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Men and health: a gender for change?

Robert Sage
BSc(Hons) PGDip
Health Promotion Specialist
Member of Men's Health Forum

Women are traditionally seen as the first port of call within the family unit in terms of providing healthcare. Society has many built-in opportunities for women to make regular contact with the healthcare system, and this breaks down barriers for women when it comes to the need to contact a GP or nurse in relation to healthcare concerns. In contrast, there are fewer regular opportunities for men to make contact, and as a result of this and other factors, men generally only make contact when ill, and often only when very ill.
This is especially true for men in their younger and middle years, as can be seen in Figure 1, where there are marked differences between the proportion of men and women who: "reported talking to a GP about their own health in the last two weeks". Between the ages of 16 and 45 there was a wide gender difference, but no difference between the ages of 55 and 75. However, Figure 2, which looks at flu jab uptake, shows that when men are invited in for a specific preventive intervention, they attend in equal proportions to women regardless of age.

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Ladies' hairdressers?
The view that men tend to present late with symptoms of ill-health, and have an apparent lack of concern for taking preventive health measures, has fuelled the stereotypical view of a macho man who believes "it will never happen to me" and is "hard to reach". And although the male attitude to health may be one barrier to their collective lack of attendance to primary care venues, there are others. A recent survey by the Men's Health Forum in response to the Department of Health's Your Health, Your Care, Your Say white paper revealed the following views from the men who responded:(2)

  • Primary care is female-oriented.
  • The process of arranging a consultation is very difficult.
  • Appointment timings conflict with working hours.

One man's quote sums up how many men feel when entering a GP practice: "The system and environment feel like they have been set up for women, so it feels like you are sitting in a ladies' hairdressers ..."

Men want to feel justified
The types of changes that men are calling for relate to improvements in the process of making an appointment, changing attitudes to ensure that men feel justified and at ease when attending health settings, and a more innovative, patient-centred approach to the timing and location of health services.
Their views on what should be done to address these issues are now likely to be backed up by the new Equality Bill, which, from April 2007, will place a duty on all public sector organisations to consider gender when planning and commissioning services. Innovative models of service delivery that men would like to see have been, and are being, tried and tested across the country, where many examples of good practice in primary care exist.(3-6) Such examples include:

  • Practice nurses and health professionals taking their blood pressure monitors out to pubs and working men's clubs in Walsall and Bradford.
  • Men's health MOTs at NHS walk-in centres in Colchester and Westminster, and a large-scale pilot of "well-man clinics" across Scotland (see Men's Health Forum Scotland website for more details).

The Equality Bill, drawn up to ensure equal pay and conditions for female workers, is set to give male health advocates the backing to push for the innovation shown in these isolated examples to become part of everyday practice.

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References

  1. Welsh Health Survey 2003/4. Available from: http://www.wales.gov.uk/keypubstatisticsforwales/content/publication/hea...
  2. Wilkins D. Response to the 'Your Health, Your Care, Your Say' consultation, 2005. London: Men's Health Forum; 2005. Available from: http://www.menshealthforum.org.uk/userpage1.cfm?item_id=1729
  3. Hampshire P. Pint please ... and a blood test. Nurs Standard 2000;14:18.
  4. Arnold P. Time for health, gentlemen? Primary Health Care 2004;14:23-4.
  5. Alderman C. Boys and their toys.Nurs Standard 2001;15:16-17.
  6. Carey J. Tackling men's health. Commun Practitioner 2002;75:250-1.

Resources
Men's Health Forum
W:www.menshealthforum.org.uk
Gender Equality Bill
W:www.eoc.org.uk/Default.aspx?page=17686
Bradford HOM Project
W:www.healthofmen.com