We must be gender-sensitive not gender-centric

Ever since men's health first edged its way onto the health agenda, its advocates have made the case for action by comparing men's health and women's health, writers Peter Baker.

The most frequently-quoted statistic is that men die five years younger than women; it also pointed out that men are less likely to go the doctor and more likely to drink excessively or drive dangerously. These inequalities between men and women's health have also been highlighted by the Department of Health — when public health minister, Yvette Cooper called the difference in life expectancy between the sexes 'one of the starkest health inequalities we face' — and, of course, by the Men's Health Forum.

But it is time the debate moved on in relation to gender and health inequalities. In fact, the Men's Health Forum has decided to stop comparing men's health and women's health except in those few circumstances where a comparison can genuinely prove illuminating.

Focusing on the differences between men's and women's health is generally unhelpful for five main reasons:

• First, crude comparisons can imply that there are no inherent biological differences between men and women. There are, of course, many important differences and these are not just related to sex-specific diseases like prostate and cervical cancers. They also relate, for example, to areas of the body where fat is deposited, with implications for the development of diabetes and heart disease, and to susceptibility to autoimmune diseases like MS.
• Secondly, comparisons can suggest that women's health is the "gold standard” against which men's health must be measured.  In fact, women's health is far from a being a gold standard — women have at least as many unmet health needs as men.
• Thirdly, they can obscure health inequalities between different groups of men and women related to social class, ethnicity and other factors.
• Fourthly, comparisons can easily lead to a competition for resources between men's and women's health services. The reality is that resources are needed for the development of better health services for men and women.
• And, fifthly and finally, comparisons between men and women, which typically emphasise men's much shorter life expectancy, can lead to a fruitless argument about which sex is the most hard done by. In fact, both men and women are currently ill-served when it comes to health.

None of this analysis is intended to deny that we clearly live and work in a society in which men, as a group, continue to be privileged and powerful and in which women, as a group, continue to be discriminated against and disadvantaged. Domestic violence is a very clear example of this and it has enormous consequences for women's physical and mental health.

However, what is becoming clear is that men and women have a shared interest in arguing for 'gender-sensitive' health policies and practices that better meet the needs of both sexes. The principal issue in gender and health inequalities is not how women and men can be made more equal in terms of life expectancy or most other health statistics. Rather, the key issue is how an understanding of gender can be utilised to help tackle the health inequalities that affect both men and women in order to improve the health of both sexes.

Unless gender is taken into account, efforts to change the inequalities related to social class, ethnicity and other key factors will be far less likely to succeed.

Peter Baker is director of the Men's Health Forum