Women and children first - Is men's health losing out to women's health?

Women are getting their health needs met while men are being left behind, says a controversial new book analyzing men's health. The author believes it's time men fought back. But is it really this simple? malehealth.co.uk asked a female health writer to investigate.

Men die too early from heart disease and cancer while health services haven't developed to meet their needs. Women wouldn't put up with it - so why should men?

It's time for men to fight their corner, argues Colin Francome, Professor of Medical Sociology at Middlesex University and author of a recently-published and provocative book appropriately called 'Improving Men's Health'.

He says women have taken more than their fair share of health resources - which has resulted in long-established well women clinics and breast and cervical cancer screening as part of mainstream health services in the UK. Even weight-loss clinics are aimed at women, even though three in five men are overweight. All this adds up to a raw deal for men. 'Middle-class women have been fighting for these changes and it's working class men who have suffered the most,' he says.

'Since the 60s when the Pill was introduced, the feminist movement has been very strong and a lot of things have gone their way,' he says. 'Many men have not adapted to the new world. A lot have found it difficult to adjust to women going out to work and threatening their bread-winner role. Comparatively they feel less adequate than women.'

This inadequacy, he believes, explains why in Britain young boys are increasingly failing at school, why men are four times more likely to take their own lives and why they are not adequately looking after their health. And because they are slower to go to their doctors, services are not so geared towards men as women - they are under-resourced and often 'male-unfriendly'.

Professor Francome says statistics make the point. Women contracting cancer in the five years to 1990 had a survival rate of 62 per cent compared to just 51 per cent for men. And he points out that in the same period, men showed a 68 per cent survival rate for diagnosed malignant melanoma. In women, the survival rate was 82 per cent. For tongue cancer, it was 50 per cent for women and only 36 per cent for men; for cancer of the salivary gland, it was 62 per cent for women and only 47 per cent for men.

British men with prostate cancer have been particularly badly affected. In England and Wales only 41 per cent of men survived for five years compared with 88 per cent - almost nine out of 10 - in the USA. Yet the disease has fared poorly in research grants - in 1997 it attracted just £47,000. Just compare that to breast cancer which received £4.4 million.

Professor Francome says the majority of female-specific cancers tend to affect women in their middle years whereas men tend to suffer from prostate cancer later in life. It therefore attracts less media attention - and less money.

He also partly blames the way men are brought up for their resistance to demanding better health services. 'Freud got it wrong about penis envy - it's really a case of vagina envy. Men are brought up to not to value their bodies - they are taught women are beautiful and that their bodies are ugly.' But Dr Ian Banks, a GP in Northern Ireland, and chair of the Men's Health Forum, rejects any suggestion that men and women should be competing for funds.

'There's no evidence that spending on women's health influences spending on men's health. There is an imbalance, yes, and men's health is not attracting the same attention,' he said. 'But both groups are not receiving the level of health funding that they should.'

In any case, he says women have been helping to get men's health a higher profile - public health minister Yvette Cooper for one. She has driven through a commitment to spend twenty times more money on researching prostate cancer until 2004. And the Department of Health is also considering screening men for the disease. Men have a lot to learn from women, he says. 'Far from dividing attention, we should be doing the exact same thing. We should celebrate the cause of women, and we should aim to work together.'

Jane DeVille-Almond is a practice nurse who runs health clinics for men in pubs in Walsall in the West Midlands with great success. She also believes that women and men should not be fighting each other to get their share of services; what's more important is developing services to match the particular needs of each gender.

Working class men don't feel comfortable going to see their GP, she argues. And if that means going out to find them in pubs on a Monday afternoon after they've cashed their giros, that's the service that needs investment.

'Not everyone's the same and needs the same type of services,' says Deville-Almond. 'We tend to imagine everyone will go to a clinic, but women are used to it - they go for family planning, when they're pregnant and they take the kids to the doctor's. But men don't. They just don't pop into see their GP for a chat.'

Her approach gets results. Health screening men in pubs yielded a 70 per cent identification rate of men with long-term health problems. The same exercise in a GP practice for one year, threw up just 4 per cent.Jane now hopes to take her clinics onto commuter trains - 'It's about having imagination,' she says. 'And the only barrier I face in getting things done is NHS bureaucracy.'

Trefor Lloyd, a men's health expert and director of a consultancy specializing in men's issues, says attitudes around health are now changing, albeit slowly. Gay men have led the way with sexual health/HIV awareness and younger men with a high disposable income are following, in part influenced by a new generation of men's health and fitness magazines.

'We've seen progress in some groups, but other groups, such as working-class men, will require intervention. Also we can see that at ages 15 to 16, mothers seem to stop taking responsibility for their sons health, and boys - even though they are at their most healthy - may need to be helped to access services then.' But he argues that health services have not been dictated by women. 'It's not a question of middle-class women getting things their way, it's just that women are regular users and this has created demand. Services have adapted to meet their needs.'

Improving Men's Health Colin Francome's book  is published by Middlesex University Press (£14.99)

Useful links

For more facts, figures and analysis of men's health issues, click here to visit the Men's Health Forum website. 

by Adele Waters, a freelance health writer and a qualified nurse.

Have your say about men's health

Do you think men are discriminated against when it comes to health? Do you think women are to blame? Or does the responsibility lie with men themselves for neglecting their health for too long? Whatever your views, we'd like to hear them. All contributions will be published on malehealth.co.uk.