Playing to men's strengths

Professor Siân Griffiths, president of the Faculty of Public Health, tells Lynn Eaton that if health professionals are to reach men, they must learn to speak their language.

As someone who has spent most of her life working in public health, Professor Siân Griffiths, president of the Royal College of Physicians' Faculty of Public Health, knows how important it is to get a health message across effectively.

And as the mother of three children — one of them a 16-year-old boy — Siân is only too well aware that, no matter how much you might wish it otherwise, boys and girls think and behave differently. Her son never wanted a gun, but despite all Siân's progressive views on sexual politics, her daughter did want a doll — much to Siân's angst.

'I gave in,' she admits, a little sheepishly. 'But boys and girls are different. Maybe the aspirations we used to have about blurring the differences are not the right way to go. Maybe the thing to do is to recognise gender differences, and play to people's strengths and try to deal with their weaknesses.'

She's bringing the same thinking to bear on public health messages, arguing that effective health campaigns, on everything from smoking cessation to safe sex, need to bear in mind how effectively they reach their target audience. 'How do you outreach men? How do you get men to take their health seriously at all ages? And how do you get them thinking of prevention?' she asks.

It was while she was public health director at Oxfordshire Health Authority, working on women's health issues, that she began to realise just how different men's health needs are. 'I started to look at the research, the differential death rates and the issues around young men: higher suicide rates, accidents at work, violence. All these issues are connected with being a man in society. All those social impacts — drink and so on — are really important for male health and wellbeing.'

She found it hard to get the issue taken seriously at first: 'It didn't catch the managers' attention, maybe because they didn't just provide services for men.' Things have changed, though, in the last ten years since the Men's Health Forum was set up. 'Men's health is definitely on the agenda. It is not a wacky sideline.'

There is, she believes, an increased awareness of health and health issues generally, which has had a knock-on effect on men's health. 'We have seen a fall in men's smoking, in men's death rates from cancer, in men's heart disease rates — we are seeing some changes. I'm sure there is more health awareness among men. It is not just a case of "my wife told me to go to the doctor” anymore.'

But she also acknowledges that the last decade has not been easy for men, who are struggling with their new identity: 'I think young men have a particularly difficult time in society now. You don't go into a job for life. The world is different. There is much more ambivalence. My daughter, who recently had a son, is very much the baby's mother, but young men don't have that identity. They have to try to find one, which is very hard for them.'

She puts smoking and obesity at the top of the public health agenda as two of the most pressing health issues. But, for men specifically, she highlights the need to raise awareness of sexually transmitted infections. She believes the other issue for men is mental health: 'I am not sure where we have got to on gender in mental health. That may be something that needs to be further explored.'

Health secretary John Reid, now a teetotal former smoker, has just announced a consultation over the future direction of public health. He says they have to decide whether the government should take a nanny state or a hands-off Pontius Pilate approach.

Siân acknowledges that this is a key decision for the future of public health. She's also keen to see how the Department of Health shapes up on tackling gender issues, and is a little sceptical about whether the department's new magazine aimed at women is the best way forward:

'I'm not sure the NHS producing women's magazines is the way I would have done it. I think there needs to be much more work done on training healthcare staff to understand the differences between men and women and the way they need to be talked to. All nurses, receptionists and everyone in contact with patients need to understand the differences.'

But she believes the forthcoming white paper on public health opens the door to putting gender issues to the fore. 'You need to make sure men's health is an issue that's raised. It is about how to do public health. How are you are going to get your message to men, particularly to working class men and men in social minority groups? Have we got the smoking cessation message written in a way that men will respond to? Those are the questions that need to continue to be asked.'

At local level, she believes Forum members can raise the issue on their primary care trust's agenda by going beyond immediate NHS colleagues. 'I think they need to think about who their champions can be, and their champions can definitely be public health directors. Health is part of local strategic partnerships, but working across sectors is part of that.

'They can use local government and local strategic partnerships as a way of raising it on the trust's agenda, and they can use local voluntary agencies, in terms of advocacy. Local action, rather than just edicts from on high, can bring about change more effectively. I would never do anything from the top down only. You have to have a balance. Local action can really make a difference to the local community.'

Similarly, at national level, the Men's Health Forum needs to keep positioning itself within the health sector in its broadest sense.

'I think it does well within the Department of Health, but it needs to think about how it works with other government bodies and how it gets them engaged and promoting health. The Social Exclusion Unit, Home Office, Environment, Work and Pensions: all those areas need to be involved. It's not just the Department of Health.'

You can't help feeling Siân is the kind of person who knows just how to play the political field, but even she admits to struggling in one area: sport. Knowing the power sporting celebrities can have on getting a health message through to men, there is still one goal she has yet to score: 'We need the whole FA signed up really, and I suppose if I was being effective, I would get them to work with all the local directors of public health.

'Maybe I should do that next week.'

• This article first appeared in MHF, the Forum's magazine.