Presentation from York conference about sustaining work with fathers. This presentation summarises key research around gender inequalities in health.

1. Working with Men & Boys:
Setting the scene
9th
November 2010
Dr Steve Robertson
Reader in Men’s Health
Centre for Men’s Health
Leeds Metropolitan University
With thanks to Prof. Alan White

2. Some background data
Men die earlier than women

3. Patterns of mortality in men and women,
15-44 years, UK, 2002
Calculated from White, AK, Holmes, M, (2006) Patterns of mortality
across 44 Countries among men and women aged 15-44. Journal
of Men’s Health & Gender 3(2): 139-151

4. These early deaths include: road traffic
accidents, suicide, violent death, drug and
alcohol related deaths.
Two-thirds of all deaths in teenage boys
are due to Road traffic accidents
Early Deaths

5. Men exceed recommended drinking limits more than women
(though this is less marked in younger age groups)
(ONS, Focus on Gender, Sept 2008)

6. Some background data (cont)
• Men are three times more likely to become alcohol
dependent
• About one in three young men use illegal drugs.
• Men are more than twice as likely to use Class A drugs.
• 78% of drug-related deaths occur in men.
Office for National Statistics, Social Trends 34 (The Stationery Office; London, 2004).

7. ‘Risk’ taking & socio-economic status

8. Some background data (cont)
Men commit the majority of crime including violent crime and 95%
of the prison population are male
ONS 2006

9. Some background data (cont)
84% of children excluded from school are boys.
Girls continue to outperform boys at all levels of education
(ONS, Focus on Gender, Sept 2008)
Pupils achieving five or more GCSE grades A*–C or equivalent: by sex

11. BUT…
This is not the whole story

12. Young men’s lives are more complex and contradictory

13. …the young men in Harland’s (2000) inner city Belfast
study (aged 14-16 years) clung desperately to narrow
and contradictory interpretations of masculinity,
believing that men should be powerful, strong, brave,
intelligent, healthy, sexy, mature, and in control of
every aspect of their lives. In reality, however, their
lives were full of ‘contradictions’ as most young men
felt powerless; feared the threat of daily violence;
were labelled ‘stupid’ in school; did not pay attention
to their health needs - particularly their mental health;
had limited sexual education; rarely asked for
support; and felt they were perceived by adults as
being ‘immature.’
Ken Harland. Acting Tough: Young Men, Masculinity and the Development of Practice in
Northern Ireland (http://www.mensproject.org/issues/kenspeech.pdf) accessed July 2010

14. McDowell, L. (2002) Masculine discourses and dissonances:
strutting ‘lads’, protest masculinity and domestic respectability.
Environment & Planning D: Society and Space 20: 97-119
Need to conform to
rebellious performances of
masculine actions
Envisage a settled future - steady
partner, house work & children
We often fail to recognise this desire in men for
‘domestic respectability’ and how this might be utilised
as a lever for moving away from the more negative
aspects of ‘protest masculinity’.

15. Taking responsibility - “as soon as you cut them (risks) down you’re doing something,
you’re controlling your life.”
Good judgement - “Also knowing that they’ve not been in trouble with the police…cos
that’s when people know they’re not being stupid, that they ain’t got stupidity.” S.4,
Q.1a, CA15);
Trust - “because people see more in you, they trust you more…and you earn their trust
more.”
Loyalty/faithfulness - “Yea, he (Jeremy Kyle) did actually cheat on his wife as well.” “I
know yeah, “Don’t cheat on your wife.”
Respect - “Gotta treat a girl right.”…”Just gotta be dead nice to the girl if you’re going
out with them”
Humour - “Just like have a laugh and stuff like that, like be happy and get on with
everyone.”
Being Popular - “Good personality, you’ve gotta be alright with everyone.”
Generosity - “Offering to buy them a drink every now and again.”
This desire for domesticity is reflected in some positive views
about relationships and responsibility (that are often juxtaposed to
public performances of sexual banter and misogyny)

16. Professionals & Gender
Female physicians spend longer with patients then male physicians and
spend more time talking about health-related lifestyle and social issues
(Roter et al 2002, JAMA)
Men receive less time than women in consultations with doctors and
explanations given are fewer in number and briefer than those given to
women (Courtenay 2000, Journal of Men’s Studies)
Ask yourself two things (and be honest!):
1)How do I see men?
2)What do I feel about working with them?

17. Men, vulnerability and relationships
There is a vulnerability about men in terms of relationships and emotions
that is not fully understood.
Men account for 75% of suicides in England and Wales
(ONS 2009) Suicides
Single, divorced and widowed men are three times more likely than their
married counterparts to take their own lives. Griffiths C, LadvaG, Brock A and Baker A.
“Trends in suicide by marital status in England and Wales, 1982–2005”. 2008: Health Statistics Quarterly no. 37.

18. Men and suicide, 2008
Calculated from: ONS (2008) Mortality statistics: Deaths registered in 2008. Review
of the National Statistician on deaths in England and Wales, 2008 . Series DR

19. The role of emotions
“As men we learn to live a lie. We learn to live as if our emotional lives
do not exist, at least as far as the ‘public world’ is concerned [. . .] We
learn to live in our minds as the source of our identities. If we had our
way as men it would be that our emotional lives did not exist at all.”
(Seidler 1994: 19)
BUT they do exist and have to find expression somehow

20. Male coping strategies (or not!)
• Men are half as likely to go to a counsellor or therapist to talk about
their feelings
• Twice as many men as women drink alcohol to cope with feeling down
• Men are half as likely as women to talk to friends about their problems
and less likely to talk to family
• Young men are the group most likely to tell a friend to “pull
themselves together” if they were feeling low
MIND (2009) Men & Mental Health: Get it off your Chest
Men are more prone to ‘instrumental’ rather than ‘communicative’
forms of action. i.e. Men are more likely to ‘act out’ rather than
‘talk out’ feelings.

21. Men’s reaction to feeling down,
stressed or depressed
Men’s Health Forum 2006

22. The ‘big build’: the upward trajectory of the
masculine enactment of emotional distress.
After Brownhill et al, 2005 in Branney & White (2008) Advances in Psychiatric Treatment 14 pp 256–262

23. “Acting out” - Extremes

24. “Acting out” - Positive

26. Successful factors in work with young men
• A proactive approach that focuses on developing young men’s
self confidence
• An appreciation of masculinity and how this impacts upon
young men’s behaviour
• Identification of issues affecting young men and using creative
ways to address these
• Programmes that offer a combination of reflection, activity and
emotion
• The practitioner’s skills, knowledge and empathy towards
young men
• Appreciation of the qualities that young men look for in a
practitioner – trust, genuineness, respect, humour, support, non-
judgemental, acceptance
Ken Harland. Acting Tough: Young Men, Masculinity and the Development of Practice in
Northern Ireland (http://www.mensproject.org/issues/kenspeech.pdf) accessed July 2010

28. Steve Robertson
Centre for Men’s Health
Leeds Metropolitan University
Leeds LS2 8NU
UK
email: s.s.robertson@leedsmet.ac.uk