Education And Debate

No man's land: men, illness, and the NHS

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7320.1058 (Published 03 November 2001) Cite this as: BMJ 2001;323:1058
  1. Ian Banks, president (ian@medic40.freeserve.co.uk)
  1. European Men's Health Forum, London WC1H 9JP

    An important obstacle to improving men's health is their apparent reluctance to consult a doctor. US research shows that men with health problems are more likely than women to have had no recent contact with a doctor regardless of income or ethnicity.1 This reluctance means that men often do not seek help until a disease has progressed.2 Late presentation can have serious consequences. For example, deaths from melanoma are 50% higher in men than women despite a 50% lower incidence of the disease. So why do men delay seeking help, and what can be done to overcome the problem?

    Summary points

    Men do care about health issues but often find it difficult to expresses their fears

    Men tend to attend their general practitioner later in the course of a condition than women and this phenomenon is exacerbated by social class inequalities

    Uptake of health information and health services can be improved by making them male friendly, anonymous, and more convenient

    Better use should be made of services such as NHS Direct, pharmacists, occupational health, and online advice

    The nature of medical school education and medical training may contribute to potential problems in consultations between male doctors and patients

    What are the difficulties?

    Suicide is now the single greatest cause of death among young men in most of the United Kingdom. One reason that more men die from suicide than women is that men are more likely to choose methods such as hanging or shooting that leave little room for medical intervention. Even so, men are less likely to talk about their problems with their peers or health professionals. Although the Samaritans claim that a large proportion of men have visited their general practitioner in the months before they take their own lives,3 a report by the Men's Health Forum concludes the opposite. A …

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