Managed by Professor Alan White, Leeds Metropolitan University

 

Writer group

• Professor Alan White (UK) -
• Professor Witold Zatonski (Poland)
• Professor Péter Makara (Hungary)
• Dr Bruno de Sousa (Portugal)
• Dr Svend Aage Madsen (Denmark)
• Dr Noel Richardson (Ireland)
• Dr Richard de Visser (UK)

 

I. Introduction

• Definition of men’s health
• The different world men of today are living in, including for example:
• The health challenges of different groups of men will be considered:
• The effect of age on men’s health will be included in this section:

 

II. Population

Main points

• The increasing longevity of much of the male population. 
• Patterns of cohabitation are changing
• Patterns of fatherhood
• Patterns of work and leisure are changing
• The data on the breath of social factors that influence men

 

Selected health indicators

Main points:

·         Men’s life expectancy increasing overall but there are countries where the past couple of decades have seen a reversal in this trend. 

·         Widely differing life expectancy is also apparent at an individual country level, where regions and localities are seen to have significant differences in life expectancy that are very closely tied to diversity and socio-economic factors. 

·         The high rate of premature death and the extent of years of life lost as an indicator of cost to the individual, his family and the economy. 

·         The social and economic implications of differences

·         Estimates for health quality for men

·         Perceived well-being shows men generally identify themselves as having better health than women (which has relevance with regard to the efficacy of health promotion campaigns that are reliant on men self identifying themselves as at risk).

 

Morbidity

Main points:

·         Analysis of the burden of chronic morbidity links to the ageing population and efficacy of modern emergency treatments.

·         Issues of multiple and complex health problems starting to dominate the health agenda compared to acute health problems that are more easily amenable to treatment.

·         Links to men’s lifestyle and the social determinants of health

·         Links to men’s risk taking behaviour - smoking, alcohol intake, and drug taking all require examination from a male specific perspective to determine what form of intervention can be effective.

·         Cross country analysis of the social determinants of health allows for mapping of lifestyle choices against countries’ overall health status in men.

 

Lifestyle and social determinants of health

Main points:

·         Lifestyles of men still one of the principle causes of premature death and morbidity in men

·         Poorer lifestyles strongly associated with socio-economic factors

·         Reduction in smoking – but levels still highest amongst men in lower socio-economic groups and in country’s in transition.

·         Alcohol consumption remains high

·         Men tend to have diet high in red meat and low in fruit and vegetables

·         Many men work in very poor environments

·         Activity levels overall are diminishing

 

Usage of health services

Main points:

·         The relation of different health systems to the overall health status of men, i.e. Bismarck or Beveridge types of health service

·         Problems in reaching men in need (e.g. mental health services, sexual health services, cancer screening, vascular screening [with links to following sections]). 

·         Recognition of the workplace as a setting of both health hazard and potential health promotion / education for men.

·         Accessing primary health services may be problematic for many men due to lack of flexible working arrangements coupled with a lack of preventative health services aimed at men.

·         The availability for specialists for men's health (e.g. on prostate cancer)

·         The increased use of on-line medicinal products by men is proving problematic due to the bypassing of normal diagnostic procedures and also the risk of counterfeit drugs.

·         Pharmaceutical products and their different effects concerning gender (this may need to go elsewhere)

 

 

 

 

 

Cardio-Vascular Disease

Main points:

 

·         Overall cardiovascular health is improving for men, but it remains the principal cause of premature death, and a significant cause of morbidity and long term chronic health problems.

·         Rate of development of cardio-vascular disease in young men

·         Sudden cardiac death as a result of alcoholic poisoning

·         Vascular screening [with link to section on usage of health services] i.e. cholesterol, BP, abdominal aortic aneurysm,

·         Increasing usage of statins

 

Cancer

Main points:

·         Men display a higher incidence rate and rate of premature death for the majority of cancers that should affect men and women equally. 

·         Men have a lower survivorship for cancer in their early years.

·         Prostate cancer is increasing as a result of the ageing population and more cases are being diagnosed as a result of testing – differences between countries exist.

·         Screening – prostate, bowel [with link to section on usage of health services]

·         Not all countries have a cancer plan that addresses how men’s risk of cancer will be tackled.

 

Other health conditions affecting men

Main points:

·         Obesity is increasing and the male form of overweight with central fat deposition increases the risk of many health problems [with links to cardio-vascular, cancer and diabetes]

·         Type 2 Diabetes is increasing in men as a result of obesity

·         The ageing society and the problems men face with their prostate health.

·         Osteoporosis is traditionally seen as a problem of older women.  There are however problems of low bone density in young male athletes, men with specific health problems and hereditary factors and a growing number of men developing the condition as a result of hormone ablation therapy for prostate cancer.

·         Asthma

·         COPD – as a result of smoking and work related lung disease the incidence of COPD remains high in many of the countries of the study. Links to lung cancer and to low income groups

 

Accidents, injuries and violence

Main points

·         Accidents form a significant proportion of deaths in younger men, with road traffic accidents being the cause of the majority of those, but large country by country variations are evident.

·         Deaths and disability as a result of transport, work related injuries; homicide and violence

·         The issue of men’s violence, both towards other men and women, is a major concern as is the issue of men as victims, of both physical and emotional trauma from men and women. 

 

Mental Health

Main points:

 

·         The gender bias in diagnostic criteria masks the extent of the problem for men.

·         High levels of undisclosed mental health problems in men as evidenced by the avoidance of help-seeking and reliance on more acceptable male outlets including alcohol abuse or aggression.

·         Stress as the highest cause of absenteeism and presenteeism (being at work, but unwell) in some countries

·         High levels of suicide among men

·         Men as abusers and as victims of abuse

·         Parkinson’s disease has a higher incidence and rate of death in men

·         Epilepsy has an effect on men that covers many aspects of their lives both as a result of the disease and the side effects of the medication.

·         The impact on the health of men as a result of rapidly changing social circumstances, with the onset of a deep recession already producing an increase in unemployment and stress-related illness.

 

Communicable Diseases

Main points:

·         Within countries undergoing major social upheaval, communicable diseases are still an important cause of premature death. 

·         The risks to men from all member states with regard to sexually transmitted diseases and HIV continues to be a challenge that few have been able to reduce.

·         The predominant focus of existing policy and practice in the areas of reproductive and sexual health has been targeted primarily at women

 

Dental and oral health

Main points:

·         Dental and oral ill-health are causes of many systemic diseases as well as being the source of marked discomfort to the individual.

·         Though the index of serious tooth decay (DMFT) is showing that there is little difference across Europe a gendered analysis of this data has not yet been undertaken. 

 

Sexual health

Main points:

·         Erectile dysfunction is a ‘sentinel’ alarm for cardiac vascular health problems, the prevalence of the problem within countries is important to know. 

·         Men’s reducing fertility

 

III. Discussion / Conclusion

 

• Moving forward on men’s health in Europe   
• The identification of gaps that can be narrowed (as identified by international comparisons, or historical comparisons or through cross gender comparisons). A discussion as to how to narrow those gaps: at the EU level and at country level    
• Recognition and understand the problem’s men are going to be facing over time – changes due to transition for men- underlying trends for men, new threats.  Especially those areas that are under the radar, no services or policy in place – new emerging issues.