Healthy variations - the state of the nation
21 Mar 2003
Two recent surveys have highlighted wide variations in men’s health across the UK. But why do we flourish in certain places and wilt in others - can some cities really be bad for our health?
In sickness and in health
The findings, reported in the consumer magazines Men’s Health and Men’s Fitness, were used to categorise cities as “Britain’s Fattest” (Glasgow) or “Britain’s Healthiest” (Leicester).
By looking at 18 different factors ranging from hospital waiting list times and doctor/patient ratios to rates of diseases such as cancer and from the level of sports facilities to air quality, Men’s Health concluded that Liverpool was the UK’s unhealthiest city, followed by Glasgow and Stoke-on-Trent.
At the other end of the scale, Leicester, it was decided, was the healthiest city, followed by Bristol, Derby, Leeds and London.
Men’s Fitness went for the more tabloid measures of numbers of pubs, fast-food outlets, health clubs and parks per head of population along with government figures on fresh fruit consumption and disease rates.
The magazine also placed Glasgow, Liverpool, Stoke and Manchester as the worst cities, and London and Leeds among the best.
So what, if anything, can we learn from the findings? Director of the Men’s Health Forum, Peter Baker, is not overwhelmed by the results. “Frankly, although these findings are very interesting, they are nothing new,” he says.
“Government statistics for ages have shown a very wide variation in men’s health across the UK. Glasgow and Manchester, for example, are well known to have the lowest life expectancy, and Dorset and the Home Counties to have the highest.”
These regional variations are also the same for women. However, what is interesting is that men’s health variations are far more dramatic. The reason for this, Peter explains, is the exact same reason behind the health variations in the first place – poverty.
Earn less, smoke more
“Surveys find that areas of high concentration of deprivation and poverty are associated with those with the worst health,” says Peter. Why? “People in deprived areas tend to smoke and drink more and have a poor diet, partly because they can’t afford anything else. It is also far harder to give up smoking if you are stressed.”
And in a vicious circle, the unhealthy behaviour is exacerbated by fewer and worse health facilities in those areas. Peter says, “It’s difficult to get GPs to set up practices in poor areas. It takes a particular type of person to want to set up on a deprived council estate.”
Furthermore, while diet is essential to good health, fresh fruit and vegetables can seem expensive compared to foods such as fish and chips, which offer more calories at a lower price.
There is also evidence that men are hit harder by poverty than women, says Peter. Because men see themselves as the provider, a lack of money causes them greater stress, and so they tend to over-compensate in their efforts to increase their “masculinity” by drinking more, smoking more and taking drugs – all of which take a toll on health.
The situation hasn’t gone unnoticed. In the past two years, there have been several reports into men’s health and what to do to tackle it more effectively. Most importantly perhaps, the Health Development Agency has produced two studies into boys’ and young men’s health – one recognising the problems and the other finding the most successful methods of tackling them.
A spokeswoman says the agency is not working on a regional model, but instead plans to tackle men’s health across the country. However, with confirmation only this week that the agency has prioritised men’s health this year, it seems inevitable that the areas to benefit first and most will be those with the worst health.
The director of public health for Glasgow, Harry Burns, is optimistic. “Compared to a decade or two ago, things are improving. But Glasgow is starting from a baseline that is far worse than any comparable city in the UK.”
All those concerned with men’s health point to the same problems and the same methods of dealing with them. Men remain ignorant about their bodies in comparison with women and they are also far less willing to talk about health problems or visit their doctor.
However, it’s not that men are unconcerned or interested – just that the health service does not engage them. Instead, it is suggested, youth clubs, football clubs and pubs – places where men feel more comfortable – should be used to a greater extent to get the message across.
Peter Baker says the schemes can make a real difference. “The first pub clinic was in Walsall in the West Midlands – a poor area – and men were queuing out the pub and up the street to have their blood pressure tested and speak to the nurse.”
However, experts suggest that the best way to improve men’s health is to redistribute wealth to poorer areas and help break the poverty/sickness cycle. That Leeds – a recently rejuvenated city – comes near the top in both men’s magazines’ polls is surely evidence that money has immediate knock-on effects.
How not to die
In the meantime, what should men be doing to improve their health? “It’s the usual bog-basic stuff,” says Peter Baker. “Smoke less, drink less, eat more fresh fruit and vegetables, do regular exercise, have a basic health check – perhaps every year – and get your blood pressure measured, particularly if you are older.”
While coming from the most deprived areas of Liverpool or Glasgow may statistically make you more likely to suffer from ill health, it remains up to the individual to look after themselves. Even a slight change in diet or exercise can mean the difference between sickness and health.
Men’s Health Forum
Health Development Agency