Christina Fabian of the UEMO, the European Union of General Practitioners discusses disrimination and the EMHF's role in challenging it
The UEMO is the first European doctors´ organisation which has a Standing Committee on Equal Opportunities. We are focusing on different kinds of discrimination of women and men, but also discrimination based on handicap, sexual orientation, race, religion etc. It is also important to be observant of new areas of discrimination which are hidden from us today.
In some European countries there are educational programs to raise the level of awareness in order to avoid risks of discrimination, for example when appointing or electing someone for different kinds of assignments where you know there are possibilities of discrimination of individuals, especially if they are representing a minority of that community.
Since a couple of years the UEMO is cooperating with the European Men´s Health Forum, EMHF. In many countries in Europe there are organisations discussing men´s health problems, since men de facto live on average five years shorter than women. To find out the reasons for this and to find solutions should definitely be a part of the equality work in our society.
The aim of EMHF is to encourage national organisations in Europe to include men´s health problems in politics. The EMHF also wants to try to influence the health care to become more available to men, and to make the health care staff more conscious of men´s health problems. Men have a different attitude towards seeking health care and the EMHF therefore also wants to make men aware of, influence and change men´s own attitude to their health.
In the enlargement of the European Union the differences in health between men and women will become even clearer, as will the differences in health figures generally between East and West, also between the male populations in the different countries.
In most European countries the differences between women´s and men´s expected length of life has increased the last forty years. The supposed lost years for men under seventy is almost twice as many as for women.
As is known, men contract more often cardiovascular diseases, and mental health problems increases with more suicides and increasing abuse.
More and more nations realize that to improve the total state of health in a population you need efforts to improve men´s health problems and their attitude towards seeking health care.
Men seek health care more seldom than women, especially when it comes to seeking general practitioners and primary health care. Maybe primary health care is felt as less available to men? Primary health care is maybe designed for women and children? Only female staff at the reception desk?
Men often leave their health problems to their wife. The GPs often hears the middle aged man excuse himself by saying: “ It is my wife who wants me to see the doctor.”! Often the wife´s suspicions of health problems are verified at the visit at the doctor. Most men work fulltime and do not take the time to seek health care at the general practitioner. The attitude of men is often more risk taking and makes it more difficult for them to seek help, as is low self esteem.
The last couple of decades focus has rightly been on women´s rights and the male dominance in health care. Studies are made on men, symptoms of women´s unhealth is in some illnesses different than men´s, but the treatment the woman receives is based on the male norm. Yet men do not seem to benefit from the male focus in health care. They die five years earlier than women and in the East European countries the differences are even larger.
The EMHF recently published an article on statistics on men´s morbidity and mortality in seventeen European countries. Clearly differences between men´s and women´s unhealth exist as well as between countries. Just as for women cardiovascular diseases are the dominating cause of death among men. Prostata cancer is increasing and of course preventive measures are being discussed.
Life style factors are as always very important and can be influenced by both men and women. More men are fat and smoke more than women, except for Sweden where women smoke more. Men have a higher suicide rate than women and the numbers are increasing. Men are more often killed in accidents and violence is linked to several factors which show unequality in health and economy.
We know that men have different symptoms than women when depressed. Drug abuse, violence and aggressions are often connected to the illness. The so called male behaviour not to show feelings, to be big and strong, etc, is also a risk behaviour.
Everyone in society is dependent on each other, women, men and children. We have to listen to each other, learn from each other and respect each other. Especially when falling ill you are in a state of dependence to those nearest to you and also to the health care. An ill person also effects the ones nearest; partner, parents or children. Everyone gains from influencing the risk factors for women and men that we know of today.
In the leading positions in society you find as known mostly men. There are several reasons for this. I am convinced that fifty percent of the leading positions slowly but surely will be held by women. I believe that this will be helpful for men too, as some of those who hold leading positions today do not suit for those positions, but would feel more comfortable at another level.
In many European countries there are organisations which focus on men´s health. EMHF would like to cooperate with these national organisations to spread inform and take part in meetings. The EMHF has among other things taken part in three world conferences on men´s health.
The purpose of EMHF is to raise awareness among men themselves of the factors which effect the unhealthiness and how they themselves, or with help, can cope with the problems.
Knowledge and facts raises awareness among health care staff about the special risk behaviour of men, and also starts a discussion about how we as health care staff can reach the men.
Christina Fabian is President of the UEMO
and a Specialist in Family Medicine, Heby, Sweden
The European Union of General Practitioners, the UEMO, is directed by the Swedish specialists in Family Medicine Dr Christina Fabian, Dr Carl-Eric Thors and Dr Benny Ståhlberg. Sweden is a member of the UEMO through The Swedish Medical Association and is represented by Dr Sven Axel Andersson. Elisabeth Sundström works at the international secretariat at the Swedish Medical Association and also works as Executive Secretary for the UEMO.
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