In Reply

We wholeheartedly agree with the correspondence from Prof. Bardehle. She has emphasized once more the importance of thinking systemically and of taking action if the aim is to reduce health inequalities in a sustained manner. This also reflects the approach we took in our studies to improve access for men with cancer and male relatives to psychosocial counseling. It clearly isn’t enough only to display flyers with information for men. A young cancer patient in one of our studies articulated this as follows: “This means I have a leaflet in my hand, which is easy these days because various flyers etc are being handed out everywhere. What this is at first is just dull information.” (1)

Flyers can convey information succinctly and are undoubtedly often helpful. Furthermore, they are comparatively cheap to produce; another reason why their use is so popular. But they are less good at communicating emotional and motivating messages than person-to-person contact—for example through an appeal by a doctor (2, 3). They are—as the patient said—“dull.” Furthermore, they target the individual and neglect structural barriers.

Measures to improve men’s health have to start at different levels instead. It takes patience, a comprehensive perspective, thorough preparation, as well as longer-term follow-up and unerring evaluation—in other words, a strategy.

This is exactly the point Bardehle is making. Quite rightly she laments Germany’s lack of commitment in this regard and demands more political determination. We think that in this setting, in addition to prevention, psychosocial provision for men requires particular attention.