Moan Free Zone

MHF conference

Delegates at the first ever Men's Health Forum conference (11 December 2001) discussed the state of men's health services and ways of improving it.

Peter Baker, Director, MHF, said: "If I had to summaries men's health, I'd say it could be better. But it's no longer helpful to compare men's and women's health because women have their own specific concerns which are different from those of men and it encourages competition. We don't want to fight over resources, instead we should work together.”

Men live on average five years less than women, a gap which widens as we descend the social class scale. Men are particularly poor at using health services which we need to change, as well as encourage them to improve their diet and lifestyle. For example, increased alcohol consumption is a growing concern with over one-quarter of men drinking over the recommended level. Nearly one-third of all men smoke; 62% are overweight; chlamydia and sexually transmitted diseases are other problem areas about which we need to raise awareness, as is stress by spending too much time at work. 

"Perhaps most importantly, health authorities and primary care groups need to develop policies to improve men's health and health promotion should be delivered in a way that is likely to appeal to men and change their attitudes.”

Richard Parish, Chief Executive of the Health Development Agency (HDA), London, argued that men's health has not received the priority it deserves and that organizations such as the MHF are greatly contributing towards raising its profile. "We now have a government which is concerned with inequalities in health and we need to design services which meet the needs of different ethnic and gender groups”. 

Parish also highlighted the need for more attention to be paid to understanding the health needs of boys and young men and properly targeting services for them, an issue which is the focus of a report carried out by Working with Men on behalf of the HAD. The report provides a snapshot of services available to boys and young men aged between 11 and 25 years, highlighting both gaps in existing services and examples of good practice. (Report available from HDA's website).

Clinical matters

Amongst several talks on clinical matters, Professor Tony Barnett, Professor of Medicine, University of Birmingham and Birmingham Heartlands Hospital, highlighted the need to tackle the obesity epidemic caused mainly by change in diet and sedentary lifestyles. "Obesity is a disease in its own right, which increases the risk of a number of other serious diseases including coronary heart disease, stroke, cancer of the prostate, breast and colon, and diabetes. By reducing obesity we can significantly decrease the number of people with these conditions but to do this, we need significant government intervention with much more resources invested in public health measures and education campaigns.”

Perhaps news to many ears, Professor Peter Collins, Professor of Clinical Cardiology, National Heart and Lung Institute, London, revealed that the sex hormone testosterone played an important part in the protection of CHD: "Studies show that testosterone directly relaxes coronary arteries in vitro by interacting with ion channels on the smooth muscle cell surface. Direct infusion of physiological concentrations of testosterone into the coronary arteries of men with coronary artery disease results in an acute significant increase in coronary blood flow. Beneficial effects on endothelial function and myocardial ischaemia have also been demonstrated but there is much work to be done before we can confirm the effects of sex hormones on the cardiovascular system. ”

Mental health

In a discussion about mental health, Rodney Elgie, President, GAMIAN-Europe, argued that it was difficult to put mental health high on the political agenda. "Most politicians don't take mental health seriously. They don't regard it as a disease or life-threatening and yet some 50,000 people commit suicided annually in the EU. In the world there is one attempted suicide every 1.7 seconds.

"Young men aged between 18 and 40 years, have by far the highest suicide rate. The stigma together with misconceptions about mental illness causes a significant barrier to men acknowledging the existence of mental illness and in seeking treatment.”

Pippa Sargent, National Coordinator, CALM (Campaign Against Living Miserably) argued that we need to continue to raise awareness about mental health and in the process destigmatise mental illness and encourage men to seek help. "The key to CALM is its communication strategy. We try to persuade men to seek help with messages in their language in places where men go, for example, with posters in urinals. We also provide a free and anonymous helpline which provides support and signposting to other services. Our key message is "don't bottle it up, sort it out” and we find that about two-thirds of our calls are from men. ”For more information about CALM click here]

Getting men to see the doctor

In a discussion on how to get me to see the doctor, Shaun O'Leary, Director of Operations, The Prostate Cancer Charity, pointed out that young men (25-39 years) are particularly bad and see their GP on average twice per year.

"Men tend not to see themselves at risk but the feedback from our nurse-led helpline, which receives thousands of calls, shows that fear of life-changing news is a big problem and that men don't want to confront it. In general, men lack knowledge about health issues and tend to ignore potentially serious symptoms because they think it would be unmanly to do so.

"An alternative way of putting men in touch with health services is by the telephone or the Internet. Men would far rather do this than face a doctor, especially regarding sex issues. Drop-in clinics, which allow anonymity, and interventions which seek men out, are also successful.”

"But there is still a long way to go, and we need to keep trying to reach men and educate them about symptoms, how disease is transmitted and what services are available. We also need to take more services to them and display more gender specific materials in clinics to make them feel more comfortable to be there.”

Taking healthcare to men

David Wilkins, Lecturer/practitioner in health promotion, Healthworks, Dorset, described the importance of tailoring intervention programmes to reach the target audience by finding out what is important to men and how to motivate them. Through as series of structured discussions with men aged between 40 and 55 years, David and his team developed a successful intervention programme to prevent coronary heart disease:

"Through our discussions with the target group, we found that the men believed it's natural to put on weight as you get older; that they regret loss of physical attractiveness but don't think it's manly to worry about it. They also viewed exercise as boring and time consuming, that being involved in a team, such as in football, is more fun than exercising alone and that competition made exercise more enjoyable. They also said that it's embarrassing to exercise in the company of people who are in good shape and that a program in the workplace was likely to be more supportive.

"By tailoring our program on these findings, we designed an inter-work competition to see who could lose the most weight in six months. Each team was supported by a professional who advised the men about healthy eating and stress management. We've now run the program successfully four times since 1995 and are about to run it again.” For more details about this programme, 'Keeping it Up', click here

Meryl Johnson, Health Promotion Coordinator, Worcestershire Health Authority, talked about new opportunities to involve patients in decisions about health, with the move to Primary Care Trusts and Strategic Health Authorities; and the importance of recruiting motivated individuals to push men's health into the forefront. "If we really want change it must begin with us, it must begin now and it must begin with empowering people to make that change happen.”

The Men's Health Improvement Programme in Worcestershire, is now in its second year and has worked to educate and raise awareness about the context of men's lives, to review and audit health visiting and midwifery and to facilitate the development of a number of community projects. Future plans include reducing inequalities and to incorporate targets for men's health. Johnson described one project where workers were offered free health checks on-site at work. The project revealed that physical health was often neglected and a lot of misguided beliefs about mental health including thoughts that they should "pull themselves together” if they felt depressed, and that most men did not get depressed. For many men, it was the first opportunity they had had to talk about their emotional state.

The importance of involving the local community in developing effective strategies for promoting better health, was echoed by Terry Drummond, Chair, Community Health UK and Advisor in Social Responsibility, Southwark, London. "We need to recognize that within local communities there are many different organizations that we can draw upon and build partnerships with.”

In a lively discussion, Jane Deville-Almond, Independent Nurse Consultant in Primary Care and Vice President of The Men's Health Forum, argued that to get men interested in health, we need to move away from the traditional medical format and make men's health more sexy and appealing. "We need to de-medicalise men's health and get rid of terms such as "well-man's clinics”, "surgery” and "clinics”. Health care should be something that every man wants and so we need to keep encouraging them by going to places where men go, such as pubs, racetracks, Harley-Davidson showrooms and barber shops.”

[Click here for details of Jane's pub clinics and Harley Davidson weekends.

Maggie Robinson, Community Learning Consultant, Community Education Development Centre (CEDC: a UK-based charity which promotes community based learning), told delegates that by identifying young men's interests, they were able to meet and educate young men about health. CEDC's set up a health challenge across a weekend football league which successfully increased their knowledge about health and led to some lifestyle changes. Nurse check-ups, at the games and practices, identified a number of men with hypertension and diabetes. Maggie Robinson also echoed a number of the other speakers by highlighting the importance of using wording which appeals to men, such as "information” lines rather than "help” lines, and argued that we need to start communicating with young children about health, for example at after school clubs. Click here for more information about CEDS's project Alive and Kicking.

Reaching men at an early age was an issue also raised by Simon Forest, a Fellow at University College London, in a discussion on sexual health. "Young men want practical and explicit information about sex and they want it at an early age. They want to know about the basics such as how large a penis should be, how to give women orgasms, and so on. They don't want to know about fertility and contraception.”

Men's Health Week

Delegates at the conference also heard about plans for Men's Health Week, which is to take place from the 10-16^th June and will coincide with Father's Day. Richard O'Neil, Director of Men's Health Week said: "It's a new and major opportunity for a wide range of organizations and individuals to work together to raise awareness of men's health issues and to develop practical and local initiatives to improve the still poor state of male health. We hope that this week will encourage men to take responsibility for their own health and to understand the benefits of being well.”

Anyone wishing to know more about Men's Health Week should visit the Men's Health Forum website (www.menshealthforum.org.uk) or email Richard O'Neil at: mensbox@aol.com.