Understanding Men & Health Prof. Steve Robertson Centre for Men’s Health

Some background data Men die earlier than women

First State of Men’s Health Report in Europe Across the EU27 countries men have a 64% higher death rate than women BUT, in the 15-44yr age range the difference is 236% (in the UK the difference in this age group is 95%) In numerical terms, there are 630,000 males deaths in the 15-65yr age group compared to 300,000 female deaths White, A. et al (2011) Men’s Health in Europe. Journal of Men’s Health 8(3): White, A. (2011) The state of men’s health in Europe: how do we compare in the UK? Trends in Urology & Men’s Health Sept/Oct White, A. et al (2011) Europe’s men need their own health strategy. British Medical Journal 343:

Relative impact of socio-economic factors Trends in life expectancy by social class 1972 – 2001 ONS Longitudinal Study MenWomen 5.5yrs8.4yrs5.3yrs4.6yrs

Why?

BUT… This is not the whole story

…the young men in Harland’s (2000) Belfast study clung desperately to narrow interpretations of masculinity, believing that men should be powerful, strong, brave, intelligent, healthy, sexy, mature, and in control of every aspect of their lives. In reality, however, their lives were full of ‘contradictions’ as most young men felt powerless; feared the threat of daily violence; were labelled ‘stupid’ in school; did not pay attention to their health needs - particularly their mental health; had limited sexual education; rarely asked for support; and felt they were perceived by adults as being ‘immature.’ Ken Harland. Acting Tough: Young Men, Masculinity and the Development of Practice in Northern Ireland ( accessed July 2010http://

McDowell, L. (2002) Masculine discourses and dissonances: strutting ‘lads’, protest masculinity and domestic respectability. Environment & Planning D: Society and Space 20: Need to conform to rebellious performances of masculine actions Envisage a settled future - steady partner, house work & children We often fail to recognise this desire for ‘domestic respectability’ and how this might be utilised as a lever for moving away from the more negative aspects of ‘protest masculinity’.

Why does this matter? Don’t care Should care “I eat healthy food generally and I cheat now and again. Alcohol’s bad for you, but we all drink, mostly everyone I know likes a drink, it actually cheers you up [...] We’ve got this throw away society and people’s perceptions are changing, everybody wants everything yesterday. People want to gain as much as possible materialistically, physically and emotionally. And that’s it, get fit one day, get drunk the next, buy the best house in the country the day after you know, and that’s a full life.” [Dan]

Yeah, but what does it mean? Men need ways to legitimate engagement in healthy practices and with health services Cardiac disease examples: Seen as a ‘male disease’ = legitimation South Asian men, masculinity and engagement Legitimation by partners Remember, once legitimated men often fully engage

Men and suicide, 2008 Calculated from: ONS (2008) Mortality statistics: Deaths registered in Review of the National Statistician on deaths in England and Wales, Series DR

The role of emotions “As men we learn to live a lie. We learn to live as if our emotional lives do not exist, at least as far as the ‘public world’ is concerned [...] We learn to live in our minds as the source of our identities. If we had our way as men it would be that our emotional lives did not exist at all.” (Seidler 1994: 19) BUT they do exist and have to find expression somehow

Male coping strategies (or not!) Men are half as likely to go to a counsellor or therapist to talk about their feelings Twice as many men as women drink alcohol to cope with feeling down Men are half as likely as women to talk to friends about their problems and less likely to talk to family Young men are the group most likely to tell a friend to “pull themselves together” if they were feeling low MIND (2009) Men & Mental Health: Get it off your Chest Men are more prone to ‘instrumental’ rather than ‘communicative’ forms of action. i.e. Men are more likely to ‘act out’ rather than ‘talk out’ feelings.

The ‘big build’: the upward trajectory of the masculine enactment of emotional distress. After Brownhill et al, 2005 in Branney & White (2008) Advances in Psychiatric Treatment 14 pp 256–262

“Acting out” - Extremes

“Acting out” - Positive

Steve Robertson Centre for Men’s Health Leeds Metropolitan University Leeds LS2 8NU UK