EMHF has adopted the following general definition of men's health:
A male health issue is one arising from physiological, psychological, social, cultural or environmental factors that have a specific impact on boys or men and/or where particular interventions are required for boys or men in order to achieve improvements in health and well-being at either the individual or the population level.
Men's health is unnecessarily poor
There is overwhelming evidence to support the contention that men's health is much poorer than it need be. This is a problem not just for men but also for women, for service providers and for society in general.
Many men die prematurely, and in higher numbers for nearly all causes of deaths. Male life expectancy can be much shorter in some countries, but recent examples of the gap slowly closing in some countries tend to indicate that contrary to popular belief, biological factors may only be but one factor influencing male relatively poorer health.
Men can be reluctant users of health services
Once they reach legal age and their parents stop taking them to the doctor, it is commonplace for men to avoid primary care unless they are experiencing significant pain or an illness has become too serious to ignore. Men also make poor use of preventative services. There is - tellingly - very little research evidence in this area, but the reasons for men's under-utilisation of primary care probably include:
Difficulty of access. A man's doctor may be based some distance from his workplace and appointments are often available only during normal working hours.
Cultural norms. Many men believe that they should 'tough out' illness for as long as possible rather than admit to 'weakness'. Similarly, is not unusual for men to be concerned that they would be 'wasting the doctor's time'.
False perceptions. Primary care may be seen as a service primarily for women and children.
Men's use of health services needs to be improved. Relatively few asymptomatic men attend for screening and many men's knowledge of health services is low.
Men's health is under-researched
Although a great deal of health research has used men as its subjects, it has rarely investigated them specifically as men. In other words, most research, whether clinical or non-clinical, looks at the impact of a particular approach or treatment on a sample of people and does not draw conclusions based on an analysis of sex or gender. It is still common for research which covers both men and women to aggregate data so that separate findings for men and women are not available. Some male-specific health concerns -for example, prostate cancer - are widely acknowledged to have lagged behind in terms of scientific research.
There is no 'user-led' movement for better male health
Part of the reason why men's health remains neglected is that men themselves have not argued, campaigned or lobbied for improvements. Few men write to their MPs or MEPs about issues like waiting times for an appointment at the hospital, for example, or difficulties in obtaining treatment - even though these matters may have serious consequences for the individual. In marked contrast to the history of women's health, most men's health advocates have been health professionals, academics or policymakers, not service users or activists. (Gay men are the only exception to this - they have led the response to the HIV epidemic.) As far as most men are concerned, it seems they are as reluctant collectively as they are individually to seek support for their health.
Men do care about their health, they just need to be approached in the right way
Male 'risk-taking' and men's apparent unwillingness to take better care of their own health have led many in the health services to assume that any attempt to improve the situation is doomed to failure. In its most extreme version, this view of men may lead to them being seen in a general way as unreliable, irresponsible and unwilling to be helped.
Gender needs to be recognsied as a key determinant of health
Socio-economic grouping and ethnicity have long been accepted as important factors in determining health status. The resultant inequalities are rightly judged unacceptable and significant policy provision has been made in response. Gender, on the other hand, continues to be viewed as a peripheral factor (or simply not viewed at all). Where gender is seen as relevant, it is often believed to be an issue for women but not for men. This lack of awareness is, in part, due to the mistaken belief that differences in health status between the sexes are mostly the result of biology and are therefore inevitable. It is also linked to the perception, again inaccurate, that the huge changes in women's lives over the past 30 years mean that we now live in a 'post-feminist' era in which the issue of gender is largely irrelevant. In fact, gender is one of the key determinants of health.
There is a growing body of health and social research demonstrating that cultural factors such as religion, ethnic background, social class and societal culture are also very strong predictors of men’s attitude to health. The ‘boys will be boys’ fatalistic approach no longer applies. It emerges that through a concerted approach between all stakeholders, the conditions favourable to the health of men and boys improving can be created. The implications of this approach are huge and far reaching. Beside the fact that men and boys represent approximately half of any country’s population, the welfare of entire social and economic communities also stand to benefit.
NB: The content of this page is adapted from Getting It Sorted, a key policy document of the Men's Health Forum England.
