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Promoting equity for mens health and social well being Healthy Men

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Title: Promoting equity for mens health and social well being Healthy Men


1
Promoting equity for mens health and social well
being Healthy Men?
  • Professor Alan White
  • Centre for Mens Health
  • Leeds Metropolitan University
  • Chair of the Board of Trustees
  • Mens Health Forum

2
Office for National Statistics 2004
3
Relative impact of socio-economic factors
Men
Women
Trends in life expectancy by social class 1972
2001 ONS Longitudinal Study
4
Life expectancy for men and women in Wetherby and
City Holbeck, 2004
5
Mortality rate ratio comparing manual classes to
non-manual classes for specific causes of death
in men aged 45-59, England and Wales.
6
Deaths by age group
Health Statistics Quarterly , 19, 2003
7
Median ratio between men and women for all 44
countries for rates of death from all causes by
age
White Holmes 2006
8
The ratio between men and women for death from
all causes for the UK (2002)
Calculated from World Health Organisation
Mortality Database 2005
9
Comparison of rates of death from selected causes
for men and women aged 15 - 44
Men
Women
Calculated from World Health Organisation
Mortality Database 2005
10
Comparison of total numbers of deaths between men
and women aged 15-44 years, UK (2002)
Sex specific cancers were removed from the
calculation
Calculated from World Health Organisation
Mortality Database 2005
11
Rates of cancer registrations, excluding sex
specific cancers, all ages
Cancer number of new cases 2003, by sex and age
ONS, 2005
12
Cancer deaths for selected causes in men and
women under the age of 75 years, England Wales,
2003
13
Registrations of newly diagnosed cases of
malignant neoplasm of colon rectum cancer (C18
C20), England, by age and sex, 2001.
Cancer statistics Registrations. Series MB1 no.
32. Registrations of cancer diagnosed in 2001,
England, Office for National Statistics
14
Deaths as a result of malignant neoplasm of colon
(C18) rectosigmoid junction, rectum and anus
(C19-C21) (combined), by age and sex, 2001 for
England Wales
Mortality statistics cause Review of the
Registrar General on Deaths by cause, sex and
age in England Wales 2001
15
Overweight and Obesity in men
  • In 1998 ? of men and ½ of women were either
    overweight or obese
  • By 2010, ¾ of men in the UK will be overweight
    and a ¼ obese.
  • Its estimated that 14,000 male deaths a year are
    directly attributable to obesity.
  • 30,000 working life years lost
  • (National Audit Office 2001)

16
Problems of weight gain
  • Men tend to get intra abdominal visceral fat
    leading to increased risk of
  • Hypertension,
  • Hyperlipidaemia,
  • Diabetes
  • Fat related cancers prostate, testis, bowel,
    liver, kidney, oesophagus, and stomach.
  • Erectile dysfunction

17
Erectile Dysfunction Cardio vascular disease
  • 57 of men with by-pass surgery had previous ED
  • 64 men hospitalised for MI had ED
  • Severe ED 16 risk of undiagnosed CHD
  • Hyper lipidaemia found in 70 of men with ED
  • Erectile Dysfunction is a sentinel alarm
  • Schulman 2002

18
Abdominal Aortic Aneurysm
  • 6,000 deaths a year in men
  • usually symptomless until they burst. If it
    bursts, only 20 survive
  • four times as common in men as in women
  • test for an aortic aneurysm is a simple
    ultrasound scan (10 an hour is possible)
  • repair of the aorta 94 per cent success rate
  • Stoate 2005

19
Mean annual consultation rates for psychiatric
disorders per 1,000 person years at risk, by age
Shah, R McNiece, R Majeed, A (2001)
Socio-demographic differences in general practice
consultation rates for psychiatric disorders
among patients aged 1664 Health Statistics
Quarterly Autumn pp5-10
20
Mean annual consultation rates for psychiatric
disorders per 1,000 person years at risk, by age
Shah, R McNiece, R Majeed, A (2001)
21
Mean annual consultation rates for psychiatric
disorders per 1,000 person years at risk, by age
Shah, R McNiece, R Majeed, A (2001)
22
Mean annual consultation rates per 1,000 men
years at risk for specified psychiatric disorders
Shah, R McNiece, R Majeed, A (2001)
23
Mean annual consultation rates per 1,000 men
years at risk for specified psychiatric disorders
Shah, R McNiece, R Majeed, A (2001)
24
Mens mental wellbeing?
  • 75 of people who kill themselves are men.
  • 73 of adults who go missing are men.
  • 90 of rough sleepers are men.
  • One man in eight is dependent on alcohol
  • Men are three times more likely than women to
    become alcohol dependent
  • Men are more than twice as likely to use Class A
    drugs.
  • Stress is now the principal cause of disability
    from work

MHF 2006
25
  • 78 of drug-related deaths occur in men.
  • Men make up 94 of the prison population
  • 72 of male prisoners suffer from two or more
    mental disorders
  • 46 of male psychiatric inpatients are detained
    and treated compulsorily.
  • 84 of children excluded from school are boys.
  • Boys are five times more likely to be diagnosed
    with ADHD
  • Poorer levels of education in many more boys than
    girls

MHF 2006
26
Death rates for Suicide, for men and women
White Holmes (2006) Calculated from WHOSIS 2005
Mortality database
27
Comparison of deaths due to transport accidents
and suicide between men and women, United
Kingdom, 2002
Transport accidents
Suicide
Calculated from WHOSIS 2005 Mortality database
28
Years of Life Lost due to deaths under 75 years
of age for selected causes, 2003
Mortality statistics general Review of the
Registrar General on deaths in England and
Wales, 2003
29
Mens usage of the health service, Great
Britain, 2003
Source Office for National Statistics UK
30
GP Consultations per year by age socio-economic
status - for men
http//www.statistics.gov.uk/STATBASE/ssdataset.as
p?vlnk5435
31
GP Consultations per year by age socio-economic
status - for women
http//www.statistics.gov.uk/STATBASE/ssdataset.as
p?vlnk5435
32
Men's perceived severe lack of social support by
ethnic group and household income, 1999
1 Annual income below 6,075. 2 Annual income
from 6,075, but below 13,365. 3 Annual income
of 13,365 and over.
Health Survey for England, Department of Health
33
Percentage of older men who report poor health by
age and marital status
Davidson Arber 2003
34
  • A male health issue is one arising from
    physiological, psychological, social or
    environmental factors which have a specific
    impact on boys or men and/or where particular
    interventions are required for boys or men in
    order to achieve improvements in health and
    well-being at either the individual or the
    population level.

MHF (2004) Getting it sorted.
35
Successful activity
  • Bradford Health of Men
  • Preston mens health initiative
  • Scottish mens health programme
  • Male health website
  • Man Manual / Brain Manual

36
Conclusions
  • Men show consistently higher incidence of, and
    premature mortality from, a number of conditions
    than women. In other words the difficulties
    facing men are broader than just the male
    specific diseases.
  • There are substantial social class differences in
    male morbidity and mortality.
  • Lifestyle is implicated in the majority of health
    conditions in men.
  • Mens health is not driven solely by their biology

37
Action points
  • Intervention needs to be aimed at the Public
    Health as well as the individual level
  • Targeting the young can have significant impact
    on the burden of disease and premature death
  • New and innovative ways of working with men and
    boys need to researched and fully evaluated.
  • Education relating to the specific needs of men
    and boys needs to be part of school curricular
    and all those charged with the health and
    well-being of the 29 million men in the UK.
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