WIXLIB

Executive SummaryImpetus for policy developmentIn recent years, there has been a growing awareness, and indeed concern, about theburden of ill-health experienced by men in Ireland.[1, 2] Male life expectancy is almost 5years lower than female life expectancy[3] and men in Ireland have higher death ratesfor most of the leading causes of death across the lifespan[4-6]. The burden of ill-healthand mortality is borne, in particular, by men from the lower socio-economic groups(SEG 5 and 6). These men are up to 6 times more likely to die from the leading causes ofdeath than men from SEG 1.[68] Young men (aged 18-35 years) are also a high-risk group– they are almost 4 times more likely to die earlier than their female counterparts[8] andcurrently have the second highest rate of suicide among the 30 OECD Member States[9].The profile of men’s health has been raised internationally in recent years through anumber of key mechanisms. These include the hosting of the first World Congress onMen’s Health in 2001, the launch of the International Society for Men’s Health (ISMH),the commencement of an international Men’s Health Week, the launch of the EuropeanMen’s Health Forum (EMHF) and the introduction of three academic journals devotedto men’s health (International Journal of Men’s Health, Journal of Men’s Health and Genderand American Journal of Men’s Health).The upsurge of interest and activity around men’s health at international level has alsobeen mirrored in Ireland. In 2001, men were identified for the first time in the NationalHealth Strategy, Quality and Fairness[55], as a separate population group for the strategicplanning of healthcare. Specifically, Action 15 of the National Health Strategy called forthe development of ‘a policy for men’s health and health promotion’, which is the firstcall of its kind internationally. This significant step has enabled men’s health in Irelandto be greatly strengthened in recent years by research, advocacy work and a varietyof grassroots projects in both the statutory and community/voluntary sectors. TheHealth Service Executive (HSE) has funded research initiatives into men’s health[1, 2], hasdeveloped a number of regional strategies on men’s health[36-38] and has funded a rangeof community development-related projects for men’s health throughout the country.Other statutory and voluntary bodies have also supported research and initiatives onmen’s health, both locally and nationally.[2, 39-42, 122]All these initiatives have generated a considerable momentum in the area of men’shealth in Ireland and this momentum, from grassroots to statutory levels, has been a keyfactor in the development of this National Men’s Health Policy 2008 – 2013.Vision for men’s health in IrelandA number of key theoretical and philosophical principles have been adopted indeveloping this policy, each of which is discussed below.1

Adopting a gender-mainstreaming approachThis policy adopts a gendered approach to men’s health and recognises gender inthe context of culturally defined masculine or feminine traits that are deemed to besocially appropriate to the sexes.[43] A ‘gender-mainstreaming’[33] approach recognisesthat gender equality is best achieved through the integration of the health concerns ofmen and women in the development, implementation and evaluation of policies, bothwithin and beyond health. Building on the Equal Status Acts 2000 to 2004, this policyendorses the approach taken by Health Canada’s Gender-based Analysis Policy[34] and theEqual Opportunities Commission’s Gender Equality Duty Code of Practice[35] in Englandand Wales, and adapts these policies as potential frameworks from which to developa gender-mainstreaming approach to men’s health in Ireland, across all Governmentdepartments, in the future.Adopting a social determinants approachThis policy adopts a social determinants[48] approach to defining men’s health. Itrecognises that social and economic factors, including poverty, are key determinants ofthe health status of men.[7] The policy aligns itself with existing strategies[49, 50] that targetthe reduction of poverty in Ireland and that seek to tackle health inequalities by workingin partnership with National Anti-Poverty Networks and the Community DevelopmentProgramme. By recognising diversity within men, this policy acknowledges the right ofall men in Ireland to the best possible health, irrespective of social, cultural, political orethnic differences.Adopting a community development approachIn recognition of the fact that one’s community, defined by geography, culture orsocial stratification, is a valuable resource for health, this policy seeks to harness socialcapital among communities of men through a community development approach. Byadopting this approach to men’s health and positioning this policy within the widersocial inclusion policy of Government[49, 50], all communities of men in Ireland may besupported to achieve optimum health and well-being.Adopting a health promotion, preventative approachIn the context of supporting health behaviour change and reducing prematuremortality among men in Ireland, this policy calls for a gendered approach to theimplementation and evaluation of health promotion policy in Ireland.[57] It centres onthree core areas – settings (e.g. workplace), populations (e.g. young men) and topics(e.g. smoking cessation) – whereby lifestyle modification is targeted via key settings andtopics through a life stage approach.[304]National Men’sHealth Policy2008 - 20122Adopting an intersectoral and interdepartmental approachUnder the aegis of the Advisory Health Forum, this policy seeks to promote men’s healthin synergy with other policies and services within and beyond the health sector. Such anapproach calls for the strengthening of alliances and partnerships with the communityand voluntary sectors, as well as with the statutory sector in areas such as education,employment, environment and social affairs.

Tackling men’s health from a strengths perspectiveThis policy endorses a positive and holistic approach to men’s health – one thataddresses the underlying causal factors that can be attributed to men’s poorer healthoutcomes and that creates health-enhancing environments for boys and men. While itis imperative not to overlook the ‘problems’, it is equally important to build on the manystrengths of men in Ireland and to challenge men to take increased responsibility fortheir own health. This policy does not seek to make men dependent on the healthcaresystem, but rather to facilitate them in looking after themselves and in their use ofappropriate services for better health and quality of life.Supporting men to become more active agents and advocates for their own healthThis policy sets out a range of initiatives, in the statutory, community and voluntarysectors, designed to support men in becoming better advocates for their own health.Research and consultationA multi-level approach, centred around research and an extensive consultation process,was adopted for the development of this policy and its implementation, set out in theAction Plan in Part III of this policy document.[60] A research project was conductedwith more than 600 men over a 3-year period (2002-2004) to explore specific healthissues. The findings of this research[1] were launched at the first National Conference onMen’s Health, held in Wexford in December 2004, attended by over 150 delegates. Theoutcomes from this conference were also documented and used to inform this policy.An extensive consultation was then conducted over an 11-month period during 2005,involving 500 stakeholders from a diverse range of organisations to individual men.The consultation comprised three distinct phases (6 men’s health days, organised intoworkshops; 7 focus groups; and a call for submissions from the public and 94 targetedinvitations). In addition, an extensive review of both the national and internationalliterature on men’s health was conducted to establish the efficacy of translating theissues raised into policy recommendations. Other issues that emerged from the widerliterature were also considered for inclusion in this policy.Key Policy AreasStrengthening public policy on men’s healthThe successful implementation of this policy needs to take account of the factorsthat have impeded men’s health reaching policy agendas in the past. It is importantthat the structures underpinning the policy are developed in accordance with bestpractice in relation to policy development[60] and that they reflect the wider theoreticaland philosophical framework that underpins this policy. In order to ensure that thetargets set out in the men’s health policy can be achieved, the necessary structures andresources will need to be put in place, together with appropriate re-orientation andintegration of existing services.3

This policy identifies the need to broaden and expand the research base on men’shealth in Ireland. A crucial first step in this regard is the development of a National Men’sHealth Research Framework and Network within the context of the existing NationalPopulation Health Research Framework. In order to facilitate this, it is proposed thata Centre for Research and Development in Men’s Health be established, to be run onan initial pilot basis for 3-5 years. It is proposed that the Centre would be based in anacademic institution (the housing costs to be borne by the institution) and that externalfunding would be sought for two research posts and a ‘start-up’ research budget. Onceestablished, the proposed Centre would actively compete for research funding fromexisting sources in which research funds are disseminated, including the NationalPopulation Health Research Framework. It is imperative that the Centre would developclose working links with local HSE and community/voluntary agencies.Promoting and marketing men’s healthThere is a need to devise promotional and marketing strategies and programmes formen’s health that both challenge and support traditional notions of masculinity – inother words, developing health messages that appeal to men by challenging them totake greater responsibility for their own health so that they will be able to fulfil theirtraditional support role as provider, protector, husband and father. This policy endorsesthe recommendations from previous national health strategies[55, 118, 120] on the need

The profile of men's health has been raised internationally in recent years through a number of key mechanisms. These include the hosting of the first World Congress on Men's Health in 2001, the launch of the International Society for Men's Health (ISMH), , ).