Ten years ago the BMJ published a special issue on men’s health.1 It noted how, although men fare better than women in most conventional measures such as top jobs and earnings, this advantage is not reflected in their health. A report we produced this summer, The State of Men’s Health in Europe,2 3 shows that little has changed. At any given age, men are still more likely than women to die from most of the leading causes, and in the European Union men have more than twice as many deaths a year as women throughout the working ages (15-64 years). This high level of premature mortality in men has psychological, social, and economic consequences for relatives, households, communities, and the workplace. Yet, in both national and European health policy, men and “masculinity” are largely taken for granted. This has limited the development of evidence based programmes that meet their health needs.

Differences in mortality and morbidity are not simply the result of biological factors; nor are they intractable. In fact, the health gap between men and women varies considerably. It is much greater in eastern Europe than in western Europe,4 and within countries it is influenced by class, education, employment, and other social determinants.5 The clustering of material, cultural, and psychosocial factors seems to be particularly detrimental to the health of many men.6 These factors contribute to gendered lifestyles and behaviours that have traditionally been seen as predominantly “masculine”7 and that cause many of the premature deaths in men. Traditional masculine attitudes are associated with unhealthy behaviours such as …