Physical activity and men’s health

Professor Alan White Centre for Men’s Health

Leeds Metropolitan University a.white@leedsbeckett.ac.uk

a.white@leedsmet.ac.uk @profalanwhite

Britain’s most active pensioner

http://www.telegraph.co.uk/men/active/11589444/How-Britains-most-active-pensioner-keeps-on-running.html

“Despite being almost 70 and having a heart condition, Philip Howells is well on the way to achieving his dream of completing 333 marathons”

The 2015 Red Rose 100

http://bit.ly/1eLDhn9

The oldest winger in town: Rugby player vows to keep on playing after scoring try on his NINETIETH birthday

http://www.dailymail.co.uk/news/article-2292779/The-oldest-winger-town-Rugby-player-vows-playing-scoring-try-NINETIETH-birthday.html#ixzz3byr4YHbi

Leeds Let’s Get Active

https://betterlivesleeds.wordpress.com/2014/04/17/you-are-an-amazing-example-to-older-people/

Any Sport (includes light intensity), Grouped sessions of any intensity, any duration by age

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Active People Dataset (2011/2012) Based on an analysis of 66,280 men and 90,980 women

Gender and participation in physical activity

• Men do more minutes moderate vigorous exercise than women: Davis, M.G.; et al. (2011)Objectively Measured Physical Activity in a Diverse Sample of Older

Urban UK Adults. Med Sci Sports Exerc., 43, 647-654.

• Women do more physical activity than men: Mesters, I et al.

(2014) Socio-demographic, medical and social-cognitive correlates of physical activity behavior among older adults (45-70 years): a cross-sectional study. BMC Public Health, 14, 647

• It varies between countries: Van Tuyckom, C. et al. (2010) Gender and age

inequalities in regular sports participation: A cross-national study of 25 European countries. Journal of Sports Sciences, 28(10), 1077-1084.

Leeds population (2011) split by age and sex

40000 30000 20000 10000 0 10000 20000 30000 40000

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Males Females

Leeds Men’s Health study - ongoing

Percentage change in male and female population across Leeds between 2004 and 2013

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Leeds Men’s Health study - ongoing

Benefits of physical activity and reduced sedentary behaviour

Strong evidence of reduced rates of: • All-cause mortality • Coronary heart disease • High blood pressure • Stroke • Metabolic syndrome • Type 2 diabetes • Breast cancer • Colon cancer • Depression • Falling Strong evidence of: • Increased cardiorespiratory and muscular fitness • Healthier body mass and composition • Improved bone health • Increased functional health • Improved cognitive function

Lee IM et al.(2012). Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet, 380(9838), 219–29.

The hidden male population

• Men with poor mental health and wellbeing

• Growing number of socially isolated older men with unaddressed health and social needs that are outside the radar of current service provision

• The majority of men who are sedentary and inactive

Social isolation, loneliness and all-cause mortality in older men and women

• Both social isolation and loneliness are associated with increased mortality.

• Mortality associated with loneliness was linked to baseline physical and mental health

• Social isolation is independently associated with mortality – habitual health-risk behaviors such as smoking, inactivity, and unhealthy

diets and health-protective behaviors such as adherence to medical recommendations

– Delay in responding to acute symptoms

Steptoe A et al. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences of the United States of America, 110(15), 5797–801.

“But once parted from spouses and jobs, and especially as infirmities intrude, old men succumb more quickly than women to a host of physical and social threats, in an unintended consequence of having according responsibility for care work and social networking to the women in their lives”

King, N., & Calasanti, T. (2013). Men’s aging amidst intersecting relations of inequality. Sociology Compass, 7(9), 699–710. (P706)

Trends in suicide death rates, by age

and sex, England & Wales, 2007 - 2013

ONS Mortality statistics, Deaths registered reports (2008-2014). Available for http://www.ons.gov.uk/ons/datasets-and-tables/index.html. Last accessed October 2014.

The Journal of Men’s Studies, Vol. 12, No. 3, Spring 2004, 207-226

“Men are at increased risk of preventable heavy impact diseases that leave them more vulnerable to premature death and chronic ill-health [1,2]. Many of the difficulties men face are a consequence of living a life that has both low levels of physical activity and high levels of sedentary behaviour [3–5]. Tackling the epidemic of stasis in men is one of the most important public health priorities, with increasing good practice now becoming available to act as a catalyst for future action.”

• Physical activity – body movement that expends energy and raises the heart rate

• Inactivity – less than 30 minutes physical activity a week

• Sedentary – time spent in low-energy postures e.g. sitting or lying

• Everyday activity – cycling, walking etc.

• Active recreation – dance, recreational walking etc.

• Sport – swimming etc.

Engagement with community programmes

Women are more likely than men to take advantage of non-gender-sensitive community physical activity interventions and by attendance they typically outnumber men 2:1

Pringle A et al. (2010) Cost-effectiveness of interventions to improve moderate physical activity: A study in nine UK sites. Health Educ J 69:211–24

Participation in ‘Fit as a Fiddle’

Age UK - ‘Fit as a Fiddle’ / ‘Fit for the Future’

The evaluation noted that men were difficult to reach and engage, with less inclination to join in usual events liked by women, such as Pilates, Tai Chi or chair-based exercises.

Men preferred activities such as football, cycling, Wii games, Nordic Walking and Health Walks, and once they were established, men became very committed.

Smith N. (2013) Fit as a fiddle: Final evaluation report. Keele University

Getting older

“Forthright in their frustration over their loss of autonomy and physicality but resigned and stoic, the men’s stories reflected masculine norms of control, invulnerability, physical prowess, self-reliance and toughness. The women were dismayed by their bodies’ altered appearances and concerned about how their illnesses might affect their significant others, thereby responding to feminine norms of selflessness, sensitivity to others and nurturance.”

Clarke, L. H., & Bennett, E. (2012). “You learn to live with all the things that are wrong with you”: gender and the experience of multiple chronic conditions in later life. Ageing and Society, 33(02), 342–360.

Later life masculinities

‘The self of the past is the underpinning of the self of the present’

‘Some older men seek fewer social contacts, as they are more satisfied by a closeness involving covert intimacy that companionship and side-by-side activity provides’

Thompson, E., & Whearty, P. (2004). Older Men’s Social Participation: The Importance of Masculinity Ideology. The Journal of Men’s Studies, 13(1), 5–24.

Older men and friendships

• Men’s friendships tend to be focused around doing something

– Often instrumental and activity based

• Talking to like-minded men valued for the emotional support it offered.

Shaw R et al. (2014). “I Think It’s a Communal Thing”: Men’s Friendships in Later Life. The Journal of Men’s Studies, 22(1), 34–52.

Ageing men and leisure

“…as men age, they are learning to be with their bodies in new somatic ways, and as such, their identities are constructed by the social meanings given to embodied experiences. …a significant site for this learning and being was in leisure.”

Wiersma, E., & Chesser, S. (2011). Masculinity, ageing bodies, and leisure. Annals of Leisure Research, 14(2-3), 242–259

Older men?

• Social determinants: – Socio-economic status, – Marital status – Housing / environment

• Intersectionality – Ethnicity – Age (young old, old, very old …) – Sexuality

• Personal preferences • Ill-health / multiple morbidities

Adapted ecological model of the determinants of physical activity

Bauman AE, Reis RS, Sallis JF, et al. Correlates of physical activity: why are some people physically active and others not? Lancet 2012;380:258–71.

Gender

Getting older men active

• Build on shoulder-to-shoulder activities i.e. walks, gardening, The Men’s Shed

• Use settings where men are comfortable – sports grounds, workplaces

• Skill up volunteers and workers to understand older men’s needs

• Link men into volunteering opportunities

• Make men feel useful – mentoring the young, creating, restoration, supporting.

Men’s National Cascade project

Male focused innovative community based approaches into physical activity and wellbeing. The project worked with Premier League and Championship football clubs; rugby and cricket clubs; older gay men’s groups; local Age UKs; independent men's groups; various local authorities, the NHS; and Preston Prison service to reach men.

Asset based approaches

• Expertise within the communities

• Willing volunteers

• Peer support

• Imagination of our older men

• An expanding older population can be a benefit to society – developing new roles and getting active at the same time

South, J (2015) A guide to community-centred approaches for health and wellbeing PHE, London

Summary

• Inactivity has marked physical and emotional consequences

• Physical activity has multiple forms and is as much about being less sedentary as running a marathon

• Physical activity is gendered and provision must reflect the scope of men’s needs

• Policy must start to recognise that ‘gender’ includes men