Key findings

Australian males are more likely than females to experience certain health concerns, including bowel and skin cancer, obesity, diabetes and stroke. They are more likely to engage in risk behaviours such as alcohol and other drug use. Males have a heightened risk of mortality, yet are more likely to think that their health is fine and that they can independently manage health concerns. Men are also less likely to engage with health services compared to women. Importantly, poor health experienced by males can also impact their families, friends and the wider community.

To monitor health trends among males in Australia, and to improve understanding of diverse health issues affecting boys and young and adult men of differing ages, locations and backgrounds, the Australian Government commissioned the Ten to Men study. Comprising around 16,000 males aged 10-55 years who resided in urban, regional and rural parts of the country at recruitment (2013/14), it is the first large-scale, nationally representative, longitudinal study to focus exclusively on investigating and improving the health and wellbeing of males in Australia.

This report investigates specific health concerns and related issues affecting boys and young and adult men across the country:

1. poor mental health, including experience of depression, anxiety, loneliness, and suicidal thoughts and behaviours
2. alcohol use
3. overweight and obesity
4. health literacy and engagement with Australia's health care system.

These topics align with a number of priority areas identified in the National Men's Health Strategy 2020-2030, including: mental health, chronic conditions, conditions where men are over-represented, and injuries and risk taking.

Overall, the Ten to Men findings presented throughout this report indicate that, problematically, Australian males who are particularly vulnerable, disadvantaged or marginalised continue to be disproportionately affected by certain health concerns. For example, unemployed males and those in areas of greater disadvantage were significantly more likely to experience mental health issues. Indigenous boys and young men had almost double the odds of being overweight or obese compared to those who were non-Indigenous. Study findings from two waves of data collection also suggest that many males who experience ill-health, or who are engaging in unhealthy behaviours (e.g. moderate- to high-risk alcohol use), do not transition to stable healthier states or practices over at least the short term. It should be noted that, with only two waves of data collection to date, it is possible that study participants did transition to healthier states/practices, but relapsed; this is something to be explored further with additional waves of data collection.

Study data did indicate that there are opportunities for professional intervention to address ill-health among Australian males. For example, most men with diagnosable mental health problems reported they had recently seen a general practitioner (GP). Men who were overweight or obese were also significantly more likely to be engaged with health care providers (e.g. GPs, dietitians and specialist services). Helping both clients and service providers identify and leverage such opportunities, especially in general practice and primary care settings, could be beneficial for the treatment and/or referral of men to dedicated health care services and resources.

Specific findings relating to the above areas are summarised below.

Mental health

• Mental ill-health remains high among Australian men, with up to 25% experiencing a diagnosed mental health disorder in their lifetime, and 15% experiencing a disorder in a 12-month period.
• Anxiety was the most common mental health disorder among Australian boys (those aged 10-14 years), at 9%.
• A significant proportion of men who experienced depression at a given point in time continued to experience it, or relapsed. Of those with self-reported severe depression in 2013/14, 40% still reported experiencing severe depressive symptoms in 2015/16.
• Loneliness was significantly associated with experiences of depression and suicidality among Australian men, above and beyond area-level socio-economic disadvantage and unemployment.
• Young men (Australian males aged 15-17 years) were the most likely to experience suicidal escalation from 2013/14 to 2015/16. Just under 3% of young men escalated to make a first suicide attempt in that time.
• Many Australian males were not accessing professional support from mental health specialists. While over 80% of men with depression, anxiety and/or any suicidality in the past year had seen a GP, only around 40% had seen a mental health professional.

Alcohol use

• Around one-fifth of Australian boys aged 10-14 years have ever consumed 'more than a sip or taste' of alcohol. This group are more likely to have friends who have drunk alcohol in the past year, compared to boys who have never drunk alcohol.
• Younger adult males, especially those aged 18-24 years, typically drink at riskier levels than their older counterparts.
• Young men (15-17 years old) who have drunk alcohol before the recommended age of 18 are more likely to engage in riskier alcohol consumption patterns in early adulthood.
• The majority of adult Australian men have drunk alcohol in the past year (88%), of which only a minority - one third - drink at moderate- to high-risk levels.
• Australian men who drank more frequently were significantly more likely to typically drink greater volumes of alcohol per session.
• Many adult males - around three-quarters - engaging in moderate-to-high-risk alcohol consumption did not transition to and maintain low-risk patterns over time.

Overweight and obesity

• The proportion of Australian males classified as overweight or obese increases with age: in 2013/14, around 20% of boys aged 10-14, 29% of young men aged 15-17, 40% of men aged 18-24, 60% of men aged 25-34, and more than 70% of men aged 35-57 were overweight or obese.
• With age, it appeared difficult for Australian males to maintain a 'normal' or healthy weight. Among those classified as initially being of a healthy weight, 91% of 10-14 year olds were still at a healthy weight two years later, compared to 82% of 18-24 year olds and 77% of 45-57 year olds.
• Very few males who were classified as overweight or obese in 2013/14 had transitioned to a healthy weight in 2015/16. For example, around 90% of men aged 35-57 who were overweight or obese remained so two years later.
• Men who were overweight or obese in both 2013/14 and 2015/16 were more likely to experience chronic health problems including cardiovascular and respiratory conditions, diabetes and arthritis.
• Among adult Australian men, risk factors for being overweight or obese included low physical activity, frequent medication use, poor diet, heavy smoking, heavy drinking and lower overall life satisfaction.

Health literacy and health service use

• Although the vast majority of Australian men - 95% in 2013/14 - considered their health to be important, only around two-thirds actively looked after their health.
• GPs were the most commonly accessed health service among adult Australian males in 2015/16.
• Around 30% of Australian men were not getting regular (i.e. annual) check-ups.
• Less than half of adult Australian males had visited a dentist in the past year. For example, in 2015/16 only around one-third of those aged 18-44 had seen a dentist in that time.
• A minority of Australian men - around 7% in 2015/16 - reported being unable to access health care when they needed it. Common barriers among this group included cost (52%) and long waiting times (35%).
• Men who identified as Indigenous Australian had around 70% higher odds of experiencing barriers to health service use than non-Indigenous men. Further, only 25% of Indigenous men had private health insurance, compared to over half (59%) of non-Indigenous men.