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

Allages

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 women2001, by country

68.0

70.0

72.0

74.0

76.0

78.0

80.0

82.0

84.0

Year

s Men

Women

Source of data:Statistics in Focus Theme 3 17/2002

Difference (%) between men and women in cancer survival across Europe

02468

1012141618

Slovenia

Malta

Czech

Rep

ublic

The N

etherla

nds

Italy

Poland

Spain

EUROCARE-4 mea

n

Northe

rn Ire

land

German

y

Belgium

Englan

d

Scotla

nd

Switzer

land

Wales

Finlan

d

Norway

Icelan

d

Irelan

d

Austria

Sweden

%

Verdecchia et al (2007) Eurocare 4

Melanoma incidence rate

02468

1012141618

Norway

Sweden

Denmark

The N

etherl

ands

Switzerl

and

Austria

Irelan

d

Finlan

d

France

German

y

United

King

dom

Belgium

Luxe

mbourg Ita

lySpa

in

Portug

al

Greece

Men

Women

Melanoma mortality rate

00.5

11.5

22.5

33.5

Norway

Sweden

Denmark

Austria

Finlan

d

The N

etherl

ands

Switzerl

and

United

King

dom

German

y

Luxe

mbourg Ita

ly

Irelan

d

France

BelgiumSpa

in

Portug

al

Greece

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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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

Rat

e pe

r 100

,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 6.42 79.4 83.2 4.83N 78.4 82.4 5.13M 76.5 80.5 5.24 75.7 79.9 5.55 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

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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