Differences make a Difference

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1 Differences make a Difference The European Mens Health Forum: Overview European Mens Health: An oxymoron? Mens use of services: Self-care & navigation Good practice: Wot does work? A Storm is coming: Man Made? 1

2 Rate per 100,000 Rate per 100,000 Suicide, men and women Male 15 to to to 44 Lithuania 02 Estonia 02 Latvia 02 Hungary 02 Finland 02 Belgium 97 Slovenia 02 New Zealand (00) Poland 02 Australia (01) Austria 02 France 00 Japan 02 Chile Canada 00 Romania 02 Norw ay (01) Slovakia 00 Czech Rep Denmark 99 USA 00 Thailand (00) Germany 01 Sw eden 01 Hong Kong 00 UK 02 Argentina (01) Portugal (02) Netherlands 03 Israel 99 Spain 01 Italy 01 Brazil (00) Greece 01 Armenia (02) Egypt Female 15 to to to 44 Belgium 97 Finland 02 Lithuania 02 Japan 02 Hong Kong 00 Hungary 02 Latvia 02 France 00 Norw ay (01) Australia (01) Slovenia 02 New Zealand (00) Austria Canada 00 Estonia 02 Sw eden 01 Denmark 99 Thailand (00) Czech Rep 02 Chile (01) Ireland 01 Netherlands 03 USA 00 Germany 01 Argentina (01) Poland 02 Slovakia 00 Romania 02 UK 02 Portugal 02 Spain 01 Italy 01 Brazil (00) Israel 99 Greece 01 Armenia (02) Egypt 00 Adapted from White & Holmes (2006)

3 Age standardised death rates for cancer, by sex and country, all ages, latest year 1 Source: EC, 2011 (forthcoming) except CY, CH FR, IT, MT, NO, SE, UK (2007). DE, LU (2006). ES, PT (2005). BE (2004).

4 % Difference (%) between men and women in cancer survival across Europe Slovenia Malta Czech Republic The Netherlands Italy Poland Spain EUROCARE-4 mean Northern Ireland Germany Belgium England Scotland Switzerland Wales Finland Verdecchia et al (2007) Eurocare 4 Norway Iceland Ireland Austria Sweden

5 HEALTH SURVEY NORTHERN IRELAND: FIRST RESULTS FROM THE 2010/11 SURVEY Parents were asked about the health of their children. For the majority (94%) of children, parents reported that their health generally is good or very good. In relation to children, aged 2-15 years, 8% were assessed as being obese based on the International Obesity Task Force guidelines, 8% of boys and 9% of girls. 5

6 We try never to forget that medicine is for the people. It is not for the profits. The profits follow, and if we have remembered that, they have never failed to appear. The better we have remembered it, the larger they have been. George W(ilhelm) Merck (29 Mar Nov 1957)

7 BPH: the growing burden Older men are commonly affected by moderate to severe symptoms associated with BPH 50% of men aged have BPH* 1 This rises to 90% in men years of age 1 Moderate to severe symptoms affect 14 30% of men with BPH 2 Around 28 million men in France, Germany, Italy, UK and Spain may have moderate to severe BPH. 3 This number is expected to increase as the population continues to age 1. Roehrborn CG et al. BJU Int 2007;100: de la Rosetta EAU Guidelines on BPH. 3. Decisions Resources BPH 2007, p. 30 7

8 Source: Eurostat proj_08c2150p Population pyramid, UK, 2010

9 Projected Population pyramid, UK, 2060 Source: Eurostat proj_08c2150p

10 The burden is set to increase UNITED KINGDOM 423 men per 1,000 aged >40 have BPH Projected prevalence increase of 1.4% per year Retirement age to increase by 1 year to 66 by 2020; and to 67 by 2050 Life Expectancy: 79 GERMANY 424 men per 1,000 aged >40 have BPH Projected prevalence increase of 1.1% per year Retirement age increasing from 65 to 67 between 2012 & 2029 Life Expectancy: 79 SPAIN 270 men per 1,000 aged >40 have BPH Projected prevalence increase of 1.3% per year Retirement age may increase by 2 years (65 67) Life Expectancy: 80 1.Decisions Resources BPH 2007, p FRANCE 421 men per 1,000 aged >40 have BPH Projected prevalence increase of 1.6% per year Retirement age up by 2 years to 62 in 2010 Life Expectancy: 81 ITALY 433 men per 1,000 aged >40 have BPH Projected prevalence increase of 1.4% per year Retirement age increasing by 3 or 6 months Life Expectancy: 80 10

11 Men are reluctant to consult about incontinence Men may assume that lower urinary tract symptoms are a normal part of ageing 1 Men with incontinence may delay seeking help from their doctor until symptoms are too bothersome and cause interference 2 My wife said I should come in because I am up 3 times a night Emberton et al. Int J Clin Pract 2007;62(1): Sun Joon Hong. BJUI, 2005; 95: Roehborn Prostate Cancer & Prostatic Disease 2005, p2 11

12 Health care professionals: a trusted source of information and advice WHICH?, 2010

13 Men s usage of the health service Consultations with GP In-patient use All ages All ages Men Women Source: General Household Survey, Office for National Statistics, 1988,1989

14 NPA INTERIM REVIEW: MEN S UPTAKE OF PHARMACY SERVICES (NOV 2012) Men on average visit a pharmacy four times a year. Average for women may be closer to 18 times per year. Nearly half (47%) of people accessing the New Medicines Service a free advice service for people taking a new medicine for a long term condition are men.

15 Self-care A historical perspective Prior to the development of the medical profession, self-care predominant. The development of the medical profession and knowledge (19 th century) as well as the development of antibiotics and other medicines (early mid 20 th century) had a dramatic impact on how ailments were addressed.

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17 Rate per 100,000 population Age standardised incidence rates for oral cancer and cervix, GB males females cervix Year of diagnosis

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19 Men confirm their concerns and need for information I frequently have to get up at least once in the night to urinate this has been going on for a couple of months. Should I be concerned? My husband has had trouble passing water for nearly 3 years but refuses to see a doctor saying it is just age. How can I get him to have it sorted out please? Please could you explain simply what the PSA test actually tests for? I have lower back pain but experience no restrictions in urination, I do tend to go more often though. I also have a feeling of heaviness in my bladder area are these common symptoms? 19

20 Self-reported frequency of BPH symptoms Banks I et al. JMH 2010 (in press) 20

21

22 Why is it important that the media help men to talk? Self-management is known to improve health status is people with chronic disease 1 Patients goals of treatment may be different from physicians goals for their patients 2 Patient s perception of their symptoms and how bothersome they are, is an important measure of treatment impact and disease improvement 2 1. Emberton et al BJIU Emberton et al Int J Clin Prac Sung Joon Hong et al. BJU International 2004;95: p2 22

23 UK national media coverage Only 2 of the UK s 10 daily national newspapers included any mention of BPH 8 of the UK s 10 daily national newspapers included mention of endometriosis BPH has not been mentioned in a BBC online news article since 2006 In the past 12-months alone, endometriosis has appeared in 4 BBC online articles 23

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