Why our men are dying too soon

I remember Uncle T. He was the one everyone called when the generator refused to start, when a stuck window needed to be forced open, or when family disputes got too heated and needed a cool head. He was solid and dependable. The kind of man who seemed built from granite and stubbornness.

So, when he started feeling tired, he did what he always did: he ignored it. He felt it was just malaria. He took some herbs, swallowed a few tablets from the roadside chemist, and got on with the business of being the family rock. By the time a cousin tricked him into a real hospital, his kidneys had already failed. He was dead within a month. He was just 52.

The truth is that Uncle T’s story is not unique. It plays out in homes across this country daily. The numbers are stark. For example, the National Bureau of Statistics estimates life expectancy in Nigeria is about 55 years for males and about 57 years for females. What this means is that a baby girl born today can expect to live two years longer than a baby boy. Some local health surveys suggest the gender gap may be even wider. These are not just statistics; these are fathers, brothers, husbands, and sons dying too early. Yet, we have failed to ask a crucial question: why are our men dying sooner?

It is a question, not with one answer, but with several. It is not about biology alone; it is about a tangled web of our own making. It is a knot woven from cultural expectations, economic pressure, a healthcare system that is not built for them, and their own stubborn, often fatal, silence.

I spoke with a few doctor friends, and one word kept coming up: “masculinity”. Not in a textbook, academic way, but as a real, tangible barrier that sits in the waiting room of every clinic. “A man’s worst fear is to be seen as a ‘baby’ or a weakling,” one physician told me. “They will endure pain that would have most of us screaming just to avoid the perceived shame of walking into a pharmacy or hospital and asking for help.”

Now, this is not merely anecdotal. Recent research from Nnamdi Azikiwe University confirms what many of us have suspected. The study, which looked at why men conceal their health problems, found that the primary driver is the need to project a tough exterior. The fear of being ridiculed or being considered weak often outweighs the fear of the illness itself.

So, what happens? Men become masters of self-medication. A persistent headache becomes high blood pressure ignored. A nagging chest pain is dismissed as indigestion. Shortness of breath is put down to being “just out of shape”. By the time the man finally agrees to see a doctor—often pushed by a worried wife or a pleading family member—the situation is dire. The disease is no longer in its early, manageable stage. It is now advanced; it is expensive to treat; and, sometimes, it is too late.

This avoidance has deadly consequences. Cardiologists across the country are raising the alarm. According to hospital admission records, heart failure in Nigerian men often occurs between ages 55 and 59, much younger than the typical age of onset—often above 70—in Europe and America. These are men in their prime, at the peak of their careers and family responsibilities.

The truth is that this is often about the risk factors we often ignore. The hypertension that goes undetected because the man has not checked his blood pressure in five years. The diabetes that silently damages blood vessels because he eats only “swallow” and never vegetables. The high cholesterol from a diet heavy in red meat and saturated fat, washed down with alcohol.

And when they do finally present at the hospital, the prognosis is often grim. Studies show that in Nigeria, more than 10 per cent of heart failure patients die during that very admission. This is not a death sentence from a sudden bolt of lightning; it is a slow-building tragedy that we have normalised.

But the silence is not merely physical. It is mental, too. We are only just beginning to scratch the surface of the male mental health crisis in Nigeria. The newly launched “Men Stay Alive Project” by the Nigerian Medical Association is a stark admission of this. Their data shows that men are three to four times more likely to die by suicide than women. Think about that.

We expect men to be providers and pillars of strength. But when the economy crushes a small business, when a marriage fails, or when the pressure to provide becomes unbearable, where do they turn? Our culture tells them to bottle it up. To “man up”. They suffer in silence, and sometimes, that silence becomes permanent.

If a man finally summons the courage to walk into a primary health centre, what does he find? He finds a system predominantly designed for maternal and child health. The personnel are used to seeing women and children. The hours are often nine until two or even four, a schedule that makes no sense for a man who works a full day and fears losing his wages.

This is backed by a study, which found that men often avoid public health facilities because they feel the environment is not for them. They complain about the cost, the attitude of the healthcare workers, and the simple fact that there are no male-focused services. Many expressed a preference for informal providers, such as patent medicine sellers and traditional healers, who ask fewer questions and do not judge them.

So, you have a perfect storm: a man who will not admit he is sick, suffering from diseases that are hitting him earlier and harder than they should, and when he finally seeks care, he steps into a system that does not quite know what to do with him.

The final blow is then delivered by financial toll. As Uncle T’s family discovered, treating advanced disease is cripplingly expensive. A professor of medicine made a radical suggestion: “Treatment for organ failure should be made free.” His reasoning was simple. By the time a man is diagnosed, he has often lost his ability to earn. The family sells land, takes loans, and sinks into poverty while the patient’s chances of survival remain low. It is a financial and emotional sinkhole that devastates families for generations.

So, what is the way forward? Much as it feels heavy, it is not without hope. We need a cultural shift as much as a policy shift.

First, we have to redefine strength. We need campaigns that celebrate the man who goes for a check-up as strong, not weak. We need to teach our boys that health is not a sign of vulnerability but the ultimate form of responsibility. Initiatives such as the “Men Stay Alive” podcast and the “Boys2Men” programme are small but vital steps in normalising these conversations.

Second, our healthcare system must adapt. We need medical facilities that offer “men’s health hours”, particularly in the evenings and, possibly, weekends. We need to train healthcare workers to be more welcoming and less judgemental. We must integrate screening for high blood pressure and diabetes into every point of care, even workplaces and clubs.

And finally, we, as a community, must break the silence. If you are a wife, do not merely complain about your husband’s stubbornness. Book an appointment for him. Drive him there. Sit with him. If you are a friend, check on your brother. Ask him, “How are you really doing?” and wait patiently for a heartfelt answer.

It is essential to always remember that a man who takes care of his health is not weak. It is acceptable to put the burden down and seek necessary help from the right quarters. It is acceptable to walk into a clinic and be honest with the doctor or health professional. That is not a sign of weakness. It is, in reality, the first step towards strength and staying alive.

Sylvester Ojenagbon, a health communication expert and certified management trainer, lives in Lagos