Five men's health issues gender duty must tackle

The Forum has identified five areas of men's health which it would particularly like to see policy makers and service providers address under the Equality Act's new Gender Equality Duty.

Under the Duty, which comes into force on 6 April, primary care trusts and other NHS and public bodies will be legally obliged to 'promote equality of opportunity between men and women' when planning and delivering services. The government has made it clear that this means bringing about measurable improvements in the lives of men and women, where one sex has previously fared less well than the other.

MHF president Dr Ian Banks believes 'men are being badly let down because of the "one size fits all" approach to health care that has bedevilled the NHS since its inception.' He says: 'the Equality Act provides the biggest opportunity to improve male health since the foundation of the NHS. But senior managers have got to show real commitment to implementing the Act. At the moment there is widespread ignorance and apathy about the new requirements.

'The Men's Health Forum will be monitoring the performance of the NHS and will not hesitate to use the new legislation to ensure compliance.'

The Department of Health is already being investigated for possible failures on race equality and the MHF wants to ensure that no local health providers suffer the same fate around gender.

The five issues are:

- Weight management:

More men than women in the UK are overweight (67% of men compared to 57% of women) but men are much less likely to be offered help and support in weight loss programmes in GP surgeries. Analysis of 1256 patients across 58 GP practices in 2004 found that only 26% of those attending structured weight loss programmes at local surgeries were men, despite the service being - in theory - equally available to both sexes. Evidence suggests that men who are offered support lose weight as effectively as women.

- Cancer:

Men are almost twice as likely as women to die from virtually all the cancers that affect both sexes, mostly because of preventable causes such as smoking, poor diet and alcohol use. This suggests that local and national cancer prevention programmes are less effective with men than women.

- Smoking:

Smoking is the single most important preventable cause of heart disease and causes virtually all cases of lung cancer. Historically, men have always been much more likely to smoke than women and although numbers of smokers have declined among both sexes (and more sharply among men), it is still the case that men are more likely to be smokers (28% of men, 26% of women). NHS smoking cessation programmes are much less likely to succeed in attracting male participants. In 2002, only 98,000 men took part in NHS programmes compared with 130,000 women (i.e. only 43% of participants were men).

- Use of Primary Care Services:

Men are much less likely to visit their GP than women. Under the age of 45, men visit their GP only half as often as women. It is only in the elderly that the gap narrows significantly — and even then women see their GP measurably more frequently than men. A survey of men conducted by the Men's Health Forum suggested that many men are unhappy with the service provided at their local GP surgery for reasons that are rectifiable: unhelpful opening hours; perceived emphasis on services for women and children; and undue bureaucracy.

- Depression: although men and women suffer equally from depression, men are less likely to seek help, clinical diagnoses are skewed towards women and more men end up killing themselves, going missing and drinking heavily. What is required is a better understanding of male mental health, better training for clinicians, awareness-raising amongst men and more accessible services.

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