Gender 'barely mentioned' by Marmot

The MHF is raising 'a number of serious concerns' about the Department of Health's current strategic review of health inequalities. And is calling on it supporters to back their campaign to get gender back on the agenda.

The Marmot Review led by Professor Sir Michael Marmot, the chair of the WHO Commission for Social Determinants, is a Post 2010 Strategic Review of Health Inequalities due to report to the Secretary of State by the end of 2009.

It will identify the evidence for the health inequalities challenge facing England, show how this evidence could be translated into practice and advise on possible objectives and measures, building on the experience of the current PSA target on infant mortality and life expectancy.

The Forum expressed its concern following the publication of the review's initial documents.

• At the foot of this article are five ways you can help the MHF.

'Our main concern is that gender health inequalities are barely mentioned in the papers published recently as part of the consultation process,' said MHF CEO Peter Baker, above. 'Where gender is mentioned, it appears solely as an issue for women. Men's health appears to be consistently overlooked. We find this both surprising and worrying. Surprising because the evidence that men's health outcomes are generally worse than women's is now well-established and widely recognised, including by the Department of Health.

'If further evidence is needed on this point, one need look no further than the MHF-backed National Cancer Intelligence Network report on the excess burden of cancer on men published on 15 June and the Diabetes UK data on men's higher risk of developing diabetes published on 14 July to name but two.'

Gender Duty forgotten

The omission of gender is also surprising given that this government introduced, only two years ago, a gender equality duty that specifically requires attention to be paid to gender inequalities in the development of policy and the delivery of services. Peter said: 'It may well be that a failure to take gender properly into account will put the Review at risk of being found non-compliant. We intend to take advice from the Equality and Human Rights Commission on this point. 

'We are worried because a failure by the Review to take proper account of gender - men as well as women - could set back the progress that has recently been made in developing a cross-cutting approach to tackling health inequalities which takes account of the different equality strands and their interaction. It is very clear, for example, that suicide cannot be properly understood unless both the social class and gender dimensions are taken into account.' Just such a cross-cutting approach is, of course, reflected in the Department of Health's Single Equality Scheme.

Too little time

The Forum is also concerned that the lack of time allowed for consultation will prevent many of those who want to participate from doing so. 'The government's code of practice on consultations states that they should run for 12 weeks,' said Peter. 'This consultation lasts just six weeks - and this overlaps with the start of the summer holidays as well as the swine flu epidemic. The short period of consultation places has a particular impact on the smaller, specialist organisations (like the Men's Health Forum) working in the equalities field. Yet these are precisely the organisations that should be fully engaged with the consultation process.'

As well as making these points themselves to Professor Marmot, the Forum has called on other organisations involved in the consultation to do what they can to ensure that these issues are properly addressed. 'We very much want the Marmot Review to succeed and to determine a sustainable and effective approach to tackling health inequalities,' Peter concluded. 'However, success depends on ensuring that all aspects of inequality and all organisations working in this field are fully brought into the process.'

Five things you can do:

1. Visit the review's website.
2. The individual report you will probably find most useful is the priority public health conditions report.
3. Read the the outline and the consultation document which has nine questions to answer. 
4. Send your comments in by 5 August.
5. You can use the box below to contact the MHF on this issue.