Public Health in Action – Not a Zero Sum Game

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With the solstice behind us and the last few days of June ahead, summer is here.  And the reminders are constant: warmer weather, relaxed dress codes and recurring vacation ads on television.  Along with the official start of summer, the month marks an important awareness period for men’s health.  Events and activities centered to encourage and engage men all over the world to be more proactively engaged in their own health and well-being, Men’s Health Month has served as an annual reminder to everyone that men aren’t invincible.  Men, in fact, succumb to disease and premature death at greater rates and earlier ages than their female counterparts.

Peter Baker, director of the Global Action on Men’s Health, wasn’t aware enough to engage in such reminders.  In my interview with him below, Peter shares his personal wake-up call to health and how that catalyzed his passion into the international men’s health movement.

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Me: How did you end up doing the work that you’re currently doing?  Describe your journey to your current role as the Director of Global Action on Men’s Health.  Describe why you’re passionate about making men healthy and why others should care about the health disparities between genders.

Peter Baker: I’ve been active in men’s health for about 20 years and involved in broader men’s issues for over 30. I came to this field through my interest in feminism and an exploration of my own masculinity through men’s groups and writing, including for a small but influential anti-sexist UK men’s magazine called Achilles Heel. I was for a time also actively involved as a volunteer in projects which aimed to end men’s violence against women.

I became a freelance journalist and writer in 1990 and contributed articles about men’s issues to a wide range of well-known UK newspapers and magazines including Cosmopolitan, GQ, The Guardian and The Independent. My involvement in men’s health specifically became much more significant when I was invited to become the health editor for a men’s magazine, Maxim, in 1995. In 1996, my book (co-written with Mick Cooper) The MANual: The complete man’s guide to life was published. This was a self-help guide for men interested in reflecting on and changing their experience of work, sex, relationships and parenting as well as health. My second book, Real Health for Men (published in 1992), focused specifically on health and well-being and the practical steps men can take to add years to their life as well as life to their years.

My interest in men’s health also stemmed from personal experience of some chronic health problems when I was in my 30s. I developed often debilitating back pain and, probably as a result of drugs taken for that, a duodenal ulcer. I’d never taken much care of my health before and, in my late teens and 20s, drank too much alcohol, eaten poorly, done little exercise and steadily put on weight. Alongside the drugs and the physiotherapy for my ulcer and back, I decided to improve my diet, cut out alcohol and start exercising. When my marriage broke down in the early 1990s, I also started psychotherapy which helped me to think about my mental health and wellbeing in a new way.

My men’s health journalism brought me into contact with men’s health advocates and specifically the Men’s Health Forum, an organization that works to improve men’s health in England and Wales. When the coordinator left in 1999, I was invited to take over on a part –time, temporary basis. In 2000, I became the Forum’s first full-time Chief Executive and I stayed for another 12 years. During that time, I helped to develop the Forum into a national charity, launched Men’s Health Week in the UK in 2002, and push men’s health issues onto the agendas of national government and the health services.

I left the Men’s Health Forum in 2012 in large part so I could focus more on the men’s health issues that most interested me without the burden of organizational management, a major aspect of my job that I’d always seen as a necessary evil. As a self-employed consultant in men’s health, I’m now able to focus much more on the issues that really interest me. I’ve mainly been working with the European Men’s Health Forum on improving men’s use of primary care services, developing a UK campaign (HPV Action) that makes the case for boys to be included alongside girls in the national HPV vaccination programme, and establishing Global Action on Men’s Health (GAMH).

GAMH came about because I’d become very aware that in most countries men’s health was not being addressed, or even talked about, and agencies with a global role, such as the World Health Organisation seemed to believe that gender was about women alone. My view is that there need not be a conflict between men’s health and women’s health; they are not binary opposites or a zero sum game. In fact, they are closely intertwined: improving men’s health would be good for women’s health and vice versa.

What makes me passionate about improving men’s health is a firm belief that, when it comes to health, men are not being treated sympathetically or fairly. Too many men are dying too young or living too many years with debilitating health problems, both physical and mental. It could be so much better.

Tackling men’s health problems is not only ethically the right thing to do – because enjoying optimal health is a basic human right – it also makes good economic sense too. We know from studies in the United States and Canada that men’s health problems are very expensive for health services and for society as a whole.

Me: What inspires you on a daily basis, especially when things get hard?

PB: I relish the intellectual and creative challenge of finding new and different ways of making change happen even in the least propitious circumstances. I’m also inspired by breakthroughs in men’s health in the least likely places; for example, I learned very recently that a National Men’s Health Policy has been developed in Iran. (Such policies had previously existed only in Australia, Brazil and Ireland.) I’ve also been impressed and actually staggered by the exponential growth in the number of men’s sheds in many countries; these are helping to reduce older men’s social isolation, improve mental wellbeing and increase participation in community projects.

Me: In what ways can healthcare and public health professionals engage men to be more proactive in their health?

PB: The Men’s Health Forum in the UK recently published an evidence-based guide to engaging men in mental health services. This contains ‘Top Tips’ that very neatly encapsulate the actions that are most likely to engage men to be more proactive in almost any aspect of their health. Here are some of them:

  • Start by understanding what the barriers are currently.
  • Communicate with men in a way that respects their maleness.
  • Be positive about men.
  • Ensure that interventions have clear objectives that its users understand.
  • Consider basing interventions on shared activities.
  • Make sure the setting is a ‘safe male space’.
  • Incorporate peer support.
  • Publicize positive examples.

Me: Describe your vision for GAMH in the future.  Where do you see it in the next year, 5 and 10?

PB: GAMH is still in its early stages and is slowly building up its infrastructure and developing its ideas and strategy. In the next 5-10 years, I expect it to be established as a small but influential international advocacy organisation with members in many more countries at all levels of income and development. It will be recognised by other global health agencies, not least WHO, as a reputable source of information, advice and guidance. It will have succeeded in putting men’s health firmly on the global gender agenda.

Me: What are the current needs in (city or country you live in) as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

PB: I live in the UK where male life expectancy still lags behind female (by four years) and where men are much more likely to die before the age of 75 (60% of all premature deaths are male). The group which has experienced the smallest decline in age-specific mortality over the past 20 years is men aged 25-45. There is a marked social gradient in life expectancy and it is steeper in men than women; in other words, deprivation has a bigger impact on men’s health than women’s.

Men are poor users of a wide range of primary care services (general practice, pharmacy, optometry and dentistry) and some screening services, especially bowel cancer screening. They are particularly reluctant to access services for common mental health problems like anxiety and depression. Part of the explanation for this is that services have not been designed with men in mind and they are not actively encouraged to use them. Workplaces also account for a wide range of health problems in men in the UK, particularly deaths and serious injuries.

Although more account has been taken of men’s health in recent years in the UK, there is still no national men’s health policy and practical action tends to be localized, patchy, short-term and small in scale. A strategic approach, both nationally and locally, is needed if men’s health inequalities are to be tackled effectively.

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One thought on “Public Health in Action – Not a Zero Sum Game

  1. Pingback: Public Health in Action: Not a Zero-Sum Game | Talking About Men's Health™

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