Men in the UK are generally reluctant users of traditional primary care services – especially general practitioners (GPs) and pharmacies – and health professionals believe this contributes to delayed diagnosis of their health problems and worse outcomes than for women, Members of Parliament have been told.
There are many areas of health where women are disadvantaged, but it is men who in general suffer the worst outcomes; for example, they are almost twice as likely to develop and die from the 10 most common cancers that affect both sexes, Peter Baker, chief executive of the Men’s Health Forum, has told the House of Commons Health Select Committee’s inquiry into health inequalities.
Male life expectancy is considerably lower than female in the UK; a baby boy born in Kensington and Chelsea, London, has the longest life expectancy, at 83.1 years, while Glasgow has the lowest at just 70.5 years. Life expectancy for women is also highest and lowest in Kensington and Chelsea and Glasgow, at 87.2 and 77 years respectively.
One of the most significant causes of poor male health is the behaviour of men and boys; many have unhealthy diets, unsafe levels of sun exposure, drink more than they should, drive dangerously and delay seeking help with health problems. However, while men are currently far from “fully engaged” in their own health, health services are equally far from “fully engaged” with men, says the Forum.
A key area where the National Health Service (NHS) could make a difference is by improving male access to health services, the group suggests. GP opening hours is one key issue, but more importantly, action needs to be taken to increase men’s knowledge of the range of available health services and how to use them. The services themselves also need to do more to present themselves as attractive and relevant to men, and there is increasing evidence that outreach services located in “male-friendly” venues – sports stadia, workplaces, working men’s clubs, even pubs – can be effective.
Health services have, to date, overwhelmingly failed to address gender inequalities in health, and there is also evidence that public health interventions may actually worsen the problem because women are more likely to take them up. Socially disadvantaged men are particularly unlikely not to make use of them, the panel heard.
There are still areas in which health service organisation directly discriminates against people on the grounds of age, added Margit Physant, health policy adviser at Age Concern. For example, mental health services continue to be planned and provided separately for “adults of working age” and for “older people,” the consequence being that some services are not accessible to older people and patients can be required to leave a service on reaching the age of 65. For example, in spite of evidence from the National Institute for Health and Clinical Excellence (NICE) that psychological therapies provide benefits at any age, the programme to improve access to these treatments has focused on “adults of working age,” she pointed out.
In addition, breast and bowel cancer screening programmes are still not extended upwards to the maximum ages at which people can achieve health gains, and NHS services which are important to maintaining health and independence, such as chiropody, are being scaled back.
The group is also concerned that the growing emphasis on patient choice, self-management of long-term conditions and electronic access to health care information place those who are less health-literate at a disadvantage. There is a danger that those in greatest need will have least access to support, warns Age Concern, which is calling for additional methods of health communication to be made available to people who cannot use mainstream sources of information.
