They smoke too much and drink too much. Men really are behaving badly - and only women can save them

The sexes' different attitudes and lifestyles reflect in their state of health, reports Nicholas Timmins

Men behave not only badly but dangerously and so far we do not really know why, according to a report from the Royal College of Nursing today.

Living with a female partner improves a man's health, the study by the college's Men's Health Forum says, while widowed, divorced and separated men are more likely to smoke or drink excessively - no data are available for homosexual couples.

Men are less likely to visit their GP, and those who do tend to do so less often than women. Yet in-patient stays in hospital and out-patient attendances are higher for men in most age groupings, probably in part because they put off seeking medical advice for longer. Also, possibly for the same reason, they die younger than women.

The forum, which links 40 organisations ranging from the British Medical Association to charities, medical and mental health groups and the Confederation of British Industry and the Trades Union Congress, said that most research has focused on biological differences between men and women. But men's beliefs, behaviour and attitudes - as both consumers and providers of health care - may be at least as important.

Men tend to see their bodies as machines, focusing on being fit, strong, energetic, physically active and in control. Women are more focused on avoiding ill health, and put greater stress on diet and rest than on exercise. Men are less likely to seek help for problems, and indeed find it difficult to do so because of their need to feel in control and self-sufficient.

Many men also report finding a conflict between their job and their health needs, while difficulties in finding employment and the absence of a partner may play a part in the steady rise in the number of suicides among young men.

Despite their belief in being fit and active, men are in fact more likely than women to smoke, drink too much and be overweight.

On top of the differences between the sexes in their own behaviour, health professionals also seem to react differently to men and women with the same symptoms - men tend to be perceived as less ill and women to be exaggerating their symptoms.

Although women have higher rates of mental illness than men, the latter make up the majority of substance abusers and are more likely to be diagnosed as being paranoid, antisocial or schizoid.

Most of the work on men's health has concentrated on biological differences, the report's author, Trefor Lloyd, said. But "in the explosion of interest around men's health, there has been very little examination of what men think and how their behaviour affects their health.

"If we can begin to understand men's risk-taking behaviour, health professionals will be much better placed to tackle the health needs of men more effectively."

The heightened risks of being male

t Men die younger than women

t Suicide is four times as common in men as in women

t Men under 65 have three and a half times the likelihood of coronary heart disease as women

t Men are more likely to smoke, drink too much and be overweight

t In childhood, males have higher rates of attention deficit, hyperactivity and conduct disorders

t Accidents account for 42 per cent of all deaths among 15- to-24- year-old men, and 17 per cent in those aged up to 44

t Almost one-third of premature deaths in men under 65 are cased by cancer, with lung and prostate cancers the most common cause

t Testicular cancer has doubled since the early Seventies with 1,200 new cases in 1992, although fatalities are decreasing