D-Day: Men's health sixty years on

Nobody knows how many men on both sides were injured or killed on the Normandy beaches on D-Day - 6 June 1944. 10,000, 15,000, 20,000? What we do know is that this year 80,000 men will die from cancer. Sixty years after D-Day, Lynn Eaton asks: are today's men any more healthy than the soldiers who landed in Normandy?

It's all too easy to look back at Britain in 1945 and merely see a world of rationing and deprivation — as well as a country that didn't then have the National Health Service we are so proud of today. Nowadays we assume that the health of the nation in the 1940s — and of men in particular — was, on the whole, pretty poor.

However, the real picture is less straightforward. The general health of British troops landing on the Normandy Beaches was, according to the military experts, probably better than it had ever been before. In fact, the overall sickness rate among troops in 1944-5 was less than half the rate during the First World War (1914-18).

The discovery of penicillin in 1929 — and its mass production in the early 1940s — had revolutionised the care of injured troops. And at home, people were healthier too. The rationing system meant many people who had previously had a low protein diet were able to have more meat and eggs than before. Immunisation campaigns had reduced deaths — particularly among children — from infectious diseases such as scarlet fever and diptheria.

It wasn't until the 1950s that scientists linked tobacco smoking with lung cancer. Until then, Hollywood images of men smoking were the norm — and everyone wanted to emulate them. In fact, troops were given a free cigarette ration. The 21st Army, who led the D Day attack, had a battle ration of 10 cigarettes a day — and three boxes of matches a week.

Although men had to be fit to fight, the idea of 'men's health' as such was never discussed. Nobody talked of improving the health of men — or women — in their own right. However, the war years also marked the start of the first national public health education campaign — on the dangers of venereal diseases. The Ministry of Health launched a £150,000-a-year campaign, including posters, adverts, films and lectures, in 1943. The following year, VD centres in Britain treated 81,082 cases of VD in men and 57,952 in women.

Such campaigns are still needed. Sexually transmitted infections (the modern term for 'VD') are on the increase again — the number of diagnosed cases of gonorrhoea alone more than doubled in men between 1996 and 2002. Syphilis, chlamydia and HIV rates are also increasing.

Sixty years on, with the National Health Service well established, and Beveridge's welfare safety net in place, we eat better food and enjoy a better standard of living. The advances in medicine — heart surgery, drugs for diabetes, and cures for some cancers — are helping to treat conditions that would previously have precipitated an early death.

Yet despite all the progress, men's health is still not adequately addressed. Over the past 30 years, women have successfully campaigned for improvements in their healthcare; men have not yet done the same. The result is that health services generally do not meet men's needs and too many men die unnecessarily young.

But doctors and other health workers have begun to realise that men's health problems are not simply related to their biological make-up. In fact, both men and women are profoundly affected by social pressures to behave in certain ways. Many men feel they cannot voice their emotions, for example, but that it is acceptable for them to drink three or four pints of beer a night, drive dangerously and enjoy a daily fry-up. It is part of the male role to take risks and to act as if indestructible.

Men often delay seeking help, putting their health at even greater risk. Many men eventually diagnosed with testicular cancer put off visiting their GP for months even though they have discovered lumps or other symptoms. Yet testicular cancer can be cured — survival rates are as high as 90%, providing treatment is given early on. Many men ignore the symptoms of prostate disease, such as needing to urinate frequently, because they wrongly believe they are simply due to old age.

Conclusion:

Judged by life expectancy alone, there has been a massive improvement in the nation's health since 1945. A man born in 1925, old enough to have been fighting on D Day, would have had a life expectancy of about 65. A woman of the same age might expect to live to 70.

Their children, born in the post-war 1950s, can expect to live until they are 76 (men) and 80 (women). And their great-grandchildren, if born in 2004, are likely to live to 80 (men) and 85 (women).

Despite these overall improvements, men's health is still a problem. Suicide rates for young men have more than doubled in the last 30 years. Prostate and testicular cancers are on the increase. Heavy drinking has led to a five-fold increase in the number of men aged 25-64 dying from chronic liver disease since 1970. A combination of sedentary lifestyles and high-fat foods has meant that more than two-thirds of men are now overweight or obese, increasing their risk of heart disease and diabetes.

• A version of this article first appeared in 'The D-Day and Normandy Landings Commemorative Album: The Enduring Legacy of the Liberation' (St. James's House; London; 2004). Click here to download PDFs of those pages.
• What are your views or memories of how men's health has changed over the last half century?