The weaker half


We all know the story, men’s health is worse than women’s in most measures, but what can be done about it? And does pharmacy have a role to play? Chris Brooker reports

What is it with us blokes? Reputation (and some evidence) has it that we don’t like to wait for our health care, that we put off getting checked, don’t adhere to medication regimens, ignore lifestyle advice, and for really serious symptoms try to ignore them all together.

It’s not a pretty picture, but is it the real story?

And if men really don’t like to wait, does pharmacy have a role as the most accessible primary care destination?

Not fitting in

In the western world, men have higher mortality rates than women, but use the health system than women, even when accounting for reproductive services, say Adelaide University public health researchers in a recent men’s health overview.

“In fact, being male is a significant risk factor for mortality in developed countries,” they said.

“Men are often blamed for being poor consumers of health services and are thus seen to be victims of their own behaviour”.  

The initial approach by men for seeking help for health-related issues tends to be indirect, they said.

“Men tend to view their partners and friends as a primary resource for help. In circumstances where men do seek primary health care, they are more likely than women to focus on physical problems and are less likely to disclose mental and emotional problems”.

Based on the perspectives of family physicians, a number of systematic barriers that prevent men from seeking help from health services have been identified. These include lack of time, poor access opportunities, having to state the reason for a visit, and the lack of a male care provider, they said.

The opportunity

Given the accessible nature of community pharmacy, not to mention the usual lack of requirement for a booking, pharmacy should be well placed to take a leading role in filling the gaps in men’s health.

Pharmacists are well placed to provide men with a wide range of advice, including the importance of taking their medications, quitting smoking, engaging in regular physical activity and eating a healthy diet.

Some experts advise to approach men’s health via an area where they may be struggling, such as fitness for sport, as a way of engaging in deeper discussions, or getting into underlying issues.

“The major burden of disease in Australian men is attributable to cardiovascular disease, cancer and injury, and, for many conditions, men have higher incidences and higher age-standardised death rates than women,” says public health academic Professor Mark Harris.

“Despite declines in cardiovascular disease mortality, ischaemic heart disease is still common and much more prevalent in men than in women aged 40–74 years, with men being twice as likely to die from it. This is partly because of the greater contribution of smoking, alcohol intake, overweight, elevated cholesterol levels and type 2 diabetes to their cardiovascular risk,” he said.

He advises primary care practitioners to ask about risk factors or early signs of major health problems, advise and motivate patients to lower their risk and assist patients with pharmacological and non-pharmacological therapies.

Getting the right look

Pharmacies need to consider their layout and look when they consider how they market to men, said Dr Anthony Brown, project manager of the Men’s Health Information and Resource Centre, a research centre linked to the University of Western Sydney.

“On the whole, men perceive health and community services as feminine and feminised and as such, think it is not set up for me,” Dr Brown told AJP previously.

“This is part of the reason why you don’t see many men interacting with pharmacists as much as they should.”

“The fact is men are interested [in their health] and they do talk… they may do it in a different way to women, but they do,” Dr Brown says.

He suggested pharmacies interested in focusing on men’s health consider the store’s colour scheme, layout, signage, product placement and the health information available.

“Who likes pretty colours? And who wants to walk through three rooms full of cosmetics and perfumes before they reach the band aids?” Mr Brown posed.

A winning strategy

Andrology Australia, the Australian Centre of Excellence in Male Reproductive Health, suggests pharmacists could maximise opportunities to talk to men about their health by taking on board the following strategies adapted from the Andrology Australia clinical summary ‘guide on engaging men in primary care settings’.

Strategies to engage men in discussions about their health include:

  • stating facts clearly during consultations;
  • using terminology that is easily understood;
  • providing written information to patients to read after they have left the pharmacy;
  • listening to and responding to patients needs to facilitate an empathetic style of communication based on respect and trust;
  • aiming to deal with their health issues quickly and comprehensively;
  • referring patients onto doctors promptly particularly if the problem remains unresolved;
  • keeping abreast of the latest development and conveying these to patients;
  • applying and explaining the role of new knowledge;
  • alleviating the perceived seriousness of health concerns by using humour thoughtfully to facilitate the building of rapport;
  • being proactive and sensitive in managing patients’ sexual and mental health concerns;
  • clinical guides for health professionals can be accessed on the Andrology Australia website.

Case study – getting the message across

Writing on the Pharmacy Guild of Australia website, Karen Brown, managing partner of Samford Chemmart Pharmacy said that “men’s health is an extremely important issue – unfortunately many men don’t seem to agree”.

“Ensuring health is a front-of-mind subject for Australian men, particularly the 30 to 50 year old age bracket, is a difficult task due to common misconceptions about health checks such as it takes too long, it doesn’t matter and I don’t need to go I feel fine….”

Engaging with and changing the perceptions of men, so they have both a better understanding of the importance of health and the simple steps they can take to make a difference in their lives, is a critical role that community pharmacists can play, she believes.

Samford Chemmart Pharmacy hosted in 2016 a men’s health information session that aimed to attract a large number of men from the community, to demonstrate the simple steps they can take to prioritise their health.

The event was highly successful, with more than 100 men aged between 30 and 80 attending. Ms Brown’s key insights from the night were:

1. Encourage attendance with an appealing keynote speaker and other incentives.

“With only a month to plan the event, we decided to engage a keynote speaker to encourage attendance. In rugby league-mad Brisbane, we looked no further than the King himself, Wally Lewis.

Wally’s sporting-legend status helped draw a crowd but his story and personal battle with epilepsy made him an extremely interesting and insightful speaker. It was important that we had a great speaker people wanted to meet, but also someone who could relate to the audience by sharing personal stories about their health and the steps they took to improve their life.

In addition, we offered an incentive of a luxury weekend away, donated by Audi Centre Brisbane, to encourage men to take a health check on the night”.

2. Have a strong message

“Wally’s main message for our audience was ‘Don’t be a Coward’ which we amplified as our hashtag for the evening across social media.

His story was inspiring and stressed the fact that we all want to live as long as we can with the people we love and to do so, sometimes we need to speak up and ask for help.

Having such a strong message delivered by someone who many see as an indestructible hero was very powerful and sent a clear message to the audience that their health should be a priority”.

3. Demonstrate the ease and effectiveness of health checks

“The core goal of the evening was to demonstrate how effective, simple and quick health checks can be.

Our first guest speaker was Samford Valley Doctor David O’Regan, a well-known and respected community member who discussed health concerns and recommended health checks for different age brackets, as well as conducting a Q&A session.

To demonstrate how simple and effective health checks are, we did more than 60 blood pressure checks on the night in the space of three hours”.

4. Create the right environment for your audience

“When discussing personal health issues with predominately strangers it’s important that your audience, regardless of age and gender, are comfortable in the environment.

One of the benefits of having a male-only event was that the attendees were very comfortable and relaxed in discussing health concerns of key importance to males, such as mental health and prostate cancer, and asking questions they may have otherwise kept to themselves.

The reaction we received from the event has been extremely positive. We started the evening with men who were encouraged to attend by their wives and we’ve since had locals visit our pharmacy on a recommendation from someone who attended our event asking us when we’ll be hosting our next one”.

Useful contacts:

Sources

Armstrong, Bruce K et al, 2007. Challenges in health and health care for Australia, MJA, 187 (9) 485-88

Baker, Peter et al, 2014. The men’s health gap. Bulletin of the World health Organization 2014: 92:618-20, 2015. A pharmacy initiative to tackle men’s health. The Pharmaceutical Journal, Vol 295, online first 26/11/2015

Phillips, Graham & Lemanska, Agnieszka

Smith, James A et al, 2006. What do we know about men’s help-seeking and health service use? MJA, 184 (2); 81-82

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