Paul Laffin: Is men’s health the forgotten inequality?

The discussion of health inequalities can sometimes appear ubiquitous at local, national, or European level. We all know the massive impact that socio-economic factors can have on a person’s health and that someone’s ethnicity can also play a significant role in determining health outcomes. But, by focusing on such contributory factors, are we ignoring the bull elephant in the room?

Although men’s overall life expectancy in Europe as a whole is increasing, life expectancy is 7.5 years lower for men (72.5) than for women (80) across Europe, a difference ranging from 11.3 years in Latvia to 3.3 years in Iceland.

These figures also disguise significant variation within countries, where such differences are closely related to socio-economic status. Northern Irish men, for example, have a life expectancy of 77 years in comparison to the UK average of 78.1years.

The factors causing such discrepancies are not surprising—poor lifestyles and the infrequent use of or late presentation to health services—to name but two. These differences are replicated across Europe with both regional and intra-regional variations.

The European Commission (EC) belatedly recognised the significance of this major health issue in 2011 with the publication of its report The State of Men’s Health in Europe.

It recognises the impact that “men’s health” issues have on society as a whole and that there is a growing consensus as to what constitutes such issues. The role of anti-smoking legislation in reducing tobacco related conditions was cited as an example of how legislation can lead to major health improvements.

However, the report also noted that “the policy documents explored through this report were notable in their lack of comment on the male specific issues” and that “although individual countries have developed health policies and strategies aimed at improving their population’s health a ‘one size fits all’ approach is evident.”

The Republic of Ireland is the one country to buck the trend with the development of a National Men’s Health Policy 2008-2013.

The EC also noted that “there appeared to be few initiatives that were directly focused onto the needs of men, either in a form that men would use or in places that men would more easily access” and that “where a male focused approach has been adopted there have been marked improvements in up-take and success of health initiatives.”

BMA Northern Ireland’s 2011 report Improving Men’s Health in Northern Ireland—the only European medical organisation to have such a policy—supports these arguments and recommends action in three distinct areas:

  • Increased research to develop a men’s health policy
  • Improved services in a supportive environment
  • Promoting individual responsibility

The European Men’s Health Forum met in Brussels during Men’s Health Week 2013 to debate how the EU can support men’s access to, and outcomes from, primary healthcare services. It was the first meeting on men’s health to bring together all the primary care professions, including general practice, nursing, pharmacy, optometry, and occupational health.

The recommendations—which include EU financial support for the pan-European exchange of best practice between primary care providers—will be published in a report and presented to the European Health Forum in Gastein, in October 2013.

This is just the beginning as recognition of the issue grows and the crucial role of public policy in improving men’s health at national and European level becomes increasingly apparent.

Paul Laffin is the EU Policy Manager, BMA.