UEMO Study on Men’s Health

“The scope for men to improve their health and prolong active healthy life is considerable”. (Calman, 1993)

GPs/ family doctors have an important role in supporting this endeavour.

Overview :

• More males than female conceived

• Mortality higher in males from foetal, infancy, though all age groups

• Gender specific illness, for example, testicular, prostatic cancer

• More men die in accidents, of suicide and premature cardio-vascular illness

• More general morbidity, associated with smoking/alcohol related/sexually transmitted diseases may converge as lifestyles change

• GPs/ family doctors see more women and children and provide good services for them. Men do not attend for many reasons, perhaps needing a dedicated clinic time.

Identifying Key Areas of Men’s Lives :

• Young single men:

Stress, insecurity, risk-taking behaviours, may attend with acne or minor injury.

• Give information on smoking, sexual health, stress, anger management, risks of alcohol and drugs.

We also refer readers to document UEMO 2006/075 on “Violence in young men”

• Men with young families:

May attend for work/insurance medicals or seek sick leave certification.

• Give advice about stopping smoking/passive smoking effects on children, stress, accidents, work safety issues, stress in employment. Alcohol abuse and depression.

• Family traits can be an opportunity to effect health gain indirectly i.e. obesity, diet, exercise.

• Middle age:

May consult with minor symptoms.

• A time of change – children grown, parent’s death, workplace/career issues

• Watch for marital separation, spousal death as higher risk of morbidity, mortality.

• Targeted screening for diabetes cardiovascular risk, alcohol dependence, depression.

• Retirement age:

• Major impact on health, pre-retirement groups may help.

• Heightened awareness of increasing prevalence of CV disease, NDDM, prostate problems, osteoporosis, cancers (particularly prostate and colorectal) depression, cognitive impairment.

Possible Starting Points:

• Men’s health worker identified in the practice team

• Men’s clinics

• Out of hours may be necessary to the men access General Practice

• Outreach – go to employer/club/pub for informing and screening

• Phone/write/invite to group self-help meetings or individual screening

Record:

• Height, weight, waist measurements

• BP cholesterol, glucose as indicated

• Cigarettes

• Alcohol/drugs/lifestyle exercise/partner/risk behaviours

• Employment details

• Family history important in colorectal cancer.

• Prostatic Specific questionnaire screening at appropriate age

• Educational literature

Conclusion

Seek adequate resources for prevention, and demonstrate effect.

Ireland had a cardiovascular mortality of 31 {cabf78295431282ca1bec49ffbe2c87b89a1285ae102b2d0687184fc21af24ba}, and introduced a secondary prevention programme “Heartwatch” in general practice. This, together with increased awareness, and primary prevention, has reduced mortality by 25{cabf78295431282ca1bec49ffbe2c87b89a1285ae102b2d0687184fc21af24ba}.

GP’s may need to liaise with other health care providers.

Toledo, 26 September, 2007