Men’s health is poor and the recession is likely to make it a great deal worse. Local services must be delivered in a male-friendly way to help address this, says Peter Baker
Keywords Men’s health, Health promotion, Public health
The economic downturn is having a dramatic impact on men’s mental health, according to a report published this month by the mental health charity Mind (2009). One in seven men who are unemployed will develop depression within six months of losing their jobs and there is a real concern that the recent fall in the male suicide rate will be reversed; 10 years ago, the Asian economic crisis led to a huge increase in those countries in affected countries.
There is also evidence that unemployment impacts on men’s physical health, with more deaths from cancer, accidents and violence.
Women’s health will suffer too of course, but men’s health is more sharply affected by social deprivation. This is probably because men tend to lack the social networks that offer some protection against the stress of job insecurity, unemployment and poverty. Work is still central to male identity and many men feel its loss acutely – yet they are frequently reluctant to discuss this or other worries.
Men were by no means in robust health when the economy was booming. Forty per cent die prematurely (before the age of 75) and, in some parts of the country, average male life expectancy lingers in the mid-60s. Men develop heart disease on average 10–15 years before women and are twice as likely to develop and die from the 10 most common cancers affecting both sexes (excepting breast cancer, which is rare in men).
Despite the gender equality duty – which, since 2007, has required health policies and services to be tailored to the needs of men and women – men’s health is not yet being tackled systematically. The Department of Health is now beginning to take more account of men’s health in national policy – although there is still a long way to go – but at the local level progress is decidedly slower and more patchy.
Men are still under-represented in smoking cessation and weight management programmes, form the minority of health trainer clients, and make up a small fraction of users of NHS community contraception clinics. They delay seeking help from GP services so they tend to present with more severe symptoms and are therefore more likely to be hospitalised. This explains why more men die from malignant melanoma even though more women actually develop the disease.
It is not thanks to their genetic make-up that men die younger than women. We now know that if services are delivered in a more ‘male-friendly’ way, men will use them and they will change their behaviours. By taking services to where men are (for example in military bases, workplaces, colleges, prisons), the National Chlamydia Screening Programme succeeded in increasing the proportion of male screens from 17% to 28% within three years.
Knowsley PCT/Metropolitan Borough Council’s Pitstop programme delivered health checks to over 3,000 local men and 85% of men who were followed up reported lifestyle changes. NHS Halton and St Helens’ Go campaign encourages men over 40 in deprived areas to take better care of their health and to make more use of health services. Fifty-seven per cent of men attending health checks have gone on to access diet and exercise interventions, smoking cessation and health trainer services.
If nothing is done to tackle men’s health, the recession will consign many more men – our fathers, grandfathers, brothers, sons, partners, friends and colleagues – to worse health and tragically premature deaths.
Peter Baker is chief executive of theMen’s Health Forum
Mind (2009) Men and Mental Health: Get it off Your Chest