International Men's Day

November 19^th is International Men’s Day 2015, aimed at raising awareness of men’s health and wellbeing, promoting male role models and celebrating men’s positive contributions, highlighting male discrimination and promoting gender equality. The UK theme for 2015 is “Make a Difference for Men and Boys”; identifying what action needs to be taken to address issues. How can we make a difference to the lives of men and boys across the world?

The latest data from HBSC England¹ is drawn from a large representative sample across England, encompassing girls and boys aged between 11 – 15 years from varying social backgrounds, ethnicities and religions. Consequently the HBSC England data provides a comprehensive picture of the lives of young boys living in England today; allowing us to identify both aspects of physical health and emotional and social wellbeing in which boys are flourishing, and also areas of concern.

Since 2002 a decline in traditional risk behaviours such as drinking alcohol, smoking tobacco, cannabis use and fighting have all been noted among adolescents. Today only a small minority (6%) of 15 year old boys report smoking on a weekly basis, falling from 28% in 2002. Likewise, the prevalence of weekly drinking among 15 year old boys has reduced sharply from 52% in 2002 to 12% in 2014. Similar reductions in substance use have been noted elsewhere; in 2014 the Health and Social Care Information Centre² reported the lowest rates of smoking and alcohol consumption among teenage boys since their research began in 1988, while the HBSC Scotland team³ recorded the fewest instances of drunkenness among 15 year old boys since 1990. Fighting is typically viewed as a male behaviour, but although more boys than girls still report being involved in fighting, the gender gap is narrowing due to a steady decline in the number of young boys who said they have been involved in a physical fight (Figure 1). This is a trend which Pickett and colleagues⁴ identified to be occurring on an international level.

Figure 1: Proportion of boys aged 11-15 years who reported being in two or more physical fights during the previous year (adapted from Brooks et al. 2015)

While the number of young boys engaging in traditional risk behaviours appears to be improving, the same cannot be said about healthy behaviours. The World Health Organization (WHO) recommends young people participate in at least 1 hour of moderate to vigorous physical activity per day. The latest HBSC England data identified less than a quarter (22%) of all boys surveyed met the recommended levels of physical activity. Moreover, the proportion of boys who are physically active for an hour every day has decreased by 6 percentage points from 2010, and is now at the lowest it has been since 2002. Similarly, fewer than half of boys reported eating fruit and vegetables every day, with no substantial changes since 2006. Sleep is a new topic for HBSC England, but the latest data suggest that this is an area of concern - only 48% of 15 year old boys reported achieving 8.5 hours sleep and nearly a third said they are unable to concentrate at school due to a lack of sleep. 

Adolescent boys are often reported to fare better in terms of health and well-being than their female peers, but there are particular areas where men are known to be at greater risk. An integral part of International Men’s Day is raising awareness of male suicide: Men are three times more likely to commit suicide than women, and the last five years has seen a 40% increase in suicides among men aged 45-49 years⁵. Despite these figures, men are less likely to be diagnosed with depression than women⁶. The HBSC England data contributes to challenging the gender stereotype surrounding emotional wellbeing, and adds to the call for action regarding young boys’ mental health. A substantial proportion of young boys reported poor emotional wellbeing (Table 1), with a quarter of 15 year old boys feeling low once a week and nearly a third feeling nervous on a weekly basis. Further, one of the most commonly reported health complaints among 15 year old boys, feeling irritable, is recognised as one of the markers of depression in men⁶. Boys’ self-reported life satisfaction is a concern, with 21% of boys reporting they are “struggling” or “suffering” and a dramatic decrease in life satisfaction among 15 year old boys in the last 4 years. In line with decreases in emotional wellbeing, 11% of 15 year old boys reported self-harming in 2014 compared with 3.2% in a comparable survey-based study conducted in 2002⁷.

Table 1: Proportion of boys who reported experiencing health complaints and emotions during the past week (adapted from Brooks et al. 2015)

	11 year olds	13 year olds	15 year olds	All ages
Feeling low	14%	15%	25%	18%
Feeling nervous	22%	25%	29%	25%
Feeling irritable	26%	32%	41%	32%
Sleeping difficulties	29%	28%	30%	29%
Felt full of energy	67%	55%	44%	57%
Felt able to pay attention	76%	65%	54%	66%

There is much focus on the emotional well-being of girls and young women, but while highlighting such issues is necessary it is equally important that we do not forget about boys and young men in the process. The idea that males are ‘doing fine’ just because they report a lower prevalence of risk factors than young women could marginalise boys’ emotional well-being needs. The HBSC England data provides an insight into the lives of adolescent boys in England today, and the temporal nature of the study allows us to make comparisons spanning over a decade. The data indicates positive behavioural changes including a decline in substance use and fighting which are worthy of celebration. However, in keeping with the theme of International Men’s Day: How can we make a difference to the lives of boys? The HBSC England data suggests we move away from traditional, masculine risk behaviours and begin to address healthy behaviours and emotional wellbeing. The majority of boys are not engaging with healthy behaviours such as physical activity, and comparisons across time suggest uptake of these behaviours are at best static, and at worst in decline. Moreover, we need greater acknowledgement that emotional well-being is an issue for the teenage boys of England just as it is for girls.

Why not check out blog posts written by our young male co-researchers? Vato and Roman recently wrote a blog titled “What we think” which explores the internal struggles adolescents face, and Harrison has written “Adolescent stress from a young person’s view”.

1.  Brooks, F., Magnusson, J., Klemera, E., Chester, K., Spender, N. & Smeeton, N. (2015). HBSCEngland National Report: Findings from the 2014 HBSC Study for England. Hatfield: University of Hertfordshire.
2. Health and Social Care Information Centre (2015). Smoking, drinking and drug use among young people in England 2014. Leeds: HSCIC
3. Currie C, Van der Sluijs, W., Whitehead, R., Currie, D., Rhodes, G., Neville, F., Inchley, J. (2015) HBSC 2014 Survey inScotland National Report. Child and Adolescent Health Research Unit (CAHRU), University of St Andrews
4. Pickett, W., Molcho, M., Elgar, F. J., Brooks, F., de Looze, M., Rathmann, K., … Currie, C. (2013). Trends and socioeconomiccorrelates of adolescent physical fighting in 30 countries. Pediatrics, 131(1), e18–26
5. Equality and Human Rights Commission. (2015). IsBritain Fairer? The state of equality and human rights 2015.
6. Wilkins, D. (2010) Untold problems: A review of the essential issues in the mental healthof men and boys. Men’s Health Forum.
7. Hawton, K., Rodham, K., Evans, E., & Weatherall, R. (2002). Deliberate self harm in adolescents: self report surveyin schools in England. BMJ, 325(7374), 1207-1211