· Features

Health and wellbeing: Gender divide - Same but different

It makes sense for employers to promote healthy living to staff. But how gender-specific does the message have to be to reflect the sexes' differing attitudes to health?

In the best-selling book, Men are from Mars, Women are from Venus, gender guru John Gray says: "Men go to their caves and women talk". He was referring to how the sexes handle stress, but he could just as easily have been talking about how men and women differ in the way they look after their health and wellbeing: men are far less likely to see their GP, have regular dental check-ups or seek health advice at a pharmacy. As such, it is much more likely male staff will develop serious health conditions because they are not receiving preventive treatments early enough.

In fact, according to the Men's Health Forum, three times as many men die while of working age than women. The good news is the workplace has huge potential for promoting health messages and delivering care. But, given the differences in how the sexes relate to health, should health and wellbeing plans for staff follow gender divides?

Peter Baker, chief executive of the Men's Health Forum, strongly believes they should: "We know from the work we've done that if you deliver specific health services at the workplace you can get men more involved. If you design health services at work in a way that is more likely to be on men's wavelength, you'll get even better results. So, a gendered approach is much more likely to be effective with men."

The good news is companies that have tailored their messaging to target men report that women appear not to be alienated by this approach. BT, for example, launched its Work Fit programme in 2005 to encourage its 90,000 UK-based staff to eat more healthily and take more exercise.

"At that time we had 75% males and the average age was around 40 to 45," says Catherine Kilfedder, group health adviser at BT. "One of our concerns was cardiovascular diseases because many of our middle-aged men didn't work out or eat a good diet, especially our engineers. We used leaflets in the style of Haynes car manuals as an engagement tool, which was obviously of more interest to men, but there was no indication women felt in any way put off or felt it wasn't relevant to them." More than 16,000 staff (75% male) registered to participate in the online programme, which sent weekly emails for 16 weeks with suggestions about how to improve their lifestyles. According to Kilfedder, BT was advised that men were more likely to respond to initiatives that are easy to use, based on clear, factual information and can be accessed anonymously.

Four years on and BT's health promotion strategy is well established. As a result Kilfedder does not believe it is necessary to bring gender into campaigns now. Instead, she prefers to construct them around conditions. Recently they have included giving up smoking, mental health, cancer and diabetes. "For the very first campaign the gender angle was very important. Now, we need to be conscious of it but most of the underlying behaviours are non-gender specific, such as healthy eating and taking exercise," she says. She adds the main difference she notices now is that women are much more receptive to face-to-face contact, whereas men prefer to be given information to read on their own.

Cornish pasty firm Ginsters has had a similar experience. It hired Steve Smeeth as active workplace manager three years ago to improve the health of the workforce. Initially, he set out to appeal specifically to the mostly male workforce by "advertising to the hilt", promoting competitive activities such as football and avoiding the use of medical jargon. "At the beginning we steered cleared of generic health promotion campaigns but now we've got the staff's trust, we can run them. We're even running a promotion on domestic violence," he says. He adds there are frequently queues for the on-site clinic, with most men choosing this option rather than their GP - unlike female employees. The firm's health insurance premium has also been reduced since the programme launched.

One of the most effective ways to catch employees' attention, but particularly men's, is by using humour. When Jo McCullagh, tobacco programme manager at heart disease charity Heart of Mersey, was tasked with reaching truck drivers, cab drivers and seafarers with healthy living messages, humour was core to her campaign. Typically, these hard-to-reach, self-employed, mainly-male workers worked long hours, did not visit GPs or take enough exercise and relied on fast food cafes for meals. McCullagh created information leaflets with cartoon characters such as Colin the Cabbie, Tommy the Trucker, Billy the Bus Driver and Seafarer Sam. "A lot of research has shown you have to address health messages for men with humour, so the graphics are all very humorous and a bit naughty," she says. "On different pages there are different graphics like the one promoting safer sex which features a driver with his arm around a busty female."

Royal Mail has also found using humour especially effective in reaching men. But chief medical officer Steven Boorman says his main dilemma is "the extent to which I use it because there's a fine line. If the tone is too flippant it devalues the message". Like McCullagh, Boorman has found making the communication light-hearted and using a mix of cartoons and authoritative text in a "plain English style" works best.

As in the cases of BT and Ginsters, Royal Mail also originally started by thinking about how to package the message so men would listen. Now, Boorman is much more focused on which channels to use to most effectively get the message to employees, male or female. "We've done traditional health promotion booklets in the style of the Haynes manual. We've also put posters up in men's washrooms, rather than distribute them in the traditional way. We've also developed some materials that can be delivered at home along with our in-house newspaper. That way, when they fall out they can be picked up by the rest of the family," he says.

So, it seems once you've managed to lure men out of their caves, they are quite willing to talk about their health and take advantage of clinics at work. That is certainly the experience of Kwik Fit's occupational health nurse adviser, Dorothy Sneddon, who is behind its recently-attained Healthy Working Lives Gold Award. "The guys don't have any problems coming in here. We have a chat and a laugh, but they get the information they want," she says. "Health promotions here are aimed at everybody, I don't differentiate. The guys and girls would be up in arms if I made the campaigns divided by gender."

HEALTH CONDITIONS MORE LIKELY TO AFFECT WOMEN

- Eating disorders are more common among women

- Women are more likely to suffer from common mental disorders such as depression, anxiety and somatic complaints

- Women are more prone to autoimmune diseases such as lupus, rheumatoid arthritis and multiple sclerosis

- Women are more susceptible to incontinence problems and anaemia

Health conditions more likely to affect men

- Men are twice as likely to become alcohol-dependent and suffer cirrhosis of the liver

- Men are more than three times more likely to be diagnosed with antisocial personality disorders than women

- Men are twice as likely to develop liver cancer

- Osteoarthritis is more common in men under the age of 45 than women

- Men are more likely to misuse drugs and take their own lives

- Excessive smoking and drinking means men are at greater risk of hypertension

- Men are more prone to epilepsy than women

- Hyperactivity disorders are more common in men

- Men are more likely to get Parkinson's disease

- Men are more susceptible to strokes and heart disease.