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Background: In 2011 the European Commission launched the report ‘The State of Men's Health in Europe’ covering the health of 290 million men across 34 European countries. This is the first official statement on the health of men in Europe. The work was carried out by a team of writers from across Europe aided by a management advisory group, a reviewing group and a broader reference group. Methods: Data from major international databases were used to compile a detailed analysis based on population data, lifestyle and preventable risk factors, use of health services and morbidity and mortality data based on the ICD-10, with the results focused on the “European shortlist” of 65 causes of death. Results: Changes in male demographics are creating a reversal in the age distribution ratio, with a decreasing younger population but increasing numbers of elderly men. The data on morbidity and mortality are most striking in relation to the high levels of premature death in men across the disease spectrum with marked differences between countries. Conclusions: The very large variations seen in the health of men across Europe demonstrates that much of men's higher risk of premature death is caused by socio-cultural factors and therefore avoidable. No country should be complacent about the health of its male population.

BACKGROUND A feature of the health of men across Europe is their higher rates of premature mortality and shorter life expectancy at birth than women. Following the publication of the first State of Men's Health in Europe report, we sought to explore possible reasons. METHOD We analyzed trends in life expectancy at birth in 19 European Union member states (EU19) between 1999 and 2008 using mortality data obtained from Eurostat. We then used Pollard's decomposition method to identify the contribution of deaths from different causes and at different age groups to differences in life expectancy. RESULTS Between 1999 and 2008, life expectancy at birth in the EU19 increased by 2.74 years for men and by 2.09 years for women. Most of these improvements were due to reductions in mortality at ages >60, with cardiovascular disease accounting for approximately half these improvements for men. In 2008, life expectancy of men in the EU19 was 5.92 years lower than that of women. Deaths from all major groups of causes, and at all ages, contributed to this gap, with external causes contributing 0.96 years, cardiovascular disease 1.80 years and neoplasms 1.61 years. CONCLUSION Improvements in the life expectancy at birth of men and women have mostly occurred at older ages. There has been little improvement in the high rate of premature death in younger men, suggesting a need for interventions to tackle their high death rate.

Ten years ago the BMJ published a special issue on men’s health. It noted how, although men fare better than women in most conventional measures such as top jobs and earnings, this advantage is not reflected in their health. A report we produced this summer, The State of Men’s Health in Europe, shows that little has changed. At any given age, men are still more likely than women to die from most of the leading causes, and in the European Union men have more than twice as many deaths a year as women throughout the working ages (15-64 years). This high level of premature mortality in men has psychological, social, and economic consequences for relatives, households, communities, and the workplace. Yet, in both national and European health policy, men and “masculinity” are largely taken for granted. This has limited the development of evidence based programmes that meet their health needs.

Hungary is entering a new phase of public health development. The ­challenges of facing the social and health impact of the economic and financial crisis require redressing of the balance between the assets and deficit models for evidence based public health. A greater focus on assets based approaches could help unlock some of the existing barriers to effective action on health inequities. Hungary has a history of asset approach in local communities. However, if an asset approach is to be realised, a number of things need to be in place to ensure that the aims and objectives of the New Hungary Development Plan (NHDP) can be reached. This chapter sets out the lessons learnt from the past and highlights the critical conditions for policy to assure they take account of the country’s assets at the national, regional and local level.