Health care must be about quality not quantity

Men could be living longer than women by the end of the century so is men's health already finished as a discrete issue? Not at all argues independent nurse consultant Jane DeVille-Almond, vice president of the Men's Health Forum. Whether it's numbers of years or numbers of cigarettes, health is about more than raw figures.   

There has been a great deal of speculation and growing concern in the press recently about our young women and their health. Rising alcohol abuse, smoking among younger women and much higher levels of stress than ever before, it is predicted that, at the end of this century, men may live longer than women.

That may seem like great news for men, but my concern is not the longevity of our men but for their quality of life. It seems that at present much of our focus on health statistics is on how long we can keep people alive. My real concern is that with this in mind we start to lose our focus on the real issue which surely has to be quality of life. For many men, when their quality of life is poor, they have no wish to comply with the health care guidelines of giving up smoking and drinking and eating a healthy diet so that they can live a little longer. Many actually do not want to live at all.

At present the average man in the UK can expect to be seriously or chronically ill for around 15 years of his life. This in it self is pretty depressing news for men but in addition many men, with the most severe chronic illness will also be socially and economically deprived causing even more distress.

Many men with whom I have had contact in my outreach clinics have confided in me as to why they dislike using our traditional heath care services in their current form. They often believe rightly or wrongly that the service as it stands is a tick box system of health care where once the appropriate box has been filled in, for example smoking, drinking, blood pressure or weight, the health professional's job is done. All records have been neatly recorded and the patient can go. This leaves the man frustrated when there is little or no opportunity to discuss why he smokes or why he drinks too much.

Even more frustrating is when a man may go with a completely unrelated problem and the nurse or GP spends more time discussing how he should improve his life style and habits rather than really listening to what is troubling him. Now I'm not saying that we shouldn't bring these issues up during our consultation but often bringing up all the negative aspects of a man's health at the first opportunity can lead to frustration for the men concerned which can ultimately cause a breakdown in the relationship with the healthcare profession. 

The big problem for those working in the health care profession is that our agenda and the agenda of the man sitting in our consulting room is often very different. The art is to make sure we address the agendas of both parties otherwise nothing will be achieved.

One of the most detrimental impacts on men's health and wellbeing is life changes such as the loss of a job or a relationship breakdown. This often increases his 'risk-taking behaviour' yet such issues are not yet legitimately discussed within our present health services for men. Not to legitimise such topics may alienate men from discussing the very problem that may eventually lead to ill health.

We should re-assess our motives for improving the health of our men and not simply be looking at how to keep people alive for longer but how to make sure that they have the best quality of life for as long as is possible. Let us remember it is quality not quantity that counts.