Despite media interest dating back more than a decade, men's health in England and Wales is, in many ways, getting worse. In the first of a series of editorials looking at men's health in various countries across Europe, Peter Baker
discusses the current issues in England and Wales.
Men’s health in England and Wales remains unnecessarily poor – and in many ways is getting worse. Over the last 30 years, suicide rates in young men have more than doubled, the incidence of prostate cancer has increased by 135%, the number of deaths from chronic liver disease in men aged 25-64 has increased five-fold and the proportion of men who are obese has more than tripled. Men in social class 5 still have a life expectancy at birth that is below average male life expectancy in the early 1970s.
Aspects of male behaviour continue to pose serious health risks, not least high levels of smoking among working-class men, excessive alcohol consumption, a preference for high-fat foods and a marked reluctance to ask for help from a health professional. Moreover, the health system has done little to help men adopt healthier lifestyles or to provide ‘male-friendly’ health promotion or primary care services.
But it would be quite wrong to claim that there are no signs of positive change. There is an increasing awareness amongst politicians, policymakers, practitioners and the public that men’s health is a problem that needs to be tackled. Two recent ministers of public health – Yvette Cooper and Hazel Blears – spoke frequently of their commitment to doing so. (The recently-appointed minister, Melanie Johnson, has not yet made known her views.) The All Party Parliamentary Group on Men’s Health, set up in 1991, has an active programme – recent meetings have looked at sexual health, prostate cancer, obesity, alcohol, and men’s health policy.
The Department of Health’s national suicide prevention strategy contains a significant section on men and it has recently established a Prostate Cancer Advisory Group in response to lobbying from 17 charities and professional organisations. The Health Development Agency, which is part of the National Health Service, is establishing a men’s health programme that aims to gather evidence of what works with men and translate this into guidance for practitioners.
At the local level, there is increasing interest in men’s health work, even though it is not yet a strategic priority for Primary Care Trusts. This is reflected in the Men’s Health Forum’s database of projects – which has increased in size from 120 to 180 organisations in just two years – and the level of activity during the annual National Men’s Health Week in June. In 2003, some 600 events took place across England and Wales during the Week, up from about 300 in 2002.
Evidence is emerging, too, that men are not as indifferent to their health as is often supposed. In the right environment, men are surprisingly willing to talk about their concerns, request information and ask for help. The Impotence Association’s telephone helpline is a good example of this: it receives thousands of calls a year from men about what is one of the most difficult health issues for most men to talk about. The very large number of visits to the UK’s only comprehensive and dedicated consumer-oriented men’s health website, www.malehealth.co.uk, reflects men’s willingness to access health information if it is provided in a way with which they feel comfortable.
The Men’s Health Forum is the leading voluntary organization in its field and works with a wide range of other bodies – charities, commercial organizations and the statutory sector – to promote men’s health in England and Wales. The MHF believes that the priority is to develop health and related public policy that takes into account the needs of boys and men. It would like to see a national men’s health policy but, just as importantly, every area of national and local policy to be men’s health ‘proofed’ – in other words, there should be a process whereby the potential impact of decision-making is evaluated to ensure that the needs of boys and men are not sidelined and, indeed, that they are at the centre of policy-making.
The MHF provides training and information services for health professionals and others interested in working with men. It undertakes research – including a current study of how to increase men’s awareness of chlamydia – and supports health promotion campaigns aimed at men. It leads National Men’s Health Week which, in June 2004, will focus on men and cancer (all cancers, not just those that are male-specific). The MHF also supports the work of the All Party Parliamentary Group on Men’s Health and was a founding member of the Gender and Health Partnership, a unique alliance of men’s and women’s organizations that promotes ‘gender-sensitive’ health policies and practices.
It is clear that there now exists a unique opportunity for the MHF and others to work together to end one of the biggest, but until recently, least recognized health inequalities and significantly improve the quality of life of the nation’s men.
For more information about the Men’s Health Forum, visit its website www.menshealthforum.org.uk.
Peter Baker is director of the Men's Health Forum England and Wales
For more about health in the various European countries see the EMHF's study into The State of Men’s Health in 17 Different European Countries
Men's Health Forum