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Introduction to a conference at the University of York on September 4, 2014 on men's health and long-term conditions - including mortality rates, cancer, heart disease, suicide and diabetes
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MEN AND LONG TERM CONDITIONSMartin Tod, CEO, Men’s Health Forum
WHY MEN’S HEALTH?
39.1%
Male deaths – under 75
25.0%
Female deaths – under 75
Source: ONS 2014
WHY MEN’S HEALTH?
19.6%
Male deaths – under 65
12.0%
Female deaths – under 65
Source: ONS 2014
1-4 years 5-19 years 20-34 years 35-49 years 50-65 years 65-79 years 80+ years -
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
273 884 3,458 10,284
30,990
81,066
111,553
203 509 1,690 6,561
21,550
61,533
165,737
Number of male and female deaths by age
Men Women
WHY MEN’S HEALTH?
Source: 2012 Mortality Statistics. ONS 2013
ALTHOUGH GAP IS CLOSING…
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
64.0
66.0
68.0
70.0
72.0
74.0
76.0
78.0
80.0
82.0
84.0
Life Expectancy at Birth – 1980-2012
Male Female
Male
Female
AND THERE ARE MAJOR INEQUALITIES
England Blackpool / Manchester East Dorset / Purbeck 65.0
70.0
75.0
80.0
85.0
90.0
79.1
74.0
82.9 83.0
79.5
86.6
Life Expectancy at birth – 2010-12
Men Women
Source: ONS
IMPROVEMENT IN THE BIGGEST KILLERS
Circulatory diseases
Cancer Respiratory diseases
0
500
1,000
1,500
2,000
2,500
3,000
3,500
3,130
2,335
981
1,746
2,004
804
Male
2002 2012
Circulat
ory dise
ases
Cance
r
Respira
tory
dise
ases
0
500
1,000
1,500
2,000
2,500
3,000
3,500
1,9451,635
675
1,118
1,471
581
Female
2002 2012
Source: ONS Age-standardised mortality rates (ASMRs) per million population
CANCER MORTALITY
Bladd
er
Bowel
Brain
and
CNS
Kidn
ey
Leuk
aem
iaLive
r
Lung
Mal
igna
nt m
elan
oma
Mye
lom
a
Non-H
odgk
in ly
mph
oma
Oesop
hagu
s
Panc
reas
Stom
ach
-
0.50
1.00
1.50
2.00
2.50
3.00
3.50 2.89
1.65 1.58 2.01
1.70 1.92 1.53 1.62 1.42 1.54
2.89
1.27
2.21
Male to female cancer mortality ratio (all ages)
Source: CRUK, Mortality rate ratios are European age-standardised, of male to female cancer mortality (excluding NMSC), UK, 2010.
SUICIDE
10 14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95+ -
50
100
150
200
250
300
350
400
5
78
213 224
252
285
367 372
311
250
169
126
81 65 59
43
15 6
Male Female
Source: 2012 Mortality Statistics. ONS 2013
LONG-TERM CONDITIONS
Now let’s talk about your long-term
condition…
SELF-REPORTED LTCs INCREASE WITH AGE
18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 to 84 85 or over0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
28%32%
41%
54%
69%
82%
90% 92%
30% 31%
39%
50%
66%
79%
89%93%
Do you have a long-standing health condition?
Male Female
Source: GP Patient Survey, July 2014
LTCs – MAJOR MALE WORKFORCE ISSUE
Source: GP Patient Survey, July 2014
SELF-REPORTED LTCs – % OF MEN REPORTING
Alzheimer's disease or dementiaBlindness or severe visual impairment
EpilepsyKidney or liver disease
Learning difficultyLong-term neurological problem
I would prefer not to sayCancer in the last 5 years
Deafness or severe hearing impairmentLong-term mental health problem
Angina or long-term heart problemDiabetes
Long-term back problemAsthma or long-term chest problemArthritis or long-term joint problem
Another long-term conditionHigh blood pressure
[Combined LTCs]
0% 10% 20% 30% 40% 50% 60%0%1%1%2%2%2%2%
3%4%5%
6%9%
10%10%10%
12%19%
54%
Source: GP Patient Survey, July 2014
MAIN DIFFERENCES IN SELF-REPORTED LTCs – DIABETES AND ARTHRITIS
Sour
ce: G
P Pa
tient
Sur
vey,
July
201
4
Medical condition MaleFemale
Men
more than women
Diabetes 9% 6%Angina or long-term heart problem 6% 4%High blood pressure 19% 18%Learning difficulty 2% 1%Deafness or severe hearing impairment 4% 4%Kidney or liver disease 2% 1%Epilepsy 1% 1%I would prefer not to say 2% 2%Cancer in the last 5 years 3% 3%
Same Long-term neurological problem 2% 2%
Women
more than men
Alzheimer's disease or dementia 0% 1%Blindness or severe visual impairment 1% 1%Long-term mental health problem 5% 5%Long-term back problem 10% 10%None of these conditions 42% 43%Another long-term condition 12% 13%Asthma or long-term chest problem 10% 12%Arthritis or long-term joint problem 10% 16%
AND WHAT ABOUT MND?Text ICED55 £5 to 70070
MOTOR NEURONE DISEASE– EARLIER & HIGHER MALE MORTALITY
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95+ -
50
100
150
200
250
Mortality from Motor Neurone Disease
Male Female
Source: ONS: Deaths registered in England and Wales, 2012
SIGNIFICANTLY HIGHER INCIDENCE• Between 1990-2005, The rate of MND in men was 54% higher than in women
• The lifetime risk of MND, adjusting for competing causes of death, was 1 in 472 (2.1 per 1000) in women and 1 in 350 (2.9 per 1000) in men.
Alonso, A., Logroscino, G., Jick, S. S. and Hernán, M. A. (2009), Incidence and lifetime risk of motor neuron disease in the United Kingdom: a population-based study. European Journal of Neurology, 16: 745–751. doi: 10.1111/j.1468-1331.2009.02586.x
WHAT HAPPENS IF YOU REMOVE THE BARRIERS?
“SR
520
East
side
pro
ject
nig
ht w
ork,
Aug
ust 2
011"
by
Was
hing
ton
Stat
e D
epar
tmen
t of T
rans
port
ation
cen
sed
unde
r CC
BY-N
C-N
D 2
.0
Wang Y et al. BMJ Open 2013;3:e003320©2013 by British Medical Journal Publishing Group
MEN ARE LESS LIKELY TO CONSULT GPs THAN WOMEN
ALTHOUGH WITH LTCs THE GAP CLOSES
LTC No LTC0%
10%
20%
30%
40%
50%
60%
70%
80%
61%
32%
68%
51%
Visited GP in the last 3 months
Male Female
Source: GP Patient Survey, July 2014
LTCs – ALSO NHS RESOURCE ISSUE
LTC54%
DK3%
% men overall
LTC69%
DK2%
% men visiting GP in last 3 months
Source: GP Patient Survey, July 2014
IS IT JUST ABOUT RESOURCES?
“Pou
nd C
oins
" by
Will
iam
War
by is
lice
nsed
und
er C
C BY
-NC-
ND
2.0
POOR MANAGEMENT OF LTCs CAN WRECK LIVES
Amputation of leg Amputation of foot
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
3,521
1,020
1,743
307
Male Female
• 49% of amputations diabetes related
• 80% preceded by a (preventable) foot ulcer
• White men living in poorer areas are the group with the highest risk of diabetes-related amputation
Source: Hospital Episode Statistics for England’s Inpatient statistics 2012-13 via Diabetes UK