1. Access to services for men in Scotland

2. 2 A brief look at: Some of the statistics and data that are available What do these tell us about how men perceive and access services? What are the challenges we face?

3. 3 Sources of data “Men and Women in Scotland: A Statistical Profile”, Scottish Executive, 2001 The Scottish Health Survey, SEHD 1998 ISD Scottish Health Statistics, www.isdscotland.org Enhancing Sexual Wellbeing In Scotland: A Sexual Health Relationship Strategy Consultation Supporting paper 5b, SEHD, 2003

4. 4 Access to GP practice team The chart presented here shows the annual contact rates, by gender and age group, for the full practice team (GPs, practice nurses, district nurses and health visitors) in the year ending March 2004.

5. 5 Visits to GP The chart below shows the annual contact rates, by gender and age group, for GP contacts in the year ending March 2004.

6. 6 ISD analysis “This chart, and the equivalent for full practice team, illustrates the marked difference in contact rates between sexes in the adult years. In the age groups 15-24, 25-44 and 45-64 the contact rate for females is markedly higher than the rate for males. In particular for 15-24 year olds the rate is more than double. However, in the older age groups (65-74, 75-84 and 85 years & over) the contact rates are much more similar for males and females.”

7. 7 Top 5 reasons for visiting GP – all ages

8. 8 Top 5 reasons for visiting GP: 15-24 year olds Top 5 Most Common Reasons for Consulting a GP by contact rate per 1,000 population by sex; year ending December 2003

9. 9 25-44 year olds Top 5 Most Common Reasons for Consulting a GP by contact rate per 1,000 population by sex; year ending December 2003

10. 10 45-64 year olds Top 5 Most Common Reasons for Consulting a GP by contact rate per 1,000 population by sex; year ending December 2003

11. 11 Self reported health For both males and females aged between 16 and 74 years old 77% of both men and women rated their general health as either “good” or “very good”

12. 12 62% of men are overweight or obese, 33% of men drink more than the recommended weekly limit, only 38% of men claiming to undertake regular physical activity, suicide rate up by 250% in last 20 years amongst young men. “Men are sometimes perceived to be reluctant to talk about their health, never mind consider the need for a regular check up. We know for example that between the ages of 15 and 64 men attend their GP practice almost half as often as women. But does this matter? The figures below would suggest that yes it possibly does matter.” SEHD Background Paper – Well Man Pilot Projects, 2004

13. 13 “ There is clearly a need to encourage men to consider their own health… we must also realise that if we are to target men who are denied health services because they are socially excluded or because of a general lack of interest or concern, we have to consider different ways of working.” SEHD Background Paper – Well Man Pilot Projects, 2004

14. 14 Mortality by gender and DepCat– CHD & Cancer

15. 15 Cancer survival rates

16. 16 Mental health The prevalence of depressive illness (anxiety and depression) as treated by GPs is significantly higher in females than in males, from age 15 throughout the life span. The mortality rate for suicides is considerably higher in males than in females and the gap has widened between 1980 and 1999. In 1980 the female mortality rate per 100,000 population from suicide was 11.0 and by 1999 this had dropped to 7.8. In contrast, the male mortality rate was 18.3 and by 1999 this had increased to 26.2.

17. 17 Sexual health Responding to the high rates of teenage pregnancy depends on increasing the involvement of boys and young men in decisions about relationships, contraception, sexual health and pregnancy. Although the number of men attending contraceptive services has increased in recent years, they still form a small proportion of overall attendances. Source: Enhancing Sexual Wellbeing In Scotland: A Sexual Health Relationship Strategy Consultation Supporting paper 5b

18. 18 Sexual health contd. “Gender is an important factor determining the source of health information used. In examining young men’s use of sexual health services, Biddulph and Blake (2001) found that the average young man was unlikely to access any help or support at all if he had a problem. Staff attitudes and lack of choice of male practitioners might also be a factor in the decision whether to seek help (Banks 2001).” Source: Enhancing Sexual Wellbeing In Scotland: A Sexual Health Relationship Strategy Consultation Supporting paper 5b

19. 19 Sexual health & gender issues “In developing services, providers need to be aware of health limiting behaviours often pursued by males and in particular their learned gendered behaviour. The latter suggests that men should be sexually experienced and competent, are the dominant species, and should conform to stereotypes, especially in relation to sexuality. In addition showing emotions is viewed as "feminine" and may cause problems with intimacy. In some ways, current services perpetuate these myths by focussing sexual health information, advice and services at women and these must be tackled if this imbalance is to be redressed.” Source: Enhancing Sexual Wellbeing In Scotland: A Sexual Health Relationship Strategy Consultation Supporting paper 5b

20. 20 What stops men from accessing services? Opening times, location, awareness The “ostrich approach” Cultural and social pressures – men should be self sufficient Lack of interest – willingness to live with the problem Availability of male specific services

21. 21 In summary… Most men think their health is good Men are less likely to access primary care services than women Men can expect worse health outcomes than women in a range of conditions Social and environmental factors must be taken into account

22. 22 What do we need to consider? If men reluctant to access services, what are the barriers they experience? What can be done to improve services? What can be done to support health professionals to engage with men more effectively? What is the role of community development in engaging with men? What different and innovative approaches could be developed?

23. 23 And finally….. when it comes to dealing with health worries, a quarter (24%) of British men still go to their mum! almost half (48%) of the men questioned said they’d turn to their wife or partner for health advice - yet only 3% said they’d used their pharmacy for general health advice. The survey was conducted by ICM Research Ltd for DPP, 2004