acronym that stands for Downtown Urban knights Defending Equality and Solidarity. It was a name created by the members that attend.
Dr Paul Gross is a family physician, founding member of DUDES club and the current health director for the program. The podcast captures their story.
- According to the World Health Organization, in most parts of the world, health outcomes among boys and men continue to be substantially worse than among girls and women (Baker et al., 2013). In 2010, women were outliving men by an average of almost six years (Baker et al., 2013). Some of the reasons for this difference are due to biological differences: testicular cancer and prostate cancer. However many reasons have a social basis: greater levels of occupational exposure to physical and chemical hazards, behaviours associated with risk-taking, health behaviour paradigms related to masculinity and the fact that men are less likely to visit a doctor when they are ill (Baker et al., 2013).
- Gender is considered a social determinant of health. While female gender carries many burdens of disease (such as in the perinatal period), men seem to experience more extreme forms of social exclusion that manifests in homelessness and severe substance abuse (Mikkonen & Raphael, 2010). For example, the suicide rate of men is four times higher than that of women (Mikkonen & Raphael, 2010). Men are also more likely to be perpetrators and victims of physical assault (Mikkonen & Raphael, 2010). About 95% of Canada’s prison population are men (Mikkonen & Raphael, 2010)
- Indigenous men are at greater risk of depression and suicide and suffer a disproportionate burden of other mental health issues compared with the general population (Mood Disorders Society of Canada, 2009)
- Further, men are generally less likely than women are to seek help with health issues and they face many barriers when accessing appropriate mental health services (Galdas, Cheater & Marshall, 2005)
- Möller-Leimkühler suggest that the way men express and cope with their depression or distress, and whether they choose to seek help for their mood is different to that of women (Möller-Leimkühler, 2003). Rather than expressing or identifying with feelings such as stress, sadness and emptiness, men typically demonstrate numbing (e.g. alcohol and drugs), risky (e.g. gambling, violence), defensive (e.g., anger, aggression) or otherwise avoidant (e.g., social withdrawal) types of coping behaviours (Möller-Leimkühler, 2003)
- In the 12 months prior to a suicide, 35% of men compared to 58% of women sought care from a mental health practitioner (Luomo, 2002)
- The 2016 Homeless Count shows that Vancouver’s homeless population over-represents men (76%), the middle-aged (between 35 and 54 years old) (48%), and people of Aboriginal identity (38%) (Thomas, 2016).
- According to a survey performed at the DUDES club, the members are highly marginalized by social and structural inequity (eg, poverty, homelessness). (Gross et al, 2016)
- Indigenous participants found increased feelings of trust, support, and connection to culture and heritage through participating in the program (Gross et al, 2016)
- Frequent attendance led to significant effects on quality of life, mental health benefits, and health confidence, regardless of ethnocultural background (Gross et al, 2016)
DUDES club website http://www.dudesclub.ca/
DUDES Club documentary http://www.dudesclub.ca/documentary-1/
Movember foundation projects https://ca.movember.com/
Heads Up Guys http://headsupguys.org/
Whenever discussing men’s health, it is easy for the conversation to sound reductionist and binary. It is important to remember that in the same way gender is on spectrum, men’s health too is on a spectrum. Men’s health is not different from women’s health but rather a continuation of community and primary care.
Baker, P., Dworkin, S., Tong., S., Banks, I., Shand, T. & Yamey, G. (2013). The men’s health gap: men must be included in the global health equity agenda. Retreived from http://www.who.int/bulletin/volumes/92/8/13-132795/en/
Mood Disorders Society of Canada. (2009). Quick facts: mental illness and addiction in Canada. Guelph, ON: Mood Disorders Society of Canada. Retrieved from: www. mooddisorderscanada.ca/documents/Media%20Room/Quick%20Facts%203rd%20Edition%20Referenced%20Plain%20Text.pdf
Galdas, P. M., Cheater, F., & Marshall, P. (2005). Men and health help‐seeking behaviour: literature review. Journal of advanced nursing, 49(6), 616-623.
Gross, P. A., Efimoff, I., Patrick, L., Josewski, V., Hau, K., Lambert, S., & Smye, V. (2016). The DUDES Club A brotherhood for men’s health. Canadian Family Physician, 62(6), e311-e318.
Luoma, J. B., Martin, C. E., & Pearson, J. L. (2002). Contact with mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry, 159(6), 909-916.
|Mikkonen, J., & Raphael, D. (2010). Social determinants of health: The Canadian facts. York University, School of Health Policy and Management.
Möller-Leimkühler, A. M. (2003). The gender gap in suicide and premature death or: why are men so vulnerable?. European archives of psychiatry and clinical neuroscience, 253(1), 1-8.
Statistics Canada. Access to a regular medical doctor, 2013. Ottawa, ON: Statistics Canada; 2014. Available from: www.statcan.gc.ca/pub/82-625-x/2014001/ article/14013-eng.htm. Accessed 2016 May 2.
Thomas, M. (2016). Vancouver Homeless Count 2016. Retrieved from http://vancouver.ca/files/cov/homeless-count-2016-report.pdf