John Minihan (Progressive Democrats)

I welcome the Minister of State, Deputy Seán Power, and his officials to the House and thank them for contributing to this significant series of statements. I also commend Senator Glynn on his perseverance in seeking this debate. When one hears that a discussion is to take place on a strategy for men's health one can be forgiven for wondering what this is trying to achieve, what is the purpose of this discussion and what drives the need for a specific policy framework on men's health.

The health promotion unit, HPU, organised a series of men's health workshops around the country last year. These consultations involved engagement with all those working with men in the statutory, private and voluntary sectors and, of course, men themselves. The report that followed this consultation process opens with the statement, "A strong public policy gives legitimacy to any men's health initiatives that might be developed in the future". It is worth considering this point. Why would initiatives in an important area such as men's health require specific legitimacy?

The answers are complex. There is disparity in health outcomes between the genders, and among men. On average, Irish men can expect to live to 73 years of age, whereas Irish women can expect to live to 78.6 years. Men die from testicular and prostate cancers although both are treatable if identified early. Heart disease is largely preventable through lifestyle changes. Men perform poorly in respect of certain lifestyle factors. They eat less fruit and vegetables than women, have a higher intake of fat, are more overweight and obese and 75% of all suicides are men, particularly young men. Deaths from road accidents are three times higher in men, especially young men. Men appear in greater numbers in mental hospitals and in prisons. Men are less likely to visit a doctor when they are ill and less likely to report symptoms of disease or illness.

These problems, specific to or more prevalent in men, pose a challenge but also incentivise a strong men's health policy. They legitimise the steps taken to address these issues. The consultation process confirmed the need for existing and future policy across all sectors to be gender and equality-proofed. All policy moves should be assessed in terms of their impact on the health of men and women.

Gender difference in health promotion needs to be discussed. Where it is discussed, contributors can be accused of reinforcing stereotypes about both women and men. In general the stereotype of the carefree, or careless man, self-assured in his own invulnerability and immortality, and some sort of inverse for women are not helpful.

I was fascinated, however, to read of a new study, published in the journal Physiology and Behaviour, which confirms a common stereotype, namely, that women tend to comfort themselves with sweet-tasting foods while men prefer meat as their so-called comfort food. We need to recognise that there are differences in behaviour between the genders which can lead to different health outcomes, without fear of being accused of reinforcing unhelpful stereotypes.

Recent media reports have highlighted the differing effects the same drug can have on male versus female patients. This does not refer to a complex, prescribed drug but to aspirin. In this month's Journal of the American Medical Association, it is reported that men taking aspirin tend to have fewer heart attacks, while women have fewer strokes. No one knows why the drug acts differently on men and women, although basic physical differences are suspected. Medical professionals are talking about developing gender-specific testing and gender-specific medicine.

The health promotion unit's excellent 2004 report, Getting Inside Men's Health, to which the Minister of State has referred, stated:

The failure to recognise gender as an interactive system is fundamentally a failure to come to grips fully with the underlying causes for men's and women's health issues. The general absence of research in Ireland on gender relations and masculinities renders our understanding of the causation of men's health problems largely vague and speculative.

We must not allow a failure to understand the importance of some gender specific public policy to compound this problem.

The HPU consultation days also revealed disparities in health outcomes among men as an individual cohort, specifically for men affected by marginalisation. These include socioeconomic inequalities in men's health, problems of access to health and social services for minority groups of men such as Travellers and ethnic minorities and personal assistance for men with disabilities.

The HPU's 2004 report states, "the differences in men's health status and health outcomes arise in particular as a consequence of age, social class, education, employment status [and] the effects of marginalisation". I would urge that any men's health strategy would take on board the report's recommendations, including a careful choice of means to deliver information to minorities, the involvement of people from such minorities in research work, the provision of aggressive community outreach programmes, and the provision of culturally sensitive public service announcements.

Any men's health strategy that is to effectively tackle the disparities I have outlined must be cognisant of certain basic facts. As the HPU has outlined, a gender approach to health would allow for the development of gender specific policies and initiatives that would enable, in particular, more marginalised and vulnerable men and women to be offered more appropriate and effective health care. It would also encourage and facilitate men to move away from narrow and stereotypical codes of acceptable behaviour, and to develop skills that would make them more adaptive to a changing culture.

I am reassured by the commitments of the Tánaiste in particular, but also by the Government generally to policies that allow for the development of gender specific policies and initiatives as specified by the health promotion unit. These include the following: broader commitments on health, such as improved transparency and effectiveness of administration and funding; restructuring of administration; the National Treatment Purchase Fund; the expansion of public hospital beds; improved staffing; and extended medical card eligibility. All of these matters will play a part in delivering better health care for men as part of the general population.

However, we must ensure that following today's commendable debate, the challenges leading to disparity regarding men's health are not only recognised in public policy, but are also adequately addressed in future policy and initiatives. The Progressive Democrats will continue to make this a key objective in policy development and implementation.