Movember Puts Spotlight on Men's Health

Over 50,000 men between the ages of 15 and 64 die each year in the UK. They're dying too young, many from diseases we should be able to prevent. In the UK, the death rate for men between 15 and 44 years old is nearly double that of women.

November is the month when over a million men swap their clean-shaven look for a moustache to show their support for Movember - a charity raising funds and awareness for prostate and testicular cancer and men's mental health.

I wonder, though, if people know this shocking fact: over 50,000 men between the ages of 15 and 64 die each year in the UK. They're dying too young, many from diseases we should be able to prevent.

In the UK, the death rate for men between 15 and 44 years old is nearly double that of women. Across all ages and across nearly all diseases, men's health is more vulnerable than women's, according to research by Professor Alan White and colleagues.

If you look at cancers that should affect men and women equally - those that aren't linked to their sex as prostate cancer is - or if you look at heart disease, liver disease, deaths from accidents and suicide or deaths from major infections: men's health is not as good as it could be and not as good as women's, though men often believe their health is better.

An even wider gap separates the health of men at opposite ends of the deprivation spectrum. What we are learning is that men seem to be particularly sensitive to the complex set of factors - economic, social, cultural - that influences everyone's health. In the UK, the average life expectancy for men is around 79 years. That's a great achievement, but in some more deprived areas, it's only about 73 - a gap in health status that is extremely difficult to reduce. Public Health England has data that gives you a sense of how this is evolving.

How can we be sure these health gaps are not just the inevitable result of how men are hard-wired? Why are we confident we could do something about it? Part of the answer lies in the differences we see across Europe. These are an important clue that some countries do a better job than others of nurturing and protecting men's health.

If men's health is not as good as it could be, it's partly down to two big issues. The first is men's greater propensity to make riskier lifestyle choices compared with women, ranging from smoking and excess drinking to illicit drug use. Among the broad generalisations, though, there are some successes worth celebrating: for instance smoking levels are falling across most of Europe.

The second big issue is that men use primary health care services less than women, many of whom will visit GPs at key milestones such as pregnancy. This seems especially the case for preventive health checks, counselling and weight loss services - worrying given some estimates that by 2030, between 41% and 48% of men in the UK will be obese.

What's behind these differences? We need to understand them better, but many point to the web of social and economic circumstances that shape individual behaviours. Some suggest cultural norms are highly relevant: heavy drinking as a "rite of passage" for young men, for instance. On a more pragmatic note, some believe men might use health services more if they could get to them at convenient times.

An agenda for men's health is gaining momentum, building on the work of the Men's Health Forum. There's a landmark report into men's health in Europe and there are new ideas for how to involve men in their health - though more research and evaluation of what works is needed. For example, the English Premier League Health initiative used sport as the hook to work with young men on general health and wellbeing.

But clearly, there's a long way still to go. That's why Public Health England runs population-wide campaigns, such as Stoptober, Change4Life and Be Clear On Cancer. These target the major risk factors (smoking and diet for instance) that drive the leading diseases (cardiovascular, some cancers, respiratory, diabetes). These campaigns seem to resonate well with men. For example, during the bowel cancer campaign, there was a 37% jump in men going to their GP with relevant symptoms, according to a review of 355 practices. That compared with 22% for women.

Another of Public Health England's priorities, NHS Health Check, is a population-wide preventive programme for 15 million men and women between the ages of 40 and 74. Its aim is to help them to understand better what their risk factors are - by measuring things like weight, blood glucose, cholesterol and blood pressure, and talking about risk behaviours - and what they can do if they need help - support for quitting smoking or weight management, for instance.

Meanwhile, cancer screening, which has historically targeted women, now includes men through the bowel cancer screening programme. And although there are no systematic screening programmes for either prostate or testicular cancer in England, the scientific evidence to inform the need for more intensive approaches is constantly being updated and reviewed by Public Health England scientists. In the meantime, campaigns such as Movember play a huge part in helping to raise awareness, promote earlier testing and diagnosis, resulting in improved survival rates.

Finally, the workplace provides another good opportunity to reach and engage with men. A growing number of businesses now recognise that employee health and wellbeing are linked to reduced absenteeism and improved productivity. Public Health England has identified workplace wellbeing as a key strategic priority, and is now working with a range of government, business and community organisations to identify the best approaches to promote and deliver better workplace health programmes. Companies can show their commitment to employee health and wellbeing by signing up to the Government's Public Health Responsibility Deal pledges on Work and Health, as Public Health England did last month.

The ambition is to change how men think about their health: by making them more aware of how they can stay healthy and giving them the information and the support to do so, when and how it suits them. By taking responsibility for staying healthy, these men will become role models for the next generation of young adults. It's a fundamental issue of equity that men should not be dying before old age, of diseases that are preventable. It's time for men's health to be as good as men think it is.

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