Boys and young men are missing out on health care because their health needs are not understood and services fail to reach them, a report today maintains.

Traditional masculine characteristics, such as high levels of drinking, smoking and drug use in adolescence, or risky driving behaviour, are rarely considered as impacting on young men's health, according to the report commissioned by the health development agency (HDA).

The report, prepared by Working With Men, a non-profit organisation, says men's health services tend to focus on specific conditions, such as prostate and testicular cancer, or on sexually-transmitted diseases. One barrier preventing medical professionals addressing wider issues is that there is no agreed definition of what constitutes men's health.

By reviewing literature on the subject, and examining more than 40 projects across England, the report provides a snapshot of current provision for males aged 11-25, highlights gaps in provision and makes initial recommendations for improving services.

Young men are portrayed as reluctant to seek help about health for fear of appearing weak, accessing services only when desperate. Projects which encourage them to use services earlier often provide phone lines or drop-ins to ensure the client does not "lose face".

Others, such as the Twilight football league, use an activity as an access point. Initiated by Wolverhampton Wanderers football club and Wolverhampton health authority, the league has youth workers collaborating with soccer coaches to tackle issues including teenage pregnancy.

The report, Boys' and Young Men's Health, suggests that projects work best when they are directly relevant to young men's lives and where there is endorsement by peers. Some were found to use a service only if they had heard from a friend, or someone else they trusted, that it was OK.

As a result, the report recommends that learning sessions for boys and young men should be more practical. It calls on health practitioners to review how they talk to this client group and whether gender may influence acceptance of the diagnosis.

Richard Parish, chief executive of the HDA, says: "The report reveals that while there are some successful innovative projects addressing young men's health needs, there are still gaps in services available. It is part of the HDA's role to ensure that the examples of good practice are made available to health workers to help improve the services offered to boys and young men."

· Boys' and Young Men's Health is available at www.hda-online.org.uk/html/resources/publications.html