dw men's health handouts

16/09/2012

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Understandingmale health

UnderstandingMale Health

What do we know about male health?

Why is men’s health poorer than it need be?

Two examples (obesity and mental health)

What works?

What needs to be done at the policy level?


What do we know aboutmale health?


What do we know about the health of men?

• Male life expectancy is lower than female life expectancy

• Men are more likely at all ages to develop most of the more serious forms of ill health

• For most serious conditions, onset in men tends to occur earlier in the lifespan


Life expectancy at birth U.K. 2012

(Office for national statistics)

Male 78.2 years

Female 82.3 years

Is the gender gap in life expectancy inevitable?

EC data in White A., The State of Men’s Health in Europe. Luxemborg: European Commission; 2011.

Generated by Foxit PDF Creator © Foxit Softwarehttp://www.foxitsoftware.com For evaluation only.

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Rate ratio male/female deaths. England & Wales, 2008. ONS data in White A., The State of Men’s Health in Europe.Luxemborg: European Commission; 2011.


Life expectancy at birth U.K. 2009

(Office for National Statistics)

Male Female

U.K 77.9 years 82.3 years

Kensington & Chelsea 84.4 years 89.0 years

Glasgow City 71.1 years 75.5 years


What do we believe about the health of men?

• Men are less well informed about health than women

• Men tend to seek medical help at a later stage than women after the development of symptoms.

• Men are less likely to follow advice in relation to the prevention of illness and more likely actively to engage in “risky” behaviour


Why is men’s health poorer than it need be?


There are only two possible explanations

1. Men are less good at taking care of their own health

2. Services are less effective in delivering advice, support, treatment and care to men


What do we believe about the health of men?

• Men are less well informed about health than women

• Men tend to seek medical help at a later stage than women after the development of symptoms.

• Men are less likely to follow advice in relation to the prevention of illness and more likely actively to engage in “risky” behaviour


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Percentages of men and women exhibiting 2/3 or 3/3 risk behaviours, by social class (smoking, harmful levels of alcohol consumption, poor diet)

0

20

40

60

80

100

% m

enti

on

ing

Women Men

Recall of potential cancer warning signs by sex

Source: Cancer Research UK. Cancer Awareness Measure 2010

Rate ratio of male to female cancer incidence 2006

Source: National Cancer Intelligence Network: The excess burden of cancer in men, 2009

Men may be more likely to delay seeking help for symptoms:International comparison of melanoma rates

0 5 10 15 20

Norway

Sweden

Denmark

Austria

Finland

The Netherlands

Switzerland

United Kingdom

Germany

Luxembourg

Italy

Ireland

France

Belgium

Spain

Portugal

Greece

Source: Health for All database 2003

05101520

Norway

Sweden

Denmark

The Netherlands

Switzerland

Austria

Ireland

Finland

France

Germany

United Kingdom

Belgium

Luxembourg

Italy

Spain

Portugal

Greece

Incidence Rates Death Rates

Men

Women

Rate per 100,000


Use of helplines by men

Cancerbackup 23% of callers are men

Roy Castle Lung Cancer Foundation 35% of callers are men

Asthma UK 21% of callers are men

BUPA Healthline 35% of callers are men

*

Breast Cancer Care 4% of callers are men

Prostate Cancer UK 26% of callers are women


Example 1: obesity

Most men wear their belts low here, there being so many outstanding bellies, some big enough to have names of their own

and be formally introduced. Those men don't suck them in or hide them in loose shirts; they let them hang free, they pat

them, they stroke them as they stand around and talk.

Garrison Keillor: Lake Woebegon Days


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66% of men are obeseor overweight compared

with 57% of women

• Men know less about diet and nutrition

• Men are less likely to eat a healthy diet

• Men are more likely to drink to excess (27% exceed 21 units weekly)

• Men are less concerned about being overweight

• Men are more likely to fail to notice that they have become overweight

• Men are more likely to deny that they have a weight problem


Obesity increases the risk of:

• Type 2 diabetes

• Heart disease

• Stroke

• Hypertension

• Several cancers

• Back pain

• Joint problems

• Sleep apnoea

• Dementia

• Death in road traffic accidents

• Poor sperm quality

Almost all of these conditionsare more common in men


69% of women routinely weighed in primary care, compared with 57% of men

70% female medical records have BMI recorded, compared with 58% of men

Far fewer participants in primary care weight loss programmes are male (10% - 30%)

Audit of the medical records of 120,000 patients. Counterweight Project Team, 2004.Hazardous Waist: tackling male weight problems. Radcliffe Publishing, 2007.


I climbed to the crest,And, fog-festooned,The sun lay westLike a crimson wound

Like that wound of mineOf which none knew,For I'd given no signThat it pierced me through.

Example 1: mental heath

Thomas Hardy: The Wound


At any one time, around 20% of women are diagnosed with a mental health problem compared to 14% of men . . . .

Almost three quarters of people who kill themselves are men.

73% of adults who “go missing” from home are men.

90% of rough sleepers are men.

Men are three times more likely than women to be alcohol dependent(6% of men are alcohol dependent compared to 2% of women).

Men are more than twice as likely to use Class A drugs(4.8% compared to 2% of women)

79% of drug-related deaths occur in men.

Men make up 94% of the prison population(72% of male prisoners suffer from two or more mental disorders).

Men commit 87% of violent crime (and are twice as likely to be victims).

Twice as many male inpatients are detained and treated compulsorily.

Men have measurably lower social support from friends and relatives.

Boys are performing less well than girls at all levels of education.

Over 80% of children permanently excluded from school are boys.


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“ . . . . men often have mental health needs that are distinct from those of women and which are particularly associated with the lived experience of being male. Some of these needs are not being met as effectively as they might. ”


What works?

Men seem a dispiriting, expensive and time-consuming

target group

Men are less motivated about their

personal health

Service providers have little enthusiasm for

meeting men’s specific needs

Men are less likely to use health services or

take part in public health programmes

Men are responsive and rewarding arget

group

Men are motivated about their personal

health

Service providers recognise the need and feel positive about the

challenge

Men will use health services effectively and will take part in public

health programmes


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Men will use health services and take part

in public health programmes . . . .

. . . . provided they are effectively designed


What do we know about designing“male-friendly” services?

• Taking services out of clinical settings, especially into workplaces

• More flexible opening hours

• Making services more streamlined and less bureaucratic

• Encouragement from spouse, partner, and other relatives and friends

• Issuing invitations and appointments

• “Male-friendly” communications and “marketing”.


My wife said I’ve arranged for you to see the doctor . . . . I said, “I haven’t got time Elsie” . . . . but to cut a long story short, I went – to please her.

Without my wife I wouldn’t be here. She saved my life. She made me go. And without that visit . . . . . .

Sir Bobby Robson on Desert Island Discs, describing his cancer diagnosis


What needs to be done at the policy level?


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National Chlamydia Screening Programme Annual Report 2010

2003 – 04 2004 – 05 2005 – 06 2006 – 07 2007 – 08 2008 - 09


2010 – 2011

1,733,271 young people screened

36.6% were male(compared with 12.5% in 2004 -05)

Positivity rates = 4.6% male, 5.6% femaleIn 2009 8% of all men and 24% of all women in the target population were screened.


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