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The invisible man:
A&E, primary care and health
literacy
Manchester2016
Ian Banks
EMHF
RSPH
Ulster University
Queens University
Leeds University
Men’s usage of the health service
Source: General Household Survey, Office for National Statistics, 1988,1989
0 5 10 15 20 25
16-24
25-34
35-44
45-54
55-64
65-74
75+
All
ages
All
ages
0510152025
16-24
25-34
35-44
45-54
55-64
65-74
75+
Consultations with GP In-patient use
Men Women
Life expectancy for men and women
2001, by country
68.0
70.0
72.0
74.0
76.0
78.0
80.0
82.0
84.0
Sweden
Switzerland
ItalyNorway
United
Kingdom
Netherlands
SpainFranceAustriaGreece
Luxem
bourgFinlandGerm
anyBelgiumDenm
arkPortugalIreland
Years
Men
Women
Source of data:Statistics in Focus Theme 3 17/2002
Difference (%) between men and women
in cancer survival across Europe
0
2
4
6
8
10
12
14
16
18
Slovenia
M
alta
C
zech
R
epublic
The
N
etherlands
ItalyPoland
Spain
E
UR
O
C
AR
E-4
m
ean
N
orthern
Ireland
G
erm
anyBelgiumEngland
Scotland
Sw
itzerlandW
alesFinlandN
orw
ayIcelandIrelandAustriaSw
eden
%
Verdecchia et al (2007) Eurocare 4
Melanoma incidence rate
0
2
4
6
8
10
12
14
16
18
Norway
Sweden
Denm
ark
The
Netherlands
SwitzerlandAustriaIrelandFinlandFrance
G
erm
any
United
KingdomBelgium
Luxem
bourg
ItalySpain
Portugal
G
reece
Men
Women
Melanoma mortality rate
0
0.5
1
1.5
2
2.5
3
3.5
Norway
Sweden
Denm
arkAustriaFinland
The
Netherlands
Switzerland
United
Kingdom
G
erm
any
Luxem
bourg
ItalyIrelandFrance
BelgiumSpain
Portugal
G
reece
Men
Women
Deaths from all causes in all adults under 75, by sex, England, Wales,
Scotland, Northern Ireland and United Kingdom 2010
Key Issues in
Men’s Health
Number of avoidable deaths*:
England and Wales, 2010
Male Female Total
71,042 46,095 117,137
61% 39% 100%
*Deaths considered avoidable in the presence of timely and
effective healthcare or public health interventions
- Office for National Statistics
Suicide, men and women
Male
0
20
40
60
80
100
120
140
15 to 24 25 to 34 35 to 44
Rateper100,000
Lithuania 02
Estonia 02
Latvia 02
Hungary 02
Finland 02
Belgium 97
Slovenia 02
New Zealand (00)
Poland 02
Australia (01)
Austria 02
France 00
Japan 02
Chile
Canada 00
Romania 02
Norw ay (01)
Slovakia 00
Czech Rep
Denmark 99
USA 00
Thailand (00)
Germany 01
Sw eden 01
Hong Kong 00
UK 02
Argentina (01)
Portugal (02)
Netherlands 03
Israel 99
Spain 01
Italy 01
Brazil (00)
Greece 01
Armenia (02)
Egypt 00
Adapted from White & Holmes (2006)
Female
0
20
40
60
80
100
120
140
15 to 24 25 to 34 35 to 44
Rateper100,000
Belgium 97
Finland 02
Lithuania 02
Japan 02
Hong Kong 00
Hungary 02
Latvia 02
France 00
Norw ay (01)
Australia (01)
Slovenia 02
New Zealand (00)
Austria
Canada 00
Estonia 02
Sw eden 01
Denmark 99
Thailand (00)
Czech Rep 02
Chile (01)
Ireland 01
Netherlands 03
USA 00
Germany 01
Argentina (01)
Poland 02
Slovakia 00
Romania 02
UK 02
Portugal 02
Spain 01
Italy 01
Brazil (00)
Israel 99
Greece 01
Armenia (02)
Egypt 00
Death rates for Homicide men and women
Female
0
10
20
30
40
50
60
70
80
90
100
15 to 24 25 to 34 35 to 44
Rateper100,000
Brazil (00)
Latvia 02
Estonia 02
USA 00
Lithuania 02
Argentina (01)
Thailand (00)
Hungary 02
Belgium 97
Romania 02
Denmark 99
Finland 02
Portugal 02
Australia (01)
Slovenia 02
Chile (01)
Netherlands 03
Austria
Czech Rep 02
Norw ay (01)
Armenia (02)
New Zealand (00)
Canada 00
Poland 02
Hong Kong 00
Israel 99
Slovakia 00
Sw eden 01
UK 02
France 00
Germany 01
Spain 01
Italy 01
Ireland 01
Japan 02
Greece 01
Egypt 00
Male
0
10
20
30
40
50
60
70
80
90
100
15 to 24 25 to 34 35 to 44
Rateper100,000
Brazil (00)
Japan 02
Estonia 02
Romania 02
USA 00
Argentina (01)
Latvia 02
Chile
Lithuania 02
Hong Kong 00
Thailand (00)
Israel 99
Armenia (02)
Finland 02
Slovakia 00
Portugal (02)
Canada 00
Hungary 02
Belgium 97
Australia (01)
New Zealand (00)
Poland 02
Slovenia 02
Italy 01
Spain 01
Czech Rep 02
Netherlands 03
UK 02
Denmark 99
Greece 01
Norw ay (01)
Sw eden 01
France 00
Germany 01
Austria 02
Egypt 00
Adapted from White & Holmes (2006)
Accidents, men and women
Male
0
50
100
150
200
250
15 to 24 25 to 34 35 to 44
Rateper100,000
Estonia 02
Latvia 02
Lithuania 02
Thailand (00)
Greece 01
Romania 02
Brazil (00)
Portugal (02)
Poland 02
Slovakia 00
Chile
USA 00
Hungary 02
Czech Rep
Slovenia 02
Spain 01
Belgium 97
Finland 02
France 00
Argentina (01)
New Zealand (00)
Italy 01
Australia (01)
Denmark 99
Austria 02
Canada 00
Armenia (02)
Norw ay (01)
Germany 01
Sw eden 01
Egypt 00
Israel 99
UK 02
Japan 02
Netherlands 03
Hong Kong 00
Adapted from White & Holmes (2006)
Female
0
50
100
150
200
250
15 to 24 25 to 34 35 to 44
Rateper100,000
Latvia 02
Estonia 02
Lithuania 02
USA 00
Thailand (00)
Romania 02
Greece 01
Czech Rep 02
Belgium 97
New Zealand (00)
France 00
Hungary 02
Poland 02
Slovakia 00
Canada 00
Finland 02
Denmark 99
Argentina (01)
Brazil (00)
Australia (01)
Portugal 02
Spain 01
Austria
Ireland 01
Italy 01
Slovenia 02
Chile (01)
Germany 01
Norw ay (01)
Israel 99
Sw eden 01
UK 02
Armenia (02)
Egypt 00
Japan 02
Netherlands 03
Hong Kong 00
Circulatory System, men and women
Male
0
20
40
60
80
100
120
140
160
180
15 to 24 25 to 34 35 to 44
Rateper100,000
Latvia 02
Egypt 00
Estonia 02
Romania 02
Lithuania 02
Hungary 02
Armenia (02)
Poland 02
Thailand (00)
Brazil (00)
Slovakia 00
Argentina (01)
Greece 01
USA 00
Portugal (02)
Czech Rep
New Zealand (00)
Slovenia 02
Denmark 99
Belgium 97
Finland 02
Japan 02
UK 02
Germany 01
Italy 01
Austria 02
Spain 01
Netherlands 03
Chile
France 00
Australia (01)
Canada 00
Israel 99
Norw ay (01)
Sw eden 01
Hong Kong 00
Female
0
20
40
60
80
100
120
140
160
180
15 to 24 25 to 34 35 to 44
Rateper100,000
Egypt 00
Brazil (00)
Latvia 02
Hungary 02
Romania 02
Estonia 02
Argentina (01)
Thailand (00)
USA 00
Lithuania 02
Poland 02
Armenia (02)
Slovakia 00
Netherlands 03
New Zealand (00)
Portugal 02
Belgium 97
Finland 02
Greece 01
Chile (01)
UK 02
Denmark 99
Germany 01
Czech Rep 02
Slovenia 02
Austria
Australia (01)
Japan 02
Italy 01
France 00
Spain 01
Canada 00
Norw ay (01)
Israel 99
Sw eden 01
Hong Kong 00
Adapted from White & Holmes (2006)
Life expectancy at birth by social class
and sex England and Wales, 2002-5
Social class Males Females % difference
1 80.0 85.1 6.4
2 79.4 83.2 4.8
3N 78.4 82.4 5.1
3M 76.5 80.5 5.2
4 75.7 79.9 5.5
5 72.7 78.1 7.4
Gender and social class
Key Issues in Men’s Health
Men less likely than
women to:
• See a GP
• Attend for a Health Check
• Opt for bowel cancer screening
• Visit a pharmacy
• Have a dental check-up
Key Issues in
Men’s Health
Key Issues in
Men’s Health
MEN’S USE OF SERVICES
WHY DO MEN TAKE RISKS
• It’s the male role
• Conceal fragility and vulnerability
• Project strength and invulnerability
• Don’t believe the evidence or are simply
less aware of it
• See self-care as a ‘women’s issue’
)
Men’s symptom awareness
Can’t Read?
Phone this number: 0878 561339
North Sea Helicopter Crash 'Was Preventable'
Families of the 16 men who died call for the Lord Advocate to look again at
the evidence and reconsider a criminal prosecution.
22:54, UK, Thursday 13 March 2014

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Men's health issues explored in depth

  • 1. The invisible man: A&E, primary care and health literacy Manchester2016 Ian Banks EMHF RSPH Ulster University Queens University Leeds University
  • 2.
  • 3. Men’s usage of the health service Source: General Household Survey, Office for National Statistics, 1988,1989 0 5 10 15 20 25 16-24 25-34 35-44 45-54 55-64 65-74 75+ All ages All ages 0510152025 16-24 25-34 35-44 45-54 55-64 65-74 75+ Consultations with GP In-patient use Men Women
  • 4.
  • 5. Life expectancy for men and women 2001, by country 68.0 70.0 72.0 74.0 76.0 78.0 80.0 82.0 84.0 Sweden Switzerland ItalyNorway United Kingdom Netherlands SpainFranceAustriaGreece Luxem bourgFinlandGerm anyBelgiumDenm arkPortugalIreland Years Men Women Source of data:Statistics in Focus Theme 3 17/2002
  • 6. Difference (%) between men and women in cancer survival across Europe 0 2 4 6 8 10 12 14 16 18 Slovenia M alta C zech R epublic The N etherlands ItalyPoland Spain E UR O C AR E-4 m ean N orthern Ireland G erm anyBelgiumEngland Scotland Sw itzerlandW alesFinlandN orw ayIcelandIrelandAustriaSw eden % Verdecchia et al (2007) Eurocare 4
  • 9. Deaths from all causes in all adults under 75, by sex, England, Wales, Scotland, Northern Ireland and United Kingdom 2010
  • 10. Key Issues in Men’s Health Number of avoidable deaths*: England and Wales, 2010 Male Female Total 71,042 46,095 117,137 61% 39% 100% *Deaths considered avoidable in the presence of timely and effective healthcare or public health interventions - Office for National Statistics
  • 11. Suicide, men and women Male 0 20 40 60 80 100 120 140 15 to 24 25 to 34 35 to 44 Rateper100,000 Lithuania 02 Estonia 02 Latvia 02 Hungary 02 Finland 02 Belgium 97 Slovenia 02 New Zealand (00) Poland 02 Australia (01) Austria 02 France 00 Japan 02 Chile Canada 00 Romania 02 Norw ay (01) Slovakia 00 Czech Rep Denmark 99 USA 00 Thailand (00) Germany 01 Sw eden 01 Hong Kong 00 UK 02 Argentina (01) Portugal (02) Netherlands 03 Israel 99 Spain 01 Italy 01 Brazil (00) Greece 01 Armenia (02) Egypt 00 Adapted from White & Holmes (2006) Female 0 20 40 60 80 100 120 140 15 to 24 25 to 34 35 to 44 Rateper100,000 Belgium 97 Finland 02 Lithuania 02 Japan 02 Hong Kong 00 Hungary 02 Latvia 02 France 00 Norw ay (01) Australia (01) Slovenia 02 New Zealand (00) Austria Canada 00 Estonia 02 Sw eden 01 Denmark 99 Thailand (00) Czech Rep 02 Chile (01) Ireland 01 Netherlands 03 USA 00 Germany 01 Argentina (01) Poland 02 Slovakia 00 Romania 02 UK 02 Portugal 02 Spain 01 Italy 01 Brazil (00) Israel 99 Greece 01 Armenia (02) Egypt 00
  • 12. Death rates for Homicide men and women Female 0 10 20 30 40 50 60 70 80 90 100 15 to 24 25 to 34 35 to 44 Rateper100,000 Brazil (00) Latvia 02 Estonia 02 USA 00 Lithuania 02 Argentina (01) Thailand (00) Hungary 02 Belgium 97 Romania 02 Denmark 99 Finland 02 Portugal 02 Australia (01) Slovenia 02 Chile (01) Netherlands 03 Austria Czech Rep 02 Norw ay (01) Armenia (02) New Zealand (00) Canada 00 Poland 02 Hong Kong 00 Israel 99 Slovakia 00 Sw eden 01 UK 02 France 00 Germany 01 Spain 01 Italy 01 Ireland 01 Japan 02 Greece 01 Egypt 00 Male 0 10 20 30 40 50 60 70 80 90 100 15 to 24 25 to 34 35 to 44 Rateper100,000 Brazil (00) Japan 02 Estonia 02 Romania 02 USA 00 Argentina (01) Latvia 02 Chile Lithuania 02 Hong Kong 00 Thailand (00) Israel 99 Armenia (02) Finland 02 Slovakia 00 Portugal (02) Canada 00 Hungary 02 Belgium 97 Australia (01) New Zealand (00) Poland 02 Slovenia 02 Italy 01 Spain 01 Czech Rep 02 Netherlands 03 UK 02 Denmark 99 Greece 01 Norw ay (01) Sw eden 01 France 00 Germany 01 Austria 02 Egypt 00 Adapted from White & Holmes (2006)
  • 13. Accidents, men and women Male 0 50 100 150 200 250 15 to 24 25 to 34 35 to 44 Rateper100,000 Estonia 02 Latvia 02 Lithuania 02 Thailand (00) Greece 01 Romania 02 Brazil (00) Portugal (02) Poland 02 Slovakia 00 Chile USA 00 Hungary 02 Czech Rep Slovenia 02 Spain 01 Belgium 97 Finland 02 France 00 Argentina (01) New Zealand (00) Italy 01 Australia (01) Denmark 99 Austria 02 Canada 00 Armenia (02) Norw ay (01) Germany 01 Sw eden 01 Egypt 00 Israel 99 UK 02 Japan 02 Netherlands 03 Hong Kong 00 Adapted from White & Holmes (2006) Female 0 50 100 150 200 250 15 to 24 25 to 34 35 to 44 Rateper100,000 Latvia 02 Estonia 02 Lithuania 02 USA 00 Thailand (00) Romania 02 Greece 01 Czech Rep 02 Belgium 97 New Zealand (00) France 00 Hungary 02 Poland 02 Slovakia 00 Canada 00 Finland 02 Denmark 99 Argentina (01) Brazil (00) Australia (01) Portugal 02 Spain 01 Austria Ireland 01 Italy 01 Slovenia 02 Chile (01) Germany 01 Norw ay (01) Israel 99 Sw eden 01 UK 02 Armenia (02) Egypt 00 Japan 02 Netherlands 03 Hong Kong 00
  • 14. Circulatory System, men and women Male 0 20 40 60 80 100 120 140 160 180 15 to 24 25 to 34 35 to 44 Rateper100,000 Latvia 02 Egypt 00 Estonia 02 Romania 02 Lithuania 02 Hungary 02 Armenia (02) Poland 02 Thailand (00) Brazil (00) Slovakia 00 Argentina (01) Greece 01 USA 00 Portugal (02) Czech Rep New Zealand (00) Slovenia 02 Denmark 99 Belgium 97 Finland 02 Japan 02 UK 02 Germany 01 Italy 01 Austria 02 Spain 01 Netherlands 03 Chile France 00 Australia (01) Canada 00 Israel 99 Norw ay (01) Sw eden 01 Hong Kong 00 Female 0 20 40 60 80 100 120 140 160 180 15 to 24 25 to 34 35 to 44 Rateper100,000 Egypt 00 Brazil (00) Latvia 02 Hungary 02 Romania 02 Estonia 02 Argentina (01) Thailand (00) USA 00 Lithuania 02 Poland 02 Armenia (02) Slovakia 00 Netherlands 03 New Zealand (00) Portugal 02 Belgium 97 Finland 02 Greece 01 Chile (01) UK 02 Denmark 99 Germany 01 Czech Rep 02 Slovenia 02 Austria Australia (01) Japan 02 Italy 01 France 00 Spain 01 Canada 00 Norw ay (01) Israel 99 Sw eden 01 Hong Kong 00 Adapted from White & Holmes (2006)
  • 15. Life expectancy at birth by social class and sex England and Wales, 2002-5 Social class Males Females % difference 1 80.0 85.1 6.4 2 79.4 83.2 4.8 3N 78.4 82.4 5.1 3M 76.5 80.5 5.2 4 75.7 79.9 5.5 5 72.7 78.1 7.4
  • 17.
  • 18. Key Issues in Men’s Health Men less likely than women to: • See a GP • Attend for a Health Check • Opt for bowel cancer screening • Visit a pharmacy • Have a dental check-up
  • 20. Key Issues in Men’s Health MEN’S USE OF SERVICES
  • 21.
  • 22. WHY DO MEN TAKE RISKS • It’s the male role • Conceal fragility and vulnerability • Project strength and invulnerability • Don’t believe the evidence or are simply less aware of it • See self-care as a ‘women’s issue’ )
  • 23.
  • 24.
  • 26.
  • 27. Can’t Read? Phone this number: 0878 561339
  • 28.
  • 29.
  • 30. North Sea Helicopter Crash 'Was Preventable' Families of the 16 men who died call for the Lord Advocate to look again at the evidence and reconsider a criminal prosecution. 22:54, UK, Thursday 13 March 2014

Editor's Notes

  1. And of course men don’t go to the doctor until it’s too late … in the case of this guy, far too late. There are elements of truth in all these stereotypes of course but my point for now is that we need to understand that men aren’t biologically programmed to be feckless and reckless and to self-destruct. But, as males, they have been brought up to behave in a particular way, which I’ll detail in a moment. What I think we need to do is understand men better and design services that take account of their socialisation and the attitudes and behaviours that are linked to that.
  2. And of course men don’t go to the doctor until it’s too late … in the case of this guy, far too late. There are elements of truth in all these stereotypes of course but my point for now is that we need to understand that men aren’t biologically programmed to be feckless and reckless and to self-destruct. But, as males, they have been brought up to behave in a particular way, which I’ll detail in a moment. What I think we need to do is understand men better and design services that take account of their socialisation and the attitudes and behaviours that are linked to that.