Understanding of health and access to services

Health literacy

There is evidence that men have lower levels of health literacy than women.

One study found that men were than twice as likely as women to have inadequate health literacy (Reference: JECH).

An analysis of people with coronary heart disease in south London found that those with low health literacy were more likely to be male, from a non-white ethnic group, live in a more deprived area, have spent fewer years in education, and were less likely to be employed (Reference: BMJ).

A large study of British adults (970 males and 1246 females) found that women were more likely than men to recall seven out of nine cancer warning signs (sReference: K. Robb).

A US study of 4,700 adults with multiple sclerosis (MS) who were taking disease-modifying medications (DMMs) found that female MS patients report better awareness of disease symptoms and have more positive perceptions of their ability to manage therapy with DMMs than male MS patients (Reference: A. Vlahiotis).

According to a National Pharmacy Association study, more men than women admit that their understanding of medicines is poor (23.1% against 15.6% women) (Reference: National Pharmacy Association).

Men are twice as likely as women to take a new prescription medicine without first reading the patient information leaflet or seeking professional advice (10.9% of men against 5.1% women).

Men’s purchase of prescription-only drugs without medical advice, usually via the Internet, is of increasing concern because of the risks of toxicity and missed diagnoses.

A study of 935 men aged 35+ years in major UK cities, found that 1 in 10 purchased a prescription-only medication without a prescription, and 50% of those men do so via the Internet.

The percentage of men purchasing prescription-only medications without a prescription via the Internet increases to 67% when considering medications for erectile dysfunction specifically (Reference: G. Jackson).

Use of services

Men are less likely than women to use general practice or to visit a pharmacy.

In England in 2008/9, general practice consultation rates for females were higher than those for males in general except for the extremes of age (i.e. the very young and the very elderly). The biggest difference between men and women was in the 20-40 age group where women attended general practice twice as often (Reference: Information Centre).

Danish research has suggested a link between between men’s lower use of primary care and their higher rate of hospital services (Reference: Journal of Public Health).

There is evidence that men do not delay seeking help longer than women for some health problems (e.g. back pain and headaches) (Reference: K. Hunt)  but that they do for others (e.g. malignant melanoma, lung cancer and bladder and other urological cancers) (References: Annals of Oncology and British Journal of Cancer).

According to National Pharmacy Association research, men on average visit a pharmacy four times a year while average for women is 18 times per year. A third of men (31%) get their partner to collect their prescription medicines (Reference: National Pharmacy Association).

Men are also likely than women to participate in the National Bowel Cancer Screening Programme, despite their higher risk of the disease. An analysis of the first 2.6m invitations issued in England found that 51% of men took part compared to 56% of women (Reference: C. von Wagner).

Attitudes to health

Men are less likely than women to acknowledge illness or to seek help when sick.

Health is often socially constructed as a feminine concern and men therefore have to behave as if they are unconcerned about their health if they wish to publicly sustain a ‘real’ male identity (Reference: A. White).

Many men appear to legitimise health service usage, only when a perceived threshold of ill health has been exceeded. There is also a tendency amongst men to play down symptoms or to view potentially serious symptoms as simply signs of growing old (Reference: A. White).

Fear surrounding the potential loss of masculinity may result in a façade of control and stoicism, instead of honesty about reporting symptoms and accepting interventions, or openness about feelings and insecurities associated with particular illnesses (Reference: A. White).

Risk-taking behaviour is associated with masculinity (Reference: A. White)  and is, therefore, generally more common in males than females. A King’s Fund study that looked at four behaviours – smoking, drinking, diet and exercise – found that men were more likely to participate in a combination of three or four risky behaviours (Reference: Kings Fund). Amongst men, there was a social gradient with professional men least likely to have three or four unhealthy behaviours and unskilled men most likely to have them.