Editorial

Graham Jackson, MD,FRCP, FACC, FESCConsultant Cardiologist,Department of Cardiology,London Bridge Hospital,London and BMI ShirleyOaks Hospital, Croydon,Surrey, UK

E-mail:gjcardiol@talk21.com

Online 18 September 2010

� 2010 WPMH GmbH. Published

Men Behaving Badly

Graham Jackson

‘‘Men Behaving Badly’’ (MBB) was one of the

most popular UK situation comedies but,

taken out of that context, MBB sums up the

challenges we face in improving men’s health

[1]. In the United States, men were found to be

more likely to be regular and heavy alcohol

drinkers, heavier smokers who were in turn

less likely to stop, non-medical illicit drug

users and more overweight compared to

women [2]. In addition, men are less likely to

undertake visits to health care professionals, to

emergency departments and to receive home

medical visits than women. Whilst this paints a

grim picture it gets worse – men are less likely to

practice preventative medicine, attend hospice

or dental care visits and have fewer hospital

discharges and shorter hospital stays than

women [3]. It comes as no surprise, therefore,

that men have a lower life expectancy than

women in most countries around the world,

irrespective of race and ethnicity, with a loss of

5–10 years [4].

When faced with this educational mountain

to climb it may seem an overwhelming target

given the scale of the ‘‘men’s health’’ problem.

When travelling on the London underground

or overground rail system, we are reminded to

‘‘mind the gap’’ between the train and plat-

form as the train pulls into the station. We can

as individuals ‘‘bridge the gap’’ and it is that

philosophy that we need to collectively apply

to men’s health [5].

Before we can bridge the gap we need to

raise awareness that a gap exists and, in turn,

can be closed. Men may not come forward for

help or be aware they need help [6]. Could it be

that seeking help reflects weakness (so-called

macho man in denial) compounded by female

rather than male-orientated environments –

doctors’ offices contain mainly female-orien-

tated magazines and posters. Or perhaps in an

by Elsevier Ireland Ltd.

environment where jobs are precarious, does a

man relate illness to lack of job security and

hesitate to seek help? Surgery hours could

more sympathetically address working hours,

allowing men to visit without taking time off

work [7].

Raising awareness of the importance of pre-

venting cardiovascular and metabolic disease,

as well as cancer, requires a major public

health initiative because of the evidence base

that prevention is effective. We cannot pick our

parents (family history of cardiovascular dis-

ease is particularly important) but we can pick

our lifestyle and, in turn, hopefully our chil-

dren will have chosen a healthy family tree. It is

not just about men’s and women’s health as

that would be too selfish, it is about our chil-

dren’s health and there cannot be a better

motive to living a healthy lifestyle. The words

roll off the pen, but the reality is that however

we present the argument we will struggle to

achieve the objective. The International Society

of Men’s Health and the Men’s Health World

Congress are the lights at the end of the tunnel,

bringing together evidence and initiatives. So

we can consider health in positive as well as

negative terms and not merely the absence of

illness.

Thomas Jefferson said not less than 2 hours a

day should be devoted to exercise. As John F.

Kennedy (1917–1963) pointed out, if the man

who wrote the Declaration of Independence

and was twice US President could give it

2 hours, our children can give it at least 15 min-

utes. Put another way, those who have no time

for exercise will sooner or later find time for

illness.

Improving health should be universal –

women have addressed the issue of better

health vigorously – men should learn from

their example – no shame just gain.

Vol. 7, No. 3, pp. 181–182, October 2010 181

Editorial

References[1] Jackson G. Men’s health left hung out to dry:

why men die earlier and suffer more. Int J Clin

Pract 2009;63(12):1669.

[2] Pinkhasov RM, Shteynshlyuger A, Hakimian P,

Lindsay GK, Samadi DB, Shabsigh R. Are men

shortchanged on health? Perspective on life

expectancy, morbidity, and mortality in men

and women in the United States. Int J Clin

Pract 2010;64(4):465–74.

182 Vol. 7, No. 3, pp. 181–182, October 2010

[3] Pinkhasov RM, Wong J, Kashanian J, Lee M,

Samadi DB, Pinkhasov MM, et al. Are men

shortchanged on health? Perspective on

health care utilization and health risk beha-

vior in men and women in the United States.

Int J Clin Pract 2010;64(4):475–87.

[4] Waldron I. Sex differences in illness incidence,

prognosis and mortality: issues and evidence.

Soc Sci Med 1983;17(16):1107–23.

[5] Meryn S, Shabsigh R. Men’s Health: past,

present and future. jmh 2009;6:143–6.

[6] Banks I. No man’s land: men, illness, and the

NHS. BMJ 2001;323(7320):1058–60.

[7] Banks I. Improving healthcare services for

men. BMJ 2009;338:b2129.