Act now: recessions kill men

Men's health is poor and the recession will make it a great deal worse, says MHF CEO Peter Baker.

The downturn will have a dramatic impact on men's mental health, says Mind in a report published last month. 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.

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's health not tackled systematically

Men were by no means in rude health when the economy was booming. 40% 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 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.

Taking services to men

Men are not doomed by their genes to die young, however. We now know that if services are delivered in a more 'male-friendly' way, men will use then and they will change their behaviours. By taking services to where men are (prisons, military bases, workplaces, colleges), the National Chlamydia Screening Programme succeeded in increasing the proportion of male screens from 17% to 28% within three years.

Knowsley PCT/MBC'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. 57% of men attending health checks have gone on to access diet and exercise interventions, smoking cessation and health trainer services.

National Men's Health Week (15-21 June) focuses on the key issue of men's use of health services. The Week offers health professionals, especially nurses working in GP and community settings, a great opportunity to reach out to men and to consider how to work with them more effectively in the long-term.

If nothing is done, however, the recession will consign many more men — our fathers, grandfathers, brothers, sons, partners, friends and colleagues — to worse health and tragically premature deaths.

• Peter is addressing these issues in a free lecture in London on 10 June 2009.
• A version of this article first appeared in Nursing Times, 26 May 2009 Vol 105 No 20 .