Action needed to improve men's health in Europe

Policies aimed specifically at men are urgently needed to improve the health of Europe's men, say experts on bmj.com today.

Action is needed throughout the life course and in every setting say Professor Alan White at Leeds Metropolitan University and colleagues whose recent report, The State of Men's Health in Europe, shows marked differences in health outcomes between men, which are strongly related to their biology, culture, and socioeconomic realities.

Right across Europe working age men have significantly higher mortality rates than working age women, particularly in Eastern Europe, which means too many avoidable premature deaths, with a heavy toll on families, communities and economies. However, the Report's most significant and pressing finding is the marked differences in health outcomes between men in different social classes living in the same country, largely influenced by social determinants such as education and employment. In every country, men in the lowest socio-economic groups have the poorest health of all.

The authors argue that public health tends to be dominated by negative portrayals of men and masculinity, where men are blamed for not attending health services and for taking risks with their health. 'This is not helpful,' they say. 'We should use strategies that work with men in a constructive way.'

So, what can be done to improve men's health in Europe?

They believe there is 'a need for a visible, integrated focus on boys' and men's health within primary and secondary school curriculums that can foster positive models of physical, psychological, and social development, ' and give boys the skills to make healthier decisions throughout their lives.

For business, collaboration between employers and unions is needed 'to promote men's health in the workplace' while policies that target marginalised groups of men are also important areas for action, they say.

There are still many barriers to men using health care, but providing services that engage men more effectively can work, they add. For example, initiatives that bring health services to men in settings such as pubs, sports clubs, schools, and youth centres have proved popular in reaching men in need.

And in terms of research, more work is needed into how different views of masculinity influence healthy and unhealthy behaviours.

They conclude: 'In policy, practice, and research there is a pressing need to examine the 'problems' with men's health and to tackle the underlying causes as well as the symptoms. This demands appropriate intersectoral and intergovernmental responses at both EU and national level.'

In an accompanying editorial, Gregory Malcher a general practitioner in Australia points out that only Ireland has a national men's health policy. 'It seems that in much of the EU men's health has not yet sufficiently entered the political, or medical, consciousness to yield meaningful changes in service delivery,' he writes.

He believes that men's health in Europe has far to go, but says this report 'represents a springboard to an exciting future.'