Extract from the presentation by Richard Fletcher.

The research carried out by Dr Gary Egger in the Newcastle Steelworks in the early part of 1992 was groundbreaking. Nobody had thought of asking men about their beer bellies before. But the Gutbuster work also linked new research into biological differences between men and women to waist reduction programs (we store fat differently with different implications for heart disease and men and women lose fat differently too). This work, (and qualitative research into men and incontinence carried out in South Australia) provides a model of research which could be applied to other areas. Recognising biological differences, and undertaking detailed, sensitive research with community samples of men could be applied to other areas, for example diabetes, asthma, depression, schizophrenia. An important part of this approach is admitting what we don't know.

At the first British men's health conference, Men's Health Matters, held in July this year in London, Professor John Strang, Head of The Addiction Unit, The Maudsley Hospital, revealed the transition in his thinking brought about by his speaking at the British conference. Having been asked to speak, he went to the data on heroin addicts. He had already done some analysis in terms of gender but always before looking for issues likely to affect females. He found, to his surprise, that the 2.5/1 male/female ratio in addicts was not due to a bias in male-oriented treatment provision. Heroin overdose deaths, time to treatment, arrests and hepatitis B rates all indicated a genuine male excess. Furthermore he found that the recent epidemic of heroin use in England was almost entirely due to males. The male to female rate, which had been steady at 2.5/1 for ten years was now 3.5/1. He then asked: "How could we have failed to spot this gender effect? Are we still failing to explore powerful gender-based protective factors?

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