Friday night in a bar at Headingley sports stadium in Leeds, half an hour before the Leeds Rhinos rugby league team kicks off, and a stall offering quick health MOTs is doing a steady trade. Andrew Harrison and Pete Westwood are busy measuring the height, weight, waist size, blood pressure and cholesterol level of men who might usually be having a pre-match pie or pint. Some volunteers get a clean bill of health; others are signed up for on-site courses to help them lose weight or stop smoking; a few are advised to visit a GP.
"The idea is to bring health services to men who may feel more comfortable having a check-up at a sports ground than they would using traditional health services, such as a GP's surgery," says Professor Alan White of Leeds Metropolitan University, one of the initiative's driving forces. "There are around 20,000 men there for the match, many of whom would usually be reluctant or unable to see their doctor. When we did some of these sessions last year, we found men who had health problems they didn't know about, such as diabetes, high cholesterol and hypertension, and pointed them to where they could get help."
The scheme is typical of White: creative, mould-breaking and determined to make a difference to the wellbeing of men. In 2004, the nurse-turned-academic became the world's first professor of men's health. He has spent years arguing for health services to be much more resourceful in engaging the 49% of the population who are often famously unwilling to talk about their bodies. Despite occasional local efforts, men's health has remained little more than a faint dot on the NHS's crowded radar.
Major breakthrough
At last, things are changing. Today the Premier League, which represents England's elite football clubs, in partnership with primary care trusts across the country, launches a groundbreaking nationwide scheme to tackle men's health. Backed by £1.63m from the New Football Pools betting firm, with a similar amount provided in match-funding by local NHS organisations and the clubs, the Premier League Health initiative represents a major breakthrough in the status of this area of healthcare.
Today White, who helped devise the programme, and the public health minister Dawn Primarolo will attend its launch at Craven Cottage, home of Fulham FC in south-west London.
As part of the scheme, 17 of the league's 20 clubs will use their pulling power to persuade men, especially in areas around stadiums that are often deprived, to start thinking seriously about issues such as diet, depression and alcohol consumption. Each club will employ a health trainer to specifically target men and, by 2012, have a permanent men's health clinic at their ground. Premier League Health builds on previous initiatives by top clubs that have used their glamour to engage young people on issues such as reading, truancy, antisocial behaviour and cooking skills.
The moment has been a long time coming, admits White. "When I got involved in men's health in the late 1990s, it had no status or low status. Worse, it had a negative connotation to some people, such as some women's groups that thought it would be a challenge on the limited resources being pumped into women's health."
White, 49, first became interested in men's health while working as a nurse with female patients. He wondered how female nurses could understand their male patients. Later, when he became a nursing lecturer, he was struck by the lack of information about men's health in textbooks and training courses. "In academia at the time, the masculinity theorists were looking at men and war, men and sex, and men and work - but men and their health was completely missing," White recalls. The Men's Health Forum, initially a sub-section of the Royal College of Nursing, emerged as a group of professionals determined to get their subject greater priority. It is now the main - indeed, only - lobbying organisation in this area.
A few minutes in White's company constitutes a crash course in the urgency of men's health. "Men tend to develop, and die from, most conditions sooner than women do," he says. "One in five men dies before 65, usually because of cancer, heart disease, an alcohol-related condition, suicide or an accident. That's a huge loss not just in economic terms, but also because these men are breadwinners and role models.
"The gap in men's life expectancy compared to women is narrowing, but is still several years. Men can have a major condition like diabetes for five or 10 years without knowing it, partly because men under 45 visit their GP less than women."
Even before he became professor of men's health, his expertise and campaigning zeal led the then public health minister, Yvette Cooper, to commission him to conduct a study on the subject for the Department of Health in 2001. Progress has been slow, though. In 2007 the now-defunct Equal Opportunities Commission identified a "health gap" that disadvantaged men and it urged the NHS to be much more male-friendly.
"Men are more likely than women to work full-time and not have access to flexitime, so getting to see their GP can be difficult," says White. "Take my son David, who's a forester. He's out at 8 o'clock every morning and again at six in the evening. If he gets to the doctors he has to take a day's unpaid leave, so it's got to be fairly serious before he'll do that. There are many men in the same position."
But even extended opening hours will not solve the problem on their own, White admits. Men's reluctance, embarrassment and prevarication are big issues, as are men's social isolation and inability to discuss their wellbeing. White argues passionately that the ingrained nature of such male characteristics means the NHS had to think imaginatively about how to reach men. It's a myth that men don't care about their own health, insists White, it's just a question of access and education. "The biggest lesson I've learned is that if you stick in your nice clinic waiting for men to come to you, chances are you'll be waiting a long time. But if you go out to where the men are, you'll have more success."
Barbers' shops
White lauds local initiatives that have taken health to men in the places they congregate, such as health checks in barbers' shops in Bradford and in a Harley-Davidson showroom in Wolverhampton. In Sefton, Merseyside, health promotion specialist Jo McCullagh has brought advice to taxi drivers, sailors and lorry drivers. So how seriously does the NHS itself take men's health? White is diplomatic but cannot disguise his frustration: "The NHS has many competing pressures and targets, and they make it hard for it to be innovative when there's not a strategic lead [on men's health]. But the NHS should have a huge incentive to become interested in men's health because 21% of men die while they're still of working age."
The 2005 Equality Act, and specifically the Gender Equality Duty it imposed on public bodies, is starting to change things. The act obliged public bodies to undertake a gender equity audit. "If you did an audit for weight-loss strategies across the country, you'd find they are mainly accessed by women and geared to women, even though more men in this country than women are overweight," says White. "If you really wanted to target those men, you'd be thinking about getting men's weight-loss groups into the workplace.
"I want to see men's health taken up as a serious issue by the whole NHS. Although there is a gender aspect to almost every health condition that disadvantages men, this isn't about men versus women. Increasingly, the debate about men's health is about the fact that men from lower socio-economic classes have worse health than better-off men."
From today, footballers will be doing their bit to help improve men's health. One-nil to White, you might say.