Why is it so important to engage men and boys in discussions over health? Why does this group remain so hard to engage? How can we break down barriers to work more effectively with men and boys?
Chaired by Graham Rushbrook, Development Adviser and Lead Assessor for RSPH, these are the questions we sought to answer in this RSPH members’ event held on Thursday 28 January in London.
It is well known that biologically there should be no difference in the number of men and women dying from preventable diseases, yet at every stage of the life course, more men than women die. In fact, almost 20% of men will die before the age of 65 compared with 12% of women.
The majority of these deaths are caused by preventable diseases, namely cardiovascular disease, cancer and respiratory diseases, which are also the leading causes of death in women but result in fewer deaths in the female population. These differences between men and women are also evident in mental health, with suicide being the leading cause of death for men under 25 and three in four of the people taking their lives being men.
There is a huge disparity between men and women when it comes to accessing services, with men less likely to engage in weight loss programmes or have NHS health checks. Men are also less likely to recognise warning signs and are less likely to visit their GP than women.
Tracy Herd, Deputy Chief Executive, Men’s Health Forum suggested that the concept of health as a female concern prevents men from accessing services and that the concept of masculinity also leads to men taking part in riskier behaviours and stoicism regarding their symptoms.
However, it is not only a case of men failing to engage with services but that services are also failing to engage with men. Naturally women will engage more with health services during pregnancy and childcare but they are also invited into the system earlier, being called for cervical screening at the age of 25 with men not being routinely approached until bowel cancer screening at 65.
For those working as health trainers or in other health services, a different setting to a healthcare environment, for example sports venues or the work place, often allows men to feel more comfortable in discussing health issues. Similarly men are more engaged in weight management programmes when there is a physical activity element. Humour, banter and camaraderie are also important in producing successful health services for men.
Although gender specific programmes can be beneficial, they are not essential, although, all programmes should be gender sensitive if men are expected to engage with them. Although men respond well to referrals – and therefore are not disengaged with the entire system – it is getting men engaged enough to use primary health care services that remains an issue.
Carolyn Pallister, Public Health Manager at Slimming World, shared a positive message regarding men using Slimming World’s weight loss programmes. The audience were interested to hear that although fewer men engage in weight loss programmes, when men sign up to a programme they do better in terms of weight loss than women, tend to stay longer, attend consistently and once they attend one session they are just as likely to attend for a second week.
This suggests that men are not put off by their experiences of programmes but are put off joining programmes. Slimming World has found that the use of male consultants can be motivating to men and that men are more motivated when they have the support of family members.
An interactive discussion with the audience invited delegates to consider their selves as a 7-10 year old child and share their views of men. Delegates finished phrases such as ‘men always...’ and ‘man flu is...’ suggesting themes of men being ‘strong’ and not showing emotion, as well as suggesting that man flu was for attention.
In his summing up, Graham highlighted that this combination of men needing to be strong and not show weakness but being told they are overreacting when they show signs of illness, reiterates why it is so hard to engage men and help them take their health seriously. In order to engage men in taking control of their health we must continue to break down stereotypes surrounding masculinity and make services more man-friendly.
Post-event feedback from delegates showed the event had been well received and informative. Delegates have since suggested themes for future events - if you would also like to make any suggestions please email Joely Campbell.