Editorials

The international men's health movement

Has grown to the stage that it can start to influence international bodies

Men's health is emerging as an important issue in an increasing number of countries around the world, notably the United Kingdom, Austria, Switzerland, Australia, and the United States. There is also increasing interest in working with men on sexual and reproductive health issues in parts of Central and South America, Africa, and Asia. However, progress towards international contact and collaboration between men's health advocates with an interest that extends beyond traditional clinical concerns such as erectile dysfunction or prostate cancer has so far been extremely slow.

In many ways this is not surprising. The idea that men have specific health needs, experiences, and concerns related to their gender as well as their biological sex is relatively newcertainly much newer than the concept of "women's health."¹ The psychosocial aspects of male health are still not accepted, or even understood, by many health practitioners and policymakers. Moreover, even in those countries where greater attention has been paid to men's health issues, initiatives have generally remained small scale. The focus of men's health advocates has, understandably, so far been intranational rather than international.

But there are now signs that men's health work has reached a sufficient level of maturity in enough countries to create a new interest in developing international links. The most important event in this process, the First World Congress on Men's Health, takes place in Vienna this month. This aims to increase awareness of men's health among the medical community, to facilitate networking, and to address current men's health issues (including erectile dysfunction, depression, and cardiovascular disease). The International Society for Men's Health will be established at the world congress, an organisation that is expected to have an advocacy as well as a networking role. The European Men's Health Initiative will also be launched at the Congress. This seeks to encourage the development of men's health policy and practice at a Europe wide level as well as within individual countries. The first step will be the establishment of a European Men's Health Forum. International research and debate will be further encouraged by the publication from this month of the US based International Journal of Men's Health.

At a time when men's health work is relatively new and underresourced in every country, it might seem premature for its advocates to devote effort and resources to establishing international networks. Arguably this will be at the expense of developing practical local projects that could begin to make a difference to male morbidity and mortality.

The potential advantages of international collaboration are almost certainly greater than the risks, however. One major benefit will be that the proponents of men's health, particularly in those countries where the arguments for improving men's health are not yet accepted, will gain encouragement from work going on elsewhere. International collaboration will also create important new opportunities for sharing information and examples of good practice.

There is now an increasing body of men's health work for health professionals to refer to. In England and Wales, for example, the Men's Health Forum has helped develop policies to tackle the growing problem of young men and suicide.² The forum was also instrumental in establishing the All Party Parliamentary Group on Men's Health in March 2001. The city of Vienna has published a report on men's health,³ introduced a cardiovascular disease prevention programme targeting men and women in different ways, and organised two men's health days in 2000 and 2001. The Swiss Foundation for Health Promotion is supporting a wide ranging men's health initiative which aims to facilitate the work of professionals and fund pilot projects (www.radix.ch/d/html/maennergesundheit.html).

In the United States Congress established an annual national men's health week in 1994 (the week ending on Fathers' Day in June). This provides an opportunity for hospitals, clinics, military bases, churches, and voluntary organisations to hold local men's health education events (www.menshealthweek.org). Earlier this year a bill was introduced in Congress to create a federal Office of Men's Health to promote research and education about diseases affecting men. Since the late 1990s the Office of Population Affairs/Office of Family Planning has funded programmes that address family planning and reproductive health information and services for men and boys (www.hhs.gov/opa/titlex/ofp.html).

In Australia, a country that has probably done more than any other to develop men's health as a mainstream issue, the federal government supported a national men's health conference in Melbourne in 1995, and a range of government funded initiatives has followed. These include a draft national policy, a second national conference, a parliamentary investigation, and policy initiatives in several states.⁴

Finally, the development of international discussion and collaboration on men's health will enable these new societies and forums to take the next step of putting men's health on the agenda of mainstream international bodies such as the European Commission and the World Health Organization. This will, in turn, strengthen the case within individual countries for establishing men's health initiatives.

Peter Baker, director. 

Men's Health Forum, London WC1H 9HR (office{at}menshealthforum.org.uk)