Public Health Annual Report 2026 - Conclusion and recommendations

Through this report, we aim to have demonstrated the need for a gender-focused call to action to improve health and wellbeing for the whole population of Cumberland. We have set out where health and wellbeing outcomes are poorer in men and characterised the wider determinants of these. We have examined the mechanisms of male identity formation through the life course and discussed how these identities interplay with social, economic and cultural factors to result in the picture we see today.

Crucially, we recognise that Cumberland is a changing landscape. There is growing public conversation around men’s mental health, reflected in the rapid expansion and high utilisation of voluntary and community sector provisions such as Andy’s Man Club, and increasing visibility of local grassroots discussion around masculinity and wellbeing.

With Cumberland experiencing the highest suicide rates among women of any local authority, and a clear link between these suicides and experience domestic abuse, and the third highest suicide rate overall, there is a clear need for coordinated, system-wide action that supports men’s health not in isolation, but as part of the health of families, communities and future generations.

The recommendations in this chapter are therefore framed at a system level. They focus on addressing upstream drivers of harm in ways that improve outcomes for men and reduce secondary impacts on partners, children and communities.

Taken together, these recommendations emphasise prevention, earlier engagement, cultural change and coordinated delivery across statutory, voluntary and community partners.

We are at a critical juncture. We have the opportunity to engage with the felt and expressed need of our population and respond to the clear and concerning story told by our mental health data.

Headline recommendations

Recommendation one

Apply a gender-transformative approach and challenge identity, culture and stigma drivers of health inequality.

Improving men’s health outcomes in Cumberland requires explicit attention to identity, culture and social norms, including expectations around masculinity, emotional expression and help-seeking.

Cumberland should adopt a gender-transformative approach (Box 5) that:

  • challenges harmful norms without reinforcing stereotypes
  • promotes diverse and positive models of masculinity
  • normalises help-seeking across the life course
  • applies this lens within education systems to address differential attainment and engagement patterns between boys and girls, supporting identity, belonging and aspiration from early years onwards
  • ensures that work on male identity sits alongside continued commitment to preventing violence against women and girls, safeguarding children and addressing abuse
  • integrates public-facing initiatives and peer-led activity with accessible service pathways

Recommendation two

Build a prevention-first, place-based system that aligns with how men engage.

Cumberland should move towards a prevention-first, place-based system of support that enables boys and men to access help early, informally and without stigma. This includes developing and expanding existing accessible wellbeing hubs or community entry points in key towns.

This requires access to support that is available through multiple entry points, including community venues, wellbeing hubs, and activity-based offers, with capacity to reach rural and coastal communities.

A prevention-first front door should prioritise:

  • early engagement before crisis
  • flexible access routes
  • continuity of contact
  • clear pathways into specialist support when risk escalates
  • embed a coordinated multi-agency postvention approach following suspected suicide, including trauma-informed support for families, schools, workplaces and primary care
  • recognise community and voluntary sector provision as a core part of the system, acting as trusted bridges

Recommendation three

Make men’s mental wellbeing a community-based conversation and shared responsibility.

Cumberland should treat men’s mental wellbeing as a place-based, community responsibility. Evidence from The Big Question and professional feedback shows that stigma, silence and lack of visible permission to talk remain major barriers to help-seeking, particularly in rural and close-knit communities. Community-led approaches can reduce these barriers and enable earlier support.

Cumberland should adopt a community asset-based approach to:

  • fund and convene place-based men’s mental wellbeing action groups in priority areas to co-produce local priorities, shape service design and expansion
  • bring together residents with lived experience, community and voluntary organisations, statutory partners and named system leads
  • support locally designed public campaigns to normalise help-seeking and challenge harmful norms

This approach requires sustained investment but offers the opportunity to align services with lived experience, reduce stigma at scale and improve early engagement. Making men’s mental wellbeing a visible, shared community concern reinforces cultural change, strengthens prevention and supports more effective use of services over time.

Box 5: The Interagency Gender Working Group Gender-transformative approach

Taking a Gender-Transformative Approach

Gender-transformative approaches aim to address the structural and social root
causes of gender inequality and thereby promote more equitable outcomes across
populations. In the context of men’s health, this means examining how gender norms
and expectations shape behaviour, identity, help-seeking and exposure to risk.

The Inter-agency Working Group (IGWG) defines a gender-transformative approach as:
A transformative approach promotes gender equality by:

Fostering critical examination of inequalities and gender roles, norms and dynamics

Recognizing and strengthening positive norms that support equality and an enabling environment

Promoting the relative position of women, girls and marginalized groups

And transforming the underlying social structures, policies, systems and broadly held social norms that perpetuate and legitimize gender inequalities

Gender-transformative approaches have been adopted globally, including MenEngage, UNICEF. and Victoria Health (VicHealth), which has applied the approach specifically to masculinities and health promotion to produce Masculinities and Health: a framework for challenging masculine gender stereotypes in health promotion.

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Gender integration continuum

The gender integration continuum (IGWG) provides a framework for assessing whether programmes reinforce, ignore or actively transform gender norms (Source: IGWG)

 

In Cumberland, applying a gender transformative lens to men's health means:

Challenging restrictive norms around masculinity in both men and women, including expectations of stoicism, self-reliance and economic provision.

Recognising that gender roles are socially constructed and influence boys’ educational engagement, men’s work identities and patterns of emotional expression across the life course.

Promoting diverse and positive masculinities that value emotional literacy, caregiving, respect and community contribution.

Addressing the structural drivers of inequality, including differential attainment, occupational segregation and economic exclusion, that shape men’s health outcomes.

Ensuring that work on men’s health strengthens, rather than competes with, efforts to prevent violence against women and girls and safeguard children.

Recognising that gender is relational, and that improving men’s health requires attention to how power, status and inequality operate between women and men and among men.