THE Department of Health launched its first advice booklet aimed at men yesterday. "Life Begins at 40: Health Tips for Men", is aimed primarily at middle-aged, working-class men, a group at particular risk of heart disease and cancer, and will be distributed through male-oriented sites, such as DIY stores and sports clubs. The booklet contains advice about smoking, drinking, stress and exercise and uses "blokey" cartoon humour to get its message across.

It is a long-overdue initiative. Health pages in newspapers and magazines are full of articles on prostate cancer, impotence and falling sperm counts, and bookshops are brimming with self-help health books for men. Pick up the phone and you can talk about sexual difficulties, depression, infertility - any problem affecting the modern male. It seems men's health is more talked about than ever.

Except by the Government. In "Our Healthier Nation", the recently published blueprint for the future of public health, men's problems are conspicuous only by their absence. But, belatedly, there are now signs of change. Although Tessa Jowell, the minister for health, rejects talk of "a crisis" in men's health, she accepts that "being a man is a cause of health inequality", and is particularly concerned about men's high levels of heart disease, stroke, lung cancer, accidents and suicide.

The minister believes the reasons for the poor state of men's health are as yet unclear, but are probably both biological and social. "Men are more likely than women to take more risks with their health and less likely to seek help at the earliest possible stage," she says.

On average, men visit their GP half as often as women. Women, says the minister, "are more in touch with health services because they are more likely to take the children". She also suggests that the rise in suicides of 71 per cent in a decade among 15 to 24-year-old men could be "something to do with unemployment, a culture of hopelessness and the loss of useful roles".

She says: "We have to build initiatives to prevent ill health and premature death which are relevant to men and they will be different from those which we develop for women. If we want to reach women, we put leaflets in supermarkets, but I think we've got to be much more imaginative about the way we reach men. Maybe information needs to go in pubs, in gyms and workplaces." Using footballers and other sports role models could also help get positive messages across. Hence the new leaflet.

But Ms Jowell places much more emphasis on the role of Healthy Living Centres (HLCs), one of the Government's big health ideas. Funded by the National Lottery, these are intended to respond to local health needs, with a focus on diet, smoking, drinking, drug misuse and physical activity.

Although she is vague about how they might work with men, the minister believes they could become sites for "well-man" clinics. A recent Gallup survey suggested that three-quarters of men would like to see more of these.

Although she is not convinced of the need for a national screening programme for prostate cancer - "the evidence is highly equivocal and it's been put on the backburner" - Ms Jowell does support promoting testicular self- examination among younger men. Rates for testicular cancer have doubled in the past 20 years.

The Government is also commissioning research into sperm counts, which have halved since 1940. "Some of the suggested trends are undoubtedly sinister, but it's important not to draw hasty conclusions without being absolutely sure about the scientific evidence," she says.

One men's health Government initiative already in place is CALM - the Campaign Against Living Miserably, a helpline for young men in Manchester, an area with twice the national rate of suicide. Since its launch in December, CALM has responded to more than 3,000 calls and the scheme has been extended beyond its original three-month lifespan. "We ought to look at CALM's effectiveness and see what can be applied to other parts of the country, perhaps through HLCs," says Ms Jowell.

But the responsibility for improving men's health does not just rest with politicians. If men were to campaign as women have, there is little doubt their health could be transformed.

Peter Baker

Comments