Men's health is one of the UK's most familiar oxymorons. Where physical well-being is concerned, the battle of the sexes is no contest. While women are on first-name terms with every crevice and contour of their bodies, most men are lost in a Neanderthal darkness and emerge blinking into the light only when they are on the verge of a near-death experience.
Men's health is something of a joke down under, too. Except it's a joke of an entirely different order, a joke that men even want to laugh at. Having realised that no matter how often and earnestly doctors repeated the central tenets of basic health awareness most men studiously ignored the message, a few Australian doctors decided four years ago to try another tack. "We call it health by stealth," says Dr Greg Malcher, a GP in Daylesford, an old mining town of about 8,000 inhabitants 70 miles outside Melbourne. "We wanted to get to men in their comfort zones, where they might be more receptive to the message."
The favourite comfort zone of the average Aussie male is the bar, so that's where Malcher organised a series of men's health nights. He assembled a line-up of prominent Aussie sports stars and assorted entertainers and promised liberal quantities of beer. Before long he had a full house of nearly 400. Even then Malcher adopted a softly, softly approach. "We started off with Simon Madden, an Aussie Rules Football player, talking about his health, before I talked about heart disease and basic preventative medicine," he says. "We then had a drag act and a bar break before moving on to more difficult topics, such as depression and suicide."
Men's nights have caught on in other areas of Australia with similar results. Malcher is not claiming an overnight transformation in the male psyche and he is aware that much more needs to be done for men in the 20-55 age group, but he does think that he is building up a bedrock of awareness; a significant number of his patients no longer regard the surgery as a no-go zone and most now know there are lifestyle choices that can affect their health.
This Men Behaving Badly approach has knocked on to health programming on Australian TV. Out have gone the camera-friendly TV doc magazine shows and in has come a stand-up, or rather sit-down, health show presented by John Clarke and Bryan Dawe, the Australian equivalents of John Bird and John Fortune. "The public seemed to respond well to the idea of two blokes who knew next to nothing about the subject talking about their health," laughs Dawe. The show, which can be seen on the Discovery Health channel in this country, drew excellent ratings in Australia and at the very least had an effect on Dawe. "A viewer stopped me in the street and asked why I still smoked," he says.
"I couldn't think of a good answer so I quit."
So how would a similarly laddish approach go down here? A few nurses have been known to hold Wellman clinics in pubs, but what would happen if we went the whole hog and stuck Martin Clunes and Neil Morrissey at the head of a men's health campaign? TV doctor Mark Porter is far from convinced it would make much difference. He believes that most men are just as interested in their health and that the problems of male diagnosis and treatment are structural as much as psychological.
"Most GPs arrange their surgeries at times that are highly inconvenient for working men. Similarly, government funding for raising awareness and improving treatments for male-specific diseases has been ridiculously low. Breast cancer and prostate cancer have similar mortality rates, but until recently breast cancer received £10 million per year while prostate cancer got just £40,000." He also reckons that magazines, such as Men's Health, which could play an important role in promoting health issues, tend, instead, to pander to the narcissistic tendencies of their readers and advertisers. "You get a lot about the perfect abs and biceps and how to satisfy your partner, but not much else."
Where Dr Porter is somewhat measured in his responses, Dr Keith Hopcroft, author of A Bloke's Diagnose It Yourself Guide to Health, is far more outspoken.
"There are a lot of myths talked about men's health and this new body fascism is only going to turn men off," he says. "Most men know that smoking and drinking too much are bad for them and don't need to have it rammed down their throat, and going on and on about testicular and prostate cancer is more likely to create a bunch of male neurotics. Testicular cancer is actually very rare and is usually accompanied by an identifiable ache, so endless bouts of self-examination are only likely to turn up harmless abnormalities that cause sleepless nights. Similarly, prostate cancer is almost unheard of in the under-fifties so talking endlessly about it is only going to clog up the surgeries with people demanding tests for an ill-ness they almost certainly don't have. Even for the over fifties, the test creates as many problems as it solves, as it can only indicate the possibility of an abnormality and, in any case, there is no evidence that early treat-ment of prostate cancer improves the outcome.
"The message for men has to be: if you think you've got a problem see your doctor. If you don't, stay away."
Some people, of course, may take this a little too literally. Dr Malcher referred a patient to get a mark on his forehead seen by a skin cancer specialist and was concerned when the appointment wasn't kept. "The patient told me that he'd gone out to the garage and removed the mark with a soldering iron," smiles Malcher. "He said it had smoked a bit but it hadn't reappeared, so he reckoned it must be OK." I guess there's men's health and then there's real men's health.
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Friday, March 23, 2007
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