Men's Health & Primary Care: Improving Access and Outcomes
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Presentation made to the EMHF Primary Care Roundtable about men's health and primary care access - including usage of the internet for health purposes - England - July 2, 2014
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Men's Health & Primary Care: Improving Access and Outcomes
- 1. IMPROVING ACCESS AND OUTCOMES
- 2. You should probably have come a little earlier
- 3. You should probably have come a little earlier Oh. So it’s my fault is it?
- 4. “The man for the job" by Ви Го is licensed under CC BY-NC-ND 2.0
- 5. Which of the following conditions, if any, do you think you know the symptoms of? 0% 20% 40% 60% 80% 100% 64% 55% 25% 5% 49% 37% 14% 22% 59% 54% 75% 72% 82% 34% 64% 51% 5% 48% 33% 71% Arthritis Bowel cancer Breast cancer Cervical cancer Dementia Lung cancer None of the above Osteoporosis Prostate cancer Skin cancer Male Female Men much less likely to claim to know symptoms Populus survey on behalf of Saga – August 2013 – 11,729 men and women 50+
- 6. Which, if any, of the following would prompt you to go the GP? 0% 20% 40% 60% 80% 100% Blood in urine Blood in stool Severe pain NET: Feeling ill Feeling ill for more than 5 days Felling ill for 3-5 days Feeling ill for 1-3 days New lumps Persistent headaches Discharge Nagging pain Weight loss Dizziness/nausea Pressure from partner/ children… Rashes Diarrhoea and sickness NHS poster/TV awareness… Anxiety Weight gain Male Female But, for any given symptom, not much less likely to want to visit the GP Populus survey on behalf of Saga – August 2013 – 11,729 men and women 50+
- 7. Wang Y et al. BMJ Open 2013;3:e003320 ©2013 by British Medical Journal Publishing Group
- 8. 0% 5% 10% 15% 20% 25% 30% 35% 1% 25% 30% 12% 4% 24% 0% 4% 9% 29% 24% 9% 2% 22% 1% 4% Screen detected Two Week Wait GP referral Other Outpatient Inpatient Elective Emergency presentation Death Certificate Only Unknown Cancer Routes to Diagnosis 2006-2010 Men Women Cancer Routes to Diagnosis 2006-2010, NCIN 2013
- 9. Cancer Routes to Diagnosis (excl. Screened Cancers) 0% 5% 10% 15% 20% 25% 30% 35% 0% 22% 27% 12% 3% 31% 0% 4% 0% 21% 27% 12% 3% 33% 1% 4% Screen detected Two Week Wait GP referral Other Outpatient Inpatient Elective Emergency presentation Death Certificate Only Unknown Men Women Cancer Routes to Diagnosis 2006-2010, NCIN 2013
- 10. “Man at work" by Hagens_world is licensed under CC BY-NC-ND 2.0
- 11. Male deaths – under 65 19.2% Female deaths – under 65 11.8% Source: ONS 2013
- 12. 2,587 11,573 530 1,546 664 7,449 757 5,183 14,000 12,000 10,000 8,000 6,000 4,000 2,000 Self-employed full-time Employee full-time Self-employed part-time Employed part-time ‘000 Men Women Source: ONS Feb-Apr 2014
- 13. MEN 3.6% 1.0% 10.0% 57.1% 28.3% Over 45 hours 31 up to 45 hours 16 up to 30 hours 6 up to 15 hours Less than 6 Hours 0% 20% 40% 60% WOMEN 10.3% 2.2% 31.0% 45.7% 10.7% 0% 20% 40% 60% Over 45 hours 31 up to 45 hours 16 up to 30 hours 6 up to 15 hours Less than 6 Hours Source: ONS Feb-Apr 2014
- 14. “SR 520 Eastside project night work, August 2011" by Washington State Department of Transportation censed under CC BY-NC-ND 2.0
- 15. Colorectal cancer screening uptake – by age and gender 49.0% 53.0% 51.0% 56.6% 56.1% 56.4% 58.0% 56.0% 54.0% 52.0% 50.0% 48.0% 46.0% 44.0% 60-64 65-69 Total Male Female C Wagner et al, “Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in England, International Journal of Epidemiology, (2011) 10.1093
- 16. 1,000,000 900,000 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 Number of tests Proportion testing positive Total tests (F) Total tests (M) % positive (F) % positive (M)
- 17. Men as proportion of those presenting for chlamydia screening 36% 27% 23% 40% 35% 30% 25% 20% 15% 10% 5% 0% Internet General Practice Sexual and Reproductive Health Services (amongst those with available data)
- 18. Internet users and non-users, by age group (years) and sex, UK 99.1 98.9 97.7 93.9 88.7 73.6 47.1 89.3 99.3 99.0 97.8 94.8 86.4 67.7 29.5 85.3 120.0 100.0 80.0 60.0 40.0 20.0 0.0 16-24 25-34 35-44 45-54 55-64 65-74 75+ All Male Female Internet Access Quarterly Update, Q1 2014, ONS
- 19. Men 38% Women 62% NHS Choices: Public Omnibus Survey Jan 2014
- 20. Used the internet to look up health or social care information 50% 59% 70% 60% 50% 40% 30% 20% 10% 0% Men Women NHS Choices: Public Omnibus Survey Jan 2014
- 21. • Men are less interested in health, but this makes surprisingly little difference once something is physically ‘wrong’… • Men are less likely to research health issues and engage in preventative and screening activities • During working age – mainly due to inconvenience – impact on earnings – and pressure of time • Because they feel ‘well’ and any communication needs to address this…
- 22. • One factor may be that men are less likely to be carers during working age • How much ‘extra’ female engagement with health services or information is due to their caring role? • The critical challenge remains engaging men in screening and improving their health behaviours… • Health via the workplace remains a critical priority • Do we need to drive awareness of pre-65 mortality?
Editor's Notes
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- Consultation rate per 1000 person-year by gender and age (5 years age band) in 2010.
- GP Referral: includes routine and urgent referrals where the patient was not referred under the Two Week Wait referral route. Two Week Wait: urgent GP referrals with a suspicion of cancer. Emergency Presentation: an emergency route via A&E, emergency GP referral, emergency transfer, emergency admission or attendance. Other Outpatient: an elective route starting with an outpatient appointment that is either a self-referral, consultant to consultant referral, other or unknown referral (these referrals would not include patients originally referred under the Two Week Wait referral route). Screen Detected: flagged by the cancer registry as detected via the breast or cervical screening programmes. Inpatient Elective: where no earlier information can be found prior to admission from a waiting list, booked or planned. DCO: diagnosis by death certificate only. Unknown: no relevant data available from IP or OP HES or from NCWT or screening.
- GP Referral: includes routine and urgent referrals where the patient was not referred under the Two Week Wait referral route. Two Week Wait: urgent GP referrals with a suspicion of cancer. Emergency Presentation: an emergency route via A&E, emergency GP referral, emergency transfer, emergency admission or attendance. Other Outpatient: an elective route starting with an outpatient appointment that is either a self-referral, consultant to consultant referral, other or unknown referral (these referrals would not include patients originally referred under the Two Week Wait referral route). Screen Detected: flagged by the cancer registry as detected via the breast or cervical screening programmes. Inpatient Elective: where no earlier information can be found prior to admission from a waiting list, booked or planned. DCO: diagnosis by death certificate only. Unknown: no relevant data available from IP or OP HES or from NCWT or screening.
- GP Referral: includes routine and urgent referrals where the patient was not referred under the Two Week Wait referral route. Two Week Wait: urgent GP referrals with a suspicion of cancer. Emergency Presentation: an emergency route via A&E, emergency GP referral, emergency transfer, emergency admission or attendance. Other Outpatient: an elective route starting with an outpatient appointment that is either a self-referral, consultant to consultant referral, other or unknown referral (these referrals would not include patients originally referred under the Two Week Wait referral route). Screen Detected: flagged by the cancer registry as detected via the breast or cervical screening programmes. Inpatient Elective: where no earlier information can be found prior to admission from a waiting list, booked or planned. DCO: diagnosis by death certificate only. Unknown: no relevant data available from IP or OP HES or from NCWT or screening.
- Men – 64% of those working full-time – 80% of those self-employed full-time