April 2024 • PharmaTimes Magazine • 28-29
// MEN'S HEALTH//
Why do we need a government men’s health ambassador and what is needed to make the role a success?
In recent years, we have started to see a shift towards the implementation of gender-specific approaches to meet the unique and differing healthcare needs that men and women have.
Following on from the publication of the Women’s Health Strategy for England and a women’s health ambassador, the UK government announced in November 2023 that it will introduce a men’s health ambassador.
Recruitment to the role is currently underway but is expected to help address the key unmet needs and disparities in men’s health.
While women face challenges accessing healthcare, life expectancy for men is persistently lower than that of women, and some conditions, for example certain cancers, are more prevalent in men and often have higher mortality rates.
These discrepancies are even more pronounced in minority groups and in deprived communities – male life expectancy in certain parts of north-west England is 68.2 years, while in parts of the south-east it is 90.3 years.
While biological factors certainly play a part, there are important socio-economic, behavioural and psychological factors that significantly contribute to these health disparities, as well as issues regarding access to services.
One of the core issues is men’s reluctance to engage in open conversations about their health and seek help.
They are less likely than women to make use of their NHS health checks for example, with around 45% of men attending these appointments,which only further exacerbates problems such as late diagnoses and poorer outcomes.
There is also generally low awareness of the conditions that disproportionately or only impact men.
The introduction of the men’s health ambassador role is part of a wider set of initiatives, including improvements to men’s health pages on the NHS website and the formation of a taskforce that aims to increase men’s uptake of NHS health checks.
If this role properly collaborates with organisations across the healthcare spectrum, it has the potential to drive meaningful change for men, and I believe there are a few key focus areas that would help.
With men’s health, one area that needs urgent attention is the societal perspective on seeking help.
The men’s health ambassador could be the key to changing societal attitudes, tackling stigma and advocating for positive conversations around men’s health.
This is a challenging space, as we know sadly too well the impact that mental health can have on men. They are three times more likely to die by suicide than women and yet just over a third of NHS referrals for psychological therapies are for men.
Taboos will take time to change, but to help the movement the ambassador will need to explore measures in the places where men feel stigma, such as in the workplace.
For example, employers can help to open discussions among colleagues by designating men’s health champions within workplaces, and schools can run programmes to create a culture where discussing health is normalised from a young age.
Not only would school programmes normalise health discussions, but it would support better knowledge and understanding around prevention of risks to future health with boys and young men.
It has been found that health literacy is very limited in males when leaving school and while some guidance is available, more formalised programmes are needed. In particular, this is an area the ambassador may want to collaborate with industry on with pro bono access to experts and resources.
‘Male life expectancy in certain parts of north-west England is 68.2 years, while in parts of the south-east it is 90.3 years’
Tackling societal perspectives and stigma must involve reaching out to those people men trust and their loved ones. That is why all people need to be educated about symptoms and armed with knowledge to better understand men’s health.
This is especially true for conditions like certain cancers. Take bladder cancer as an example, which impacts men on a far greater scale, approximately three times more than women, and varies starkly with deprivation.
There is a lack of awareness about the signs and symptoms of bladder cancer, which can lead to delayed diagnosis and poorer outcomes.
Some men don’t tell their loved ones or go to the doctor after noticing symptoms and in other cases symptoms may be dismissed by doctors.
A survey commissioned by the World Bladder Cancer Patient Coalition highlighted that many patients visited their doctor multiple times before being referred to a specialist.
That perseverance that is needed by men to get checked out will only be bolstered if both they and their loved ones know about important signs and symptoms that they need to push for tests on.
To maximise their reach, awareness campaigns should also focus on friends, families, employers and colleagues of men in high-risk groups, to create a network of support to recognise signs and symptoms in the men in their lives and encourage them to seek help.
That network will look different for men of different ages, areas, backgrounds and ethnicities. Inclusivity and the removal of barriers to access for care will be crucial for the ambassador, and fostering an environment where all men feel they can seek advice will be essential.
Older men, those from ethnic minority backgrounds, those in the LGBTQ+ community and those living in rural or underserved communities may need tailored solutions.
For example, LGBTQ+ men and those assigned male at birth may not feel comfortable seeking help for certain conditions and could be concerned about stigma, while those from underserved communities may lack resources to attend appointments.
The ambassador will need to work closely and sensitively with these groups through the existing forums and representatives in their communities together with their service providers, harnessing a carefully tailored set of channels to advocate for system change.
We saw this approach work well for COVID vaccination uptake in underserved communities and must learn from it at a system level.
We are increasingly seeing high-profile individuals openly discuss their health, most recently with King Charles sharing his cancer diagnosis, after which cancer charities including Prostate Cancer UK and Macmillan reported a surge in visits to their websites.
Celebrities and other well-known figures telling their stories and using their voices to amplify key messages around seeking healthcare could contribute significantly to changing societal norms around masculinity and health.
Diverse representation will matter here, and it’s incredibly important that diversity, equity and inclusion principles underpin all activity, engaging with people from a range of backgrounds, ages, races and sexualities to help permeate the hardest-to-reach groups.
The men’s health ambassador is a role that is eagerly anticipated by many who are continuously working to champion men’s health.
Many believe there is still a need for a men’s health strategy to mirror the Women’s Health Strategy for England that was published in 2022.
I am hopeful that, until then, the ambassador can start to rewrite the story for men in England and replicate it throughout the UK.
Dr Stuart Hill is Medical Director UK and ROI at Merck Healthcare.
Go to merckgroup.com