Men’s health: should we compare it to women’s?

Monday, July 29th, 2013 |

Male life expectancy remains dismal in many parts of England and Wales. In 2009-11, a baby boy born in Blackpool could expect to live for just under 74 years, according to National Statistics’ data published last week. But a boy born in the rather more affluent area of East Dorset can expect to live over nine years more while a girl born in East Dorset can look forward to another 13 years of life. Men’s health is still far worse than it could and should be.

Average male life expectancy across England and Wales has improved in recent years – from 77.5 years at birth in 2005-7 to 78.8 years in 2009-11. The difference between males and females has also shrunk a little, from 4.2 years to 4.0 years over the same four-year period. But the difference in outcomes between different groups of men and between the sexes remains stark.

A desire to tackle men’s health problems should not just be motivated by unfavourable comparisons with women, however. Even if men in the UK enjoyed higher life expectancy than women, or if other key health outcomes or risk factors were better for men than women, this would not mean that men’s health advocates could sit back and start looking for other things to do. Women’s health campaigners have certainly, and quite rightly, not packed up because their health outcomes are in many ways better than men’s.

In the unlikely event (for the foreseeable future at least) that men become healthier than women, there would almost certainly still be health inequalities between different groups of men both within the UK and in comparison with other countries. These differences would suggest, regardless of how well or badly women are doing, that many men are not achieving optimal health.

Understanding sex differences is also central to the development of successful public health interventions. A recently-published journal article looking at attitudinal barriers to bowel cancer screening shows this very clearly. Essentially, men and women were deterred from screening for different reasons. Women, for example, were more likely to be put off by the physically intrusive and embarrassing nature of an endoscopy. Men, on the other hand, had a deeper-seated fatalism about cancer and doubts about the preventive or protective elements of screening. So long as screening participation rates are below the optimum for either sex, and it really does not matter which has the higher or lower rate, these insights should be used to inform future interventions.

Men’s health advocates should wary of over-emphasising the comparisons with women for another important reason. Clearly, there is no group besides women to compare men too – we have not yet encountered an alien civilisation, or a different species here on Earth, that can be of any help in this respect. And equality legislation encourages us to compare the sexes in order to persuade policymakers and practitioners to take action. But there is a danger that, by emphasising women’s better outcomes, their health could become seen as unproblematic or that resources could be transferred from women’s health to men’s.

So long as men’s health is unncessarily poor, action will be needed to put this right, regardless of how well or badly women are doing. And vice versa. But we must still of course make use of an understanding of men’s and women’s different attitudes, beliefs needs behaviours to inform the actions needed to tackle the problems facing both sexes.

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