Men’s Health: The Last Frontier?

Tuesday, April 23rd, 2019 |

British men have died at a younger age than British women since at least the time of Queen Victoria’s accession and they will continue to do so for the foreseeable future. This is not some strange peculiarity of these islands: the pattern is repeated throughout every region of the world. There is not a single country where men outlive women. In both the UK and globally, there is currently a four-year difference in life expectancy between the sexes.

It is a paradox that while we live in a society in which men mostly hold the key positions of power, health policymakers and service providers have not been directed to address this inequality. Men’s health is notable by its absence in most global and national health policies and funding programmes. An analysis of the World Bank’s gender and global health programme showed that it paid scant attention to men’s health issues.

Only three countries – Australia, Brazil and Ireland – have introduced national men’s health policies. (Iran is thought to be preparing a policy but news from the health ministry in Tehran is sketchy.) In the UK, despite equality legislation requiring action to address sex and gender inequalities, research by the Men’s Health Forum and the Centre for Public Scrutiny found that men’s issues were not properly addressed in local strategic health plans.

But the stars may now be aligning more favourably for a new and more systematic approach to men’s health. One game-changer is the UN’s Sustainable Development Goals (SDGs) for health. These focus on reducing premature mortality from non-communicable diseases (NCDs) such as cancer, diabetes and cardiovascular disease, all of which affect men disproportionately.

World Health Organisation (WHO) data published last week shows that the probability of a man aged 30 dying from a NCD before 70 is almost 50% higher than for a woman aged 30. Men are also twice as likely to die as a result of a traffic injury, another health problem covered by the SDGs. WHO is now realising that the SDG targets simply cannot be met unless greater account is taken of men.

The WHO’s European region last year approved a men’s health strategy – an important step forward even if the recommendations are not binding on the 53 member states. Carissa F. Etienne, Director of the WHO region for the Americas and Caribbean (PAHO) has said that ‘we at PAHO are convinced that efforts to improve public health must include attention to both men’s and women’s health.’ PAHO will soon be publishing a report on masculinity and health.

Crucially, evidence about how to improve men’s health is now starting to pile up. Policymakers and practitioners no longer have to make an educated guess about what might work; they can instead draw on a wide range of well-evaluated case-studies. The response to an outbreak of yellow fever in Angola in 2016 provides a good example. 70% of confirmed cases were in men but low numbers were being vaccinated. This was because the vaccination campaign was not well adapted to men’s needs: many did not know where to get vaccinated, others were unable to access clinics during working hours, the vaccine itself was believed to be dangerous and some men were deterred by long waits when they did attend clinics.

Vaccination uptake only increased once male-targeted marketing was introduced, including commercials featuring famous football players, and vaccination was made available after working hours and at weekends. There was also door-to-door vaccination in areas with particularly low coverage.

Global Action in Men’s Health, an international network of men’s health organisations, researchers and advocates, has set out some key ways forward in its new report on men and self-care. These include the development of health policies (including national men’s health policies) that recognise the needs of men, measures to improve men’s health literacy, making health services more accessible to men, and better training in men’s health for health professionals.

It is also essential for services to take account of male gender norms, in other words the ways men have been brought up to think and behave. This is the secret of the success of the Scottish men’s project, Football Fans in Training, which takes advantage of many men’s interest in football to engage men in a healthy lifestyle and weight loss programme delivered at top-flight football clubs.

Programmes and policies to improve men’s health must complement those aimed at women. There is no binary choice here. Investment is needed in the health of both sexes to ensure better health for all.

This blog was first published as ‘The Forgotten Sex: Why is men’s health ignored by policy makers‘ by The Telegraph on 15 April 2019.

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