In 2007, many European countries will choose to highlight the specific issues affecting men with long-term health conditions. These include men’s increased risk of developing a condition because of risk-taking lifestyles, delays in diagnosis due to men’s late presentation to health services, and men’s reluctance to take appropriate care of themselves and to access support services once diagnosed.
Men are affected by a wide range of long term conditions:
- About one-third of all men report a longstanding illness.
- Musculoskeletal problems are the most common longstanding health problem for men. 16 per cent of men report experiencing back pain over the whole of the previous 12 months.
- Cardiovascular disease is the second most common problem. Over several million European men are estimated to have had either angina or a heart attack.
- About one third of men have raised blood pressure (more than 140/90mmHg) or are being treated for it. Almost 80% of men with hypertension are not receiving treatment.
- Over 4% of men have diagnosed diabetes but an estimated additional 3% of men aged 35 and over have undiagnosed diabetes.
- Men living with HIV or AIDS are over twice the number of females.
- Hundreds of thousands of men are diagnosed each year with prostate cancer, many of whom live with it for many years with or without treatment.
- Many men live with long-term mental health problems such as anxiety or depression.
There are a wide range of other long-term conditions affecting large numbers of men, including chronic glaucoma, deafness, haemophilia, incontinence and epilepsy.
There are significant inequalities between different groups of men. In general, older men are more likely to be affected – the proportion rises with age and almost two thirds of men aged 65+ report a long-standing illness. Significantly more unskilled men report a longstanding illness than their professional counterparts. Asian men are more likely to develop cardiovascular disease or diabetes than the general population. Gay men are much more likely to be living with HIV or AIDS than heterosexual men.
Inadequacy of care provision
Health services have been slow to recognise the particular issues affecting men in relation to long-term health conditions. The lack of ‘male-friendly’ primary care services can delay diagnosis and inhibit men’s use of ongoing care and support services. Pharmacy services are not yet sufficiently engaged with men to provide advice and information about self-care. Published health information is rarely designed to appeal to the male reader. Just one-third of participants in courses run by the Expert Patients Programme to help people with a long-term condition control their symptoms are male. Policy about long-term conditions has not properly taken account of gender differences and issues specific to men.
This approach will soon have to change – not only because health services that are truly responsive to individual needs must take account of gender as well as age and ethnicity but also because of the increasing European policy focus on ensuring equal opportunities. In the UK, for example the Equality Act will, from April 2007, require health services at all levels to promote equality of opportunity between men and women.
Impact of diverse national contexts
Varying conditions exists between countries that relate to the diversity of often culturally influenced public attitudes to health and to historical differences in healthcare systems. Such variations may need to be taken into account when working to address the particular challenges for the management of long term health conditions in men.