Terence Blacker: When it comes to health, men are second-class citizens

Campaigns for breast cancer draw headlines. Male cancers do not

In yet another instance of disastrous news management from the government, the launch of National Men's Health Week has coincided with a story that Tessa Jowell is now Cabinet minister with special responsibility for getting the Prime Minister to take more care of himself. Gordon Brown is said to be so pasty, frazzled and generally strung out that, according to a Sunday newspaper and the inevitable well-placed source, Jowell will be "quietly making sure he gets proper rest rather than staying up fretting and plotting all hours."

This early silly-season story is mildly insulting to Tessa Jowell, but the real joke is on the Prime Minister, a man apparently so eaten up with paranoia and ambition that, unless a woman helps him get enough rest, his health is at risk. A variation on the same general message has emerged from a rather more serious report concerning men and cancer, which is published this week. According to Cancer Research UK, men are 40 per cent more likely to die of some form of cancer than women, and 16 per cent more likely to get the disease in the first place. If gender-specific forms of cancer are excluded, the figures become truly mind-boggling. Men are almost 60 per cent more likely than women to get cancer and 70 per cent more likely to die from it.

The reaction to these figures has been quite extraordinary. Had a report been published showing that it was women who are significantly more at risk from a killer disease, alarm bells would be rightly be ringing at every level of our society. The Minister for Women would make a grave statement about the scandal. National Health executives would demand a review of screening procedures. There would be a glut of something-must-be-done, we-are-all-guilty editorials.

With men leading the cancer mortality figures, it is all rather different. The reaction has generally been a weary shake of the head and an agreement that it is the unhealthy lifestyle of men, their stupidity about their own wellbeing, which is to blame. Headlines have jokily made reference to men's fear of doctors. Male obesity and drinking habits have been mentioned. In short, the cause of the problem has been quite presented as being quite simple. It is men themselves.

These views are utterly bizarre. The Cancer Research UK figures provide a glaringly obvious indicator that thousands upon thousands of people are unnecessarily dying painful and miserable deaths, that as they do so they are costing the NHS millions of pounds, that a major area of gender inequality exists and may well be getting worse. And what is the response? Pull yourselves together, guys.

In fact, nothing is less individual, more obviously shared across gender and class, than expectations of male behaviour. The joke references to man flu, which we enjoy every winter, only works because it is assumed that men think themselves tough whereas in fact they fall apart at the first snuffle.

Look at TV commercials, reality shows, pop videos. Women who worry about themselves and their health are responsible; men who do the same are self-obsessed wimps. Many GPs, weirdly, confirm the same bias. Men may be told to get themselves medically checked up but when they do, doctors frequently do little to reassure them or to allay their embarrassment.

Meanwhile campaigns for breast cancer, all pink and positive, get headlines and celebrity endorsements, but male cancers are altogether less promotable and sexy. Men with prostate cancer have "consistently reported a worse experience of NHS care than patients with other common cancers and our new research indicates that this legacy continues," according to a recent statement from the Prostate Cancer Charity To a certain extent, this bias reflects who we are. Female values may be extolled in politics and business but, in the life we all live, it is the shucks-it's-only-scratch Clint Eastwood model of masculinity that commands respect and desire. That cliché of sitcom world, the male weakling who frets about his health, is funny because it accords to our own evolutionary bias.

It is too easy and too lazy to explain away the terrible imbalance between the health of men and women in terms of male slobbishness, and it is socially irresponsible to prattle pointlessly about lifestyle choices. Rather than delivering a general scold, government might introduce practical measures to help the situation and save lives. Setting up a mandatory medical check-up for men at certain stages of their life would be a useful start.

terblacker@aol.com