1. Kalgoorlie Forum On 16th April 2009 a National Male Health Policy public forum was held in Kalgoorlie, WA from 6pm to 8pm, preceded by an hour of informal discussion over light refreshments. Attendance at the forum was by invitation and public advertisement. Some 12 people attended. Structure of the forum Informal conversation over light refreshments Formal welcome Acknowledgement of traditional ownership Brief introduction by the facilitator Peter Dunn A presentation from a representative of the Department of Health and Ageing on key issues in men’s health Participant discussions − Small group discussions − Group feedback Closing remarks 1, Priority Setting Firstly, participants were given the pre-prepared list of ten items which might form part of a National Male Health Policy. These ten items had been drawn from an extensive web search of Departmental papers that were available for public access. Participants were asked to agree on which three items are the most important to them, and which three the least. If a table could not come to agreement, individuals were given the option of submitting an alternative ranking. Input 2, Additional Items Participants were then asked to continue their small group discussions, focusing on suggesting additional items they felt should be included in the policy. They were asked to record this on provided sheets and submit it at the conclusion of the evening. Group feedback After approximately 40 minutes of small group discussion, the facilitator invited each table to share their conclusions with the room. This led to an interesting and informative whole- group discussion which allowed participants across the spectrum to get an alternative insight into the issues at hand and express their own opinions. During this discussion the responses to the priority setting were graphed and displayed, giving immediate visual feedback on the priorities of the room. This had the effect of stimulating further discussion and clarification, giving a richer understanding of the group’s interpretations and intentions in their rankings. Input 1: Priority setting Some tables were able to reach consensus on the priority setting, while others submitted multiple forms. The combined results are shown in Figure 10, below. Figure 10: Priority Setting Results, Kalgoorlie 6 5 s t n e d 4 n o p s e 3 R f o r e b 2 m u N 1 0 a b c d e f g h i j Most Important Least Important Participants also took the opportunity to make some more specific comments about items A and B. Legend: Indicates item was ranked ‘most important’ by commenter Indicates item was ranked ‘least important by commenter Item Comments A. Using language in the policy that men can Would be picked up in H if appropriately relate to addressed B. Focusing on ease of access to health care for Needs to address national / State men: D close tie but picked up in I if awareness project all encompassing C. Increasing the body of evidence/research about men’s health issues D. Considering the assistance men from culturally and linguistically diverse backgrounds might require to improve their health E. Considering specific training for health practitioners caring for Aboriginal and Torres Strait Islander men F. Examining different options for men in rural and remote areas and men in metropolitan areas Item Comments G. Improving gender balance in the focus of health care provision (“male friendly GP clinics, men’s magazines, images of men/fathers) H. Working to increase the awareness of men’s health issues in the community I. Encouraging the provision of training to health practitioners in how to address men’s health needs J. Promoting and adapting local men's health projects that are currently working Input 2: What’s missing? The following additional items were suggested. These comments were taken verbatim. Examining different option for men under stress from family or relationship breakdown. Providing real solutions for fatherhood e.g. separation and fatherhood Conduct research on health symptoms from separation and family breakdown Risk to men 25 – 64: − Heart attack − Smoking − Exercise − Suicide − Accidents Raise tobacco tax Address sport in schools, exercise in work environment, smoking Open up medical schools to many more students – make communication as essential paper Reinforce discipline (including physical). This leads to self discipline which can lead to fitness, diet, behaviour changes, more self control in aggression, driving Historical health aspects that worked need to be investigated and implemented where relevant Address 5 major causes causing / contributing to death amongst separate male cohorts Items on yellow page too prescriptive in some cases – need to be broader Lobbying / bludgeon AMA to contribute / encourage universities to increase medical student intake Sense of belonging, healing, self awareness – i.e. indigenous expands “Men in Sheds” Screening services Use networks – publicise – formal curriculum in personal and community health Compulsory health checks for all employees on a yearly basis – can be done in the workplace, makes the ‘health’ issue a more ‘normal’ point of discussion. This of course will cover both male and female employees, however I think the men will benefit more as they, at the moment, are not so inclined to have regular check ups Making health / fitness club membership tax deductible for employers to encourage more participation Funding for Men’s Health Officer to facilitate / promote / coordinate / disseminate information / programs Access = timely and affordable especially in rural and remote areas! E.g. doctors in remote areas charging $100 consult. Men who have just worked a 12 hr shift don’t want to visit a dr if it takes ages / costs a lot / is not a convenient time especially if only a minor ailment. Look at towns like Karratha, WA. Charge $100 a consult. Corporate incentives for all-sizes of businesses to promote health club membership – at present it is a fringe benefits tax Adverts that appeal to men – compare with beer ads! Re health and vegies etc Make men act on awareness Promoting fundamentals of fathering and role models by men – ‘family unit’ Awareness take action Screening workforce or not employed Pressure BSL Education boys and men: − Schools – male teachers in schools − Family – family outings at home − Housing Delegation of funds (long term) Male attitudes about their own health Holistic mental health issues / housing / chronic disease Aboriginal communities Divorce cases – Problem for men (counselling) depression − Stress − Suicide − Alcohol − Drugs Preventative task force. Reform Committees. Aboriginal men’s policy and non-aboriginal men’s policy No mention of factors that impact on health (factors – outside ‘health’) i.e. education – social / emotional / historical / cultural / environment Allocation of funds – for men’s health. Need to be flexible when funding. Be able to respond to opportunities. Need long term funding Links to other policies being developed. Links to other task forces currently underway e.g. chronic / lifestyle / workforce The need for policies at the highest level to support the health promotion / education being delivered at grass roots level e.g. smoking / alcohol Need to tackle bodies that influence poor health outcomes for men e.g. alcohol industry, fast food outlets, sponsorship, advertising, etc More places in universities for training doctors A national exercise program Anti fast food advertising, prime time? T. U. Program – Fast health food! (Inexpensive) Screening between 4.00pm – 6.00pm Stress resulting from divorce and the imbalance of asset distribution and custody of children Discussion notes During the whole-group discussion the Hay Group facilitator and Departmental representatives took notes of the key themes raised by participants, as outlined below. Awareness An issue is that men can be aware of health issues but don’t end up making changes to behaviour. Policy The Government is not serious because it won’t ban smoking because of the taxes that are paid. The taxes don’t pay for health costs. Masculinity Need to break some of the male attitudes. If you can connect emotionally to what’s happening, then you do something. Holistic / wellness approach Yellow sheet too prescriptive, doesn’t reflect a holistic view and socioeconomic factors need to be addressed, not a disease focus. Eg community stores impact on diabetes, and overcrowded housing in Indigenous communities. Nothing about legislation that supports healthy living eg taxes. Need to have the ‘big guns’ at all levels. Local priorities Question around the priorities across different forums and whether they will be presented differently. There could be local issues. Important to pick up on Adrian’s point that access issue in Kalgoorlie could be different to Bankstown. Education Need a national curriculum in relationships from primary to high school for males and females because of the breakdown in nuclear families and the roles families played. Need to get more male teachers and role models in education. Need a curriculum over 30 years to make a difference. Family and community Families don’t have meals together at night. This should happen more with advertising campaigns saying men shouldn’t take kids to fast food. Fathers as role model – often children are aware of what they should eat, but parents are packing lunches, and they see Dad not eating vegetables. 70% of marriages end up in divorce. Men have a particular problem in handling distress from marriage breakdown. The symptoms are alcohol, drugs. More research is needed and giving men options in coping with this. Stress in providing fatherhood during the separation. Issue of imbalance in separation and men needing to financially support the family even when they have a new family or circumstances change. Funding Funding needs to be long term and how it is allocated – needs to be flexible and sometimes the framework used is ridiculous. Frameworks change too soon with no time to implement. Need to commit to long term goals and objectives. COAG provides a mechanism for long term funding over 10-20 years that’s not dependent on election cycles.
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