Good news: UK men live longer, Bad news: only if they are rich

At last, some good news for the weaker sex. The beleaguered British male, long burdened with worse health than women and notorious for whingeing about it, is witnessing one of the biggest rises in life expectancy over the past 20 years in Europe.

At last, some good news for the weaker sex. The beleaguered British male, long burdened with worse health than women and notorious for whingeing about it, is witnessing one of the biggest rises in life expectancy over the past 20 years in Europe.

A survey of men's health across 17 countries, published yesterday, shows Britain is now ranked in the top five for male life expectancy, up from tenth place in 1980. The British male can now expect to live almost 76 years, compared with just more than 70 two decades ago.

The longest-lived men in Europe are the Swedes, with a life expectancy of almost 78 while bottom of the league is Ireland where men live on average to 73.

Men in Britain now outlive their compatriots in the Netherlands, France, Denmark, Spain, and Greece. Over the past 20 years they have overtaken all five countries. Only Scandinavian, Swiss and Italian men live longer.

But the good news ends there. It only applies to half the male population, the high-earning, non-smoking, bicycling men of the South. Real men, who do not eat vegetables, have lower incomes and live in the North die as they have always done, before their time.

The improvement in life expectancy for men in Britain is concentrated in the higher social classes. Ian Banks, a GP in Belfast and president of the European Men's Health Forum, who launched the survey in Brussels, said: "If you break it down by class we have got the biggest divide in life expectancy. The difference between the haves and the have-nots is greatest in the UK. Men in the lower-income groups have not seen an improvement in their life expectancy for 30 years."

Men in Dorset lived on average 10.7 years longer than men in Glasgow, show figures from the Office for National Statistics. "The average life sentence served by men in British jails is 10.2 years, so we are committing men in Glasgow to a life sentence just for living there," Dr Banks said. Second, despite the improvement in male life expectancy, men still have a long way to go to catch up with women. The average male life expectancy is still lower than for women 20 years ago.

"For almost every medical condition affecting both sexes across Europe, men die sooner than women," Dr Banks said. "The only exceptions are asthma and musculo-skeletal disorders. The best example is melanoma [the most serious form of skin cancer]. There are more cases in women, but more deaths in men. Only when you look across Europe do you realise that something is going on."

A main reason for men's poorer health was their reluctance to attend to it. In addition to the conventional risks of driving too fast, drinking too much and eating the wrong sort of food, men add to their problems by ignoring their health. They are less likely to go to the doctor and thus less likely to have problems picked up early and dealt with. Out of a desire to appear strong and invulnerable in a still-macho culture, they neglect early warning signs of disease.

"The one common factor across Europe is late presentation," Dr Banks said. "Men use their GPs less than women when they are young but start going more often when they get older and their prostate starts to get bigger. The definition of middle age for a man is when his prostate is bigger than his brain."

Reluctance to attend to problems early, when they can be dealt with by the GP, means men are heavier users of hospitals than women as they age.

But men have also been hit by changes in the incidence of disease. Liver failure has increased fivefold in the past 30 years (associated with increased drinking), prostate cancer has doubled and testicular cancer, a disease of young men, has quadrupled.

But heart disease has fallen in the UK more sharply than in other countries from its high levels 20 years ago. As men have given up smoking - mainly in the higher-income groups - lung cancer deaths have fallen. Britain also has one of the lowest death rates in Europe from road accidents, a major killer of young men. Taken together, these have helped boost male life expectancy in the UK, but with a disproportionate impact on higher social classes.

A further boost to men's health may have come from the British male's romantic aspirations. While divorce rates have soared in all European countries, so have remarriage rates, and nowhere higher than in the UK. More than a quarter of men in Britain have now remarried, and marriage is good for men's health. Married men live longer than unmarried men. But marriage has the opposite effect on women; unmarried women live longer than those who become hitched.

Despite two decades of efforts to get men to open up emotionally and seek help when they need it, they continue to rely on their partners, who do most of the caring. "If a woman is married to a sick man it may affect her health," Dr Banks said. "Does the rise in the remarriage rate mean women's life expectancy will go down?"

The report, which brings together the latest mortality and morbidity figures for Europe, found men see themselves as having better health than women, even though it is actually worse. Heart disease is the biggest killer through the continent, but there are wide variations between countries, with northern Europe at highest risk. Southern European countries have a higher risk of stroke.

Lung cancer accounts for 11 per cent of male deaths in Belgium and 4 per cent in Sweden, but in all countries the rates are falling as smoking declines. More men are diagnosed with lung cancer than women, with a 12-fold difference in the UK.

Prostate cancer accounts for 3 per cent of all male deaths in Europe, with Sweden ranked highest and Greece lowest. The disease is commoner in northern Europe but stomach cancer is commoner in the south. The UK has one of the lowest incidences of deaths from external causes, including injury and suicide, accounting for 4.1 per cent of all deaths, compared with 12.2 per cent in Finland. Alcohol plays a major role in accidental deaths, one in four of those involving a young man.

One of the biggest contributors to male ill-health is lack of physical activity. Almost one in three men in Europe is considered insufficiently active.

The authors of the report, by the European Mental Health Forum in Brussels, called for more research into the underlying reasons for the health inequalities between men in different countries, and between men and women.

"Public health strategies in European countries must address the respective health needs of men and women rather than relying on a 'one policy fits all' approach," they said.