Preparing for old age is always going to be too little too late.

The things you have to do to give yourself a decent chance of a good old age are well-known by all of us. You need to eat well, exercise a bit and stay away from drugs (yes, alcohol counts) and other stuff that’s obviously bad for you. You need to fix things when they break in your body, and that includes teeth: an astonishing amount of bacterial infections can be mouth-related.

Whether you’re a man or a woman, you need to stay away from violent men who will hurt you all too readily. There are lots of violent men, everywhere.

Men need to manage their tendency to take fatal risks, to drive cars too fast, to run those red lights. Without intervention, more baby boys are born than girls but by the time they reach twenty those numbers have balance out. Boys die in greater numbers.

Men should work at building meaningful relationships, friendships, community, family. Being connected helps mental health and an extraordinary number of men kill themselves. It is the largest cause of death unto the age of fifty-five.

If health and longevity was a woman’s only aim, she’d probably avoid men entirely – too dangerous, too needy.

If we could choose such things, then being born wealthy obviously helps. Nothing kills quite as consistently as poverty.

The fundamental problem with almost of all of this, is that the things that you could do, have to be done from your early adult life and no one in their twenties believes that they will ever die. Not them.

By the time you’re approaching sixty and can actually start to see the shape of your old age, it’s too late for a lot of things that will make a difference. Stopping smoking helps at any age of course, but by then your chances of cancer or emphysema are high.

Losing weight will helps with arthritis but it will take years of improved roughage to sort out those bowel problems and by the time you’re approaching sixty, keeping regular is something people talk about all too often.

Growing old is not for wimps.

But dying young isn’t such a great alternative.

So eat your greens young man, and pray that some poor unsuspecting woman will adopt you into her life.

WH Auden (1907 – 1973) wrote a poem Epitaph on a Tyrant that found its way onto the side of a carriage on the Northern Line Tube, part of London’s Metro system.

The poems are part of a long-standing effort to bring a bit of culture to the commute and just occasionally they catch the eye and make a person think. Maybe not so much now that everyone has a mobile to grab their attention, Just enough.

Epitaph on a Tyrant

Perfection, of a kind, was what he was after,

His own definition, his own kind

And the poetry he invented was easy to understand;

Certainty, small words, easy solutions to complex problems

He knew human folly like the back of his hand,

Someone to follow, someone else to blame,

And was greatly interested in armies and fleets;

A mob, a troll militia where sticks and stones became bullets and guns

When he laughed, respectable senators burst with laughter,

And some knew no better, but plenty of them did and turned their faces away

And when he cried the little children died in the streets.

Never his children, not on his streets.

Our children, our streets.

From Another Time by W. H. Auden, published by Random House. Copyright © 1940 W. H. Auden, renewed by The Estate of W. H. Auden.

Does it ever stop? We’re retired so the only admin in my life is managing the house. It never ends.

Sometimes though it feels more never-ending than others.

This started with an oven breakdown. Closely followed by a safety scare. And you might think that a visit from the electrician, a new fuse box and a safety check from UK Physical Network, the guys in charge of the electricity supply infrastructure in the UK would be enough.

But from the very start, I knew this would not end with a new fuse box, or even a new system head, apparently the connection between your domestic supply and the broader network. The minute the issue was raised, living in my 1908 house, it was obviously going to be a fundamental problem with my electricity supply. Ho hum.

The guys arrived to dig up my electricity connection, unannounced sometime before eight o’clock in the morning. They stuck a card through the door with a number to ring except it wasn’t their number. There are three separate divisions and for whatever reason the number they gave me was for the souther division. A very nice man on the other end of the call gave me the number for the eastern and the London division.

I live in London so surely I should ring the London number. Alas, no. Third time lucky and the Eastern Division managed to find my reference number. They would call the team and see if they could come back to work on the supply, probably tomorrow. And no, since it was recorded as emergency safety work, they couldn’t give me a time.

An hour later, a team wracked up with a mini digger. Work commenced. One six foot hole at the bottom of the driveway, closing down half of the road and fencing off two house widths of the road and the guys decided the problem wasn’t down there. They headed off for lunch.

Back an hour or two later and another six foot hole, they stopped for supper. After an hour or so, they tested the connection right next to the house, and they decided that the problem wasn’t there either. Another team would likely be required.

Before leaving though, he decided to test the reading at the new service head. The acceptable limit would be 0.8 (ohms?) The reading was 0.13. He took it again, and then again. He switched the meter off and on again, The reading stayed low at 0.13. Right then. All done.

They left. Two six foot holes left behind. It took another day or so for another entirely unannounced team to arrive to almost completely fill both holes, and another day for the guys with concrete to completely fill the holes.

Two days later people arrived to remove the barricades around the holes. Another day later and someone arrived to power wash the driveway.

I have had a seemingly never-ending collection men arrive to dig holes and fill them, all very efficient individually and all extremely polite.

It should feel like success.

Except the car has started to whine when it starts up, and all of the new small city cars seem to be electric. There’s a government deal offering £3500 off a new electric car so we took a look at the well-reviewed Hyundai Inster. I have a test drive on Sunday, an electric charger due to be delivered and an electrician supposed to tell me when he can come to fit it to my lovely new fuse box.

Delivery times for these new cars are 3-6 months.

I feel as if I’m on some kind of domestic upgrade treadmill and all I want to do is get off.

When does it ever end?

Men die younger. Women live longer in poorer health.

Women and girls experience more disability in every region of the world, but men and boys bear a greater share of the global mortality burden. The 2016 Global Burden of Disease data show age-standardised death rates per 100 000 population of 1002 for men and 690 for women. If we understand why, then maybe we can address the causes.

A recent report in the Lancet talks about why men might be dying younger than necessary, whether it’s an innate physical cause or something else. It concludes that “Many of the drivers of men’s ill-health are linked to perceptions and attitudes about manhood and the overall structural organisation of men’s lives and relationships.”

It concludes that our attitudes to what being male means rather than the biological reality, is the problem. And the report goes further to add that the problem is made worse because around the globe, these attitudes are largely ignored, largely invisible. Across the globe, we pay ” insufficient attention to the intersections between masculine norms and men’s health within public health systems”.

An abundance of evidence shows health outcomes and experiences to be different for women and men, and this is true across time, space, and culture. The impact of biological sex accounts for a fraction of these differences; gender explains the rest.

Gender refers to the social phenomena and relationships of males and females in terms of their roles, attributes, and opportunities. In health and otherwise, advantage and privilege are largely the domain of maleness and men. That gender is socially constructed; it lies on top of human biology.

Decades of global research has provided a foundation to continue deepening our understanding of masculinity and masculine norms. Theories of hegemonic masculinity and precarious manhood have established a common set of norms, attitudes, and behaviours related to what it means to be a man in today’s society.^5, 6 

As the recent Lancet Series on gender equality, norms, and health and other publications have recently highlighted, adherence to these specific masculine norms is associated with unhealthy behaviours. Norms are those often unconscious definitions and expectations of being a woman or a man. They guide and exert pressure to conform to certain behaviours.

Norms do not just exist on an individual or interpersonal level but are powerfully embedded in our cultures, institutions, economies, and ways of being. As the recent lancet series articulates across five papers, rigid gender norms undermine the health and wellbeing of all people—girls and women, boys and men, and gender minorities

The Lancet series lays out extensive empirical analyses and literature reviews to document how norms can be either protective or harmful to health: through gender operating as a determinant of health, by influencing health behaviours, and via expression in health systems, policies, and programmes. It shows how rigid gender systems that perpetuate injustices towards girls and women also disadvantage boys and men.

Highlighting and recognising the importance of gender norms provides an opening to understanding how to create needed change. Ultimately, as the Series concludes, the transformation of gender inequality and norms is a political act. Is the world ready to act?

Gender is a slippery thing. On the one hand, it’s everywhere—#MeToo, pay gap reporting, high-profile sexual misconduct cases, and the campaigns to advance women in science, medicine, and global health. WHO consistently states gender equality to be a cross-cutting feature of its work. Gender is ubiquitous in the UN system: UN Women, UNFPA, UNICEF, and the sustainable development agenda.

On the other hand, it’s nowhere. Not in the universal health coverage plans, not among WHO’s ten priority global health threats, and not tied to governance or the accountability of organisational and government leaders. Despite decades of funder and journal policies, sex and gender are not routinely reported in research. Increasingly prevalent gender mainstreaming programmes have proved largely ineffective. 

Gender now runs the risk of being treated like motherhood and apple pie—a common good no one would disparage, but neutered of its radical political nature. Or as “everyone’s problem but no one’s responsibility”, as Geeta Rao Gupta and colleagues argue in their Lancet series paper. An uncomfortable truth is that the shift in global health thinking from women and girls to gender has depoliticised the agenda intended to transform lives and wellbeing. Despite the good intentions of broadening child, adolescent, and maternal health to their larger social context, the gender equality aspiration hasn’t translated into a meaningful action and accountability agenda for women or men.

It hasn’t resulted in men exercising their political prominence and power to drive equity.  And it hasn’t sufficiently overcome the brutal reality for millions of women and gender minorities in the world who suffer sexual and domestic violence, lack access to essential prerequisites for health and safety, or are denied basic human rights and control over their own bodies. Gender analyses that simply reaffirm the value placed on traditional masculinity over femininity, rather than link this to broader relations and patterns of economic and political power, will only ensure the status quo

Promundo Global’s 2019 report, Masculine Norms and Men’s Health: Making the Connections, shows that seven key male health behaviours—poor diet, tobacco use, alcohol use, occupational hazards, unsafe sex, drug use, and limited health-seeking behaviour—account for more than half of all premature male deaths and about 70% of men’s illnesses.

All seven behaviours are partly related to masculine social norms that reinforce the notion that manhood is associated with self-sufficiency, stoicism, risk-taking, and hypersexuality. These norms, individually and collectively, encourage a specific set of health behaviours across the globe that are among the drivers of men’s poor health outcomes and have implications for both men and women.

Research has also called attention to the social determinants of men’s poor health, particularly how restrictive ideas about manhood intersect with poverty, ethnicity, gendered employment patterns, and other factors. Recognising the importance of these issues, the WHO Regional Office for Europe released a strategy in 2018 for addressing men’s health and a similar document from the Pan American Health Organization is expected to be released later in 2019.

Public health experts and researchers need to expand the understanding of men’s physical and psychosocial health to build an evidence base for programming and policy. Presently, much research on masculinity and men’s health draws on a deficit-based approach, whereby men are pathologised or masculinity is framed as inherently problematic or toxic.

It is important to recognise and leverage the fact that many men take care of their individual health and wellbeing and often access health care through their support for the health and wellbeing of their partners or children. Being male needs to be seen as the solution to the problem.

Efforts to address men’s health should build on men’s positive health practices, experiences, and desire for health care, and the importance of taking care of themselves for their own wellbeing and those around them including women, who often bear the social and economic costs of men’s poor health.

Some men seek preventive care, support their partners and children in accessing health care, and use health services adequately. Moreover, many men around the world engage in health promoting behaviours such as regular exercise, healthy diets, and practising safe sex.

Academics and researchers should research healthy masculine norms that could promote healthy behaviour, such as responsibility and self-control, alongside men’s positive involvement as fathers, partners, caregivers, and community members.

Through an asset-based approach, the public health community can help pivot and amplify the conversation to be more constructive and begin to incentivise healthier behaviours among men through embracing positive and health-conscious masculine norms.

Additionally, academics, in partnership with health-care professionals, should evaluate the effectiveness of different health-promotion approaches for male engagement, norm and behaviour change, and health-care service provision throughout the life course, taking account of dynamics of power and poverty.

Rather than blaming men, or presenting masculinity as inherently toxic or damaging, we need to articulate a positive masculine approach, a gendered and intersectional lens that articulates evidence-based concepts of healthy masculinities and men’s wellbeing. The public health community must capitalise on the growing momentum of attention to gender and to men’s health within a framework of universal health coverage.

Men’s health matters for everyone; by adopting a gendered, asset-based approach that embraces social determinants of health, we will be able to improve the health and wellbeing of countless men, women, and families around the world.

I have never thought of myself as a hoarder. It creeps up on a person. Nearly thirty years in the same house and who doesn’t have a stack of who knows what under the bed?

The problem with stuff, lots of stuff, is that sooner or later you have to reckon with it. The carpet fitters are coming in which means all of the furniture will need to be moved about, which in turn means all the stuff lying about and inside the large pieces of furniture will need to move.

The obvious answer is to take this opportunity to throw out a whole load.

Faced with this challenge, my partner is moving at glacial speed through the files that cover every single shelf, wall and floor in our smallest room upstairs. A few years back, faced with the same challenge he managed just two files and carried a betrayed look on his face for at least a month. It got so bad that I offered to clear my files first, only to realise that of the hundreds stashed in the room, only two were mine. Paperwork has never been my weakness.

Meanwhile I’ve made six trips to the tip, most unwisely one on the weekend when everyone and their dog seems determined to empty their dumpy bags full of garden waste.

The surprise is how much bedding we seem to have accumulated. There really is no reason for more than two sets, one to wash and the other to ‘wear’ and yet it would seem that in nearly thirty years, I have never thrown a single sheet out.

Ho hum.

Where stuff cannot be thrown away (basically because it’s not mine and he just cannot deal) then it’s been put in plastic boxes in the garage. Why not the loft? Because the loft is already as full as can be obviously and out of sight, up a loft ladder means that stuff will still be there when we die. At least in the garage, the stuff is visible and one step closer to the tip.

My daughter came home (from her house two streets away) and finally cleared her room. The childhood globe was regretfully put into the tip pile alongside her school artwork. Her memory box was apparently too large for her house (seriously?) so is now located in my garage waiting for space to appear in their loft. If it ever gets there, it too will no doubt languish until the grandkids (God-willing) are left to deal with the house clearance.

Having put the carpet fitting into the diary for the wrong week (one week early) we are now almost ready for them to arrive, next week.

Now about that naked photo in the bedroom….

When I moved into my house, many years ago, the carpet was muddy green. We lived with it for a reasonable amount of time until our own stains, added to the stains of people who came before us just became too much.

The kids were past the really messy stage, we told ourselves, quite incorrectly as it turned out. We decided to splurge on a lovely grey wool carpet, up the stairs and throughout the bedrooms. Downstairs has hard floors, mostly parquet.

Life moved on. The kids were messy. The cats scratched their way through parts of the carpets trying to get into their preferred bedrooms. Basically all was okay.

And then the moths arrived. Carpet and clothing moths are small and easily ignored until they reach critical mass and you’re faced with proof that they’ve eaten their way through your house. We had a small radiator leak in the un-used bedroom. It was fixed and the door closed. A few weeks later and the damage moths can cause to a damp piece of wool carpet was all too obvious.

We limped along with chemical sprays, blocks for the wardrobes (carpet moths eat clothes) and pheromone traps. The latter are especially gruesome as they trap the male moths on sticky paper, more a way to allow you to track how bad your infestation is (very bad) than to actually rid yourself of the problem.

Female carpet moths lay their eggs in quiet dark places with a food supply. They munch their way through fibres containing lignin, so animal products such as wool, cashmere, feathers, silk. Your cotton quilt cover is probably safe but your feather or wool stuffing in the quilt, less so.

Clothes were thrown out, sent to the dry cleaners and packed away in vacuumed plastic bags under the bed. Still the moths kept appearing.

Finally this Summer (just before the oven broke and the electricity scare came to light) I committed to a new carpet, the only condition that it may not contain any wool for the moths to eat. I also mentioned the three cats which quickly ruled out any thoughts of a loop carpet since they love to shred them with their claws. talking my way through the various artificial fibre options, we went for the one most similar to what we have already in place.

Apart from the moths, I like the look and feel of my carpet.

It turns out there are a lot of grey cut twist pile carpets out there. Shades of grey and cream neutrals seem to be the most common choices, though I was told that green is coming back into fashion.

But there really are a hundred shades of grey, and not all artificial fibres are equal. I’ve chosen the bluest grey and the easiest material to clean. In theory a glass of red wine should some out with a simple cold water wash. Ho hum.

And then there was the choice to re-carpet all of the house or just the rooms with obvious damage: the whole house was more expensive but only if we could persuade ourselves that we wouldn’t be looking at finishing the job after another five years of moths moving from room to room in search of munchies.

A whole house with new carpet just in time for any grandkids to arrive. Great.

My built in oven broke, or at least was on its way out. I could turn the knob (yes, it’s that old) to the required setting but there was absolutely no certainty it would switch on.

We did the maths and worked out that it was maybe 15-20 years old. Ho hum. Time for a replacement.

Being middle-class wealthy, we headed to John Lewis after a quick look through the Which Consumer Guide to domestic appliances and chose their BEST BUY, plus the option for them to take away the old oven and fit the new one.

Everything was going really well. They arrived. The old oven was removed and the new one installed. A quick safety check and they could leave.

Oh dear.

Apparently the impedance in my electricity supply to the oven socket was too high at 1.35 (ohms?) So the men uninstalled the oven and left with instructions that I needed to contact a qualified electrician to sort things out. The implication was that my electricity supply was unsafe.

Cheery news – not.

My electrician arrived, checked the oven, saw no problem but agreed that the impedance to the rest of the kitchen was too high and moreover that my very old fuse box could probably do with replacing. he wasn’t ready to say that I needed an entirely new earth system, but possibly?

He is honest as the day is long so having fitted the oven, I’ve scheduled some time for him to replace the fuse box next week. Once that job is done, we can check the impedance again and see if it’s still too high and a new earth is required (different company UK Power Networks) to make my house safe.

A new fuse box will at least have an RCD (Residual Current Device) that will trip quickly if there’s a fault though to be honest, after living with the current one for nearly thirty years and no harm, I’m pretty blasé about the situation.

What was driving me crazy was having a new oven sitting in my kitchen unusable, even though given the heat we’re seeing at the moment I had no desire to bake.

Now that it’s finally connected I have different issues. It’s wifi enabled, talks to my phone and seems to get daily software updates.

Why?

There is an author that I exchange emails with, provide some feedback to her novels etc. She has an editor so I’m generally just commenting on the narrative flow, raising the obvious questions and being a huge fan. She writes dystopian fiction, or at least that series I’m most connected to is a piece of American dystopian fiction.

I can’t imagine how tricky it is to write dystopian fiction in a country where that dystopia is playing out in real-time in government. Obviously it’s missing the werewolves and other woohoo but everything else is pretty much there. Wait a few days and the net appalling thing will happen.

I am of an age to have grown up believing basically that the Americans were the heroes, that whatever might happen, the Americans were there to stand up for the downtrodden democracies around the world against aggressors.

I never expected to see video of Americans being pulled from their beds, from the streets by armed thugs wearing balaclavas.

Who imagined the American president siding with the Russian dictator Putin over poor Ukraine?

How did we reach a stage where Americans thought it right or reasonable to keep a body alive until it started rotting before cutting out a half-developed baby?

Where is the popular uprising, complete with excessive guns that were promised in the event of central government overreach?

The US president has crashed world markets, upended alliances, cancelled aid leading to the death of thousands, maybe millions worldwide. And all the time, the powers that should check him stay silent.

It’s not so much the single elderly man that leaves me worrying but rather the people around him riding his victory, encouraging his excesses.

The world is paying for the choice that America made between the competent black woman and this sh*t show.

Tax law changed in the UK, specifically Value Added Tax, a form of sales tax, now applies to private school fees. Given that typical fees for a day school are around £15k, the fact that they were exempt from VAT saved people a reasonable amount of money each year. So much so, that a small minority of parents will now have to relocate their children from private to state school.

I might have got into a fight with one of them on social media.

Before that change was implemented there were lots of claims that we’d see an influx of children into the state system that would not be able to cope, that in fact very little money would be made by the government making this change as a result.

It turns out that there re around 650k pupils in private schools in the UK, of which maybe 35k are estimated to be transferring to the state sector, a small proportion of the total. The change in tax will net the government a tidy sum that can be spent on free school meals for poorer kids, for more teachers and improved infrastructure in the state system.

For me, it seems like a good policy with good outcomes.

Of course my children are long past their school years and we could afford to send them to private schools even if VAT had been applied. Like most parents paying for the privilege, we were not at all price sensitive. During a time of low to no inflation, school fees doubled over six years. No one left their private schools.

The woman arguing with me on my socials doesn’t know my own kids’ educational background of course. She assumed that my children, if I had any, were state educated. She assumed my position was one of grievance, that I begrudged her something we could not afford ourselves.

Am I a hypocrite? Possibly. It doesn’t feel like the right word though.

I have never fooled myself that I wasn’t buying my girls something of value with their education, an advantage, and that as a consequence of that choice, other people’s children would be disadvantaged. It felt and still feels to me, that girls have plenty of disadvantages in life and spending money to advantage them went a small way to balancing that disadvantage. I accepted that it was unfair. Of course it was.

I have voted all of my life for a political party and system where in and ideal world both private and religious education would cease to exist. I would be happy in that world. But since we’re not there, and we could afford it, we chose private single-sex schools. I don’t regret the choice.

Having said all of that, the benefits of private education are not as great as you’d think. My girls had both good and bad teachers. they were in selective schools so the width band of educational needs was narrowed and easier to teach. This also meant that they had no idea that they were cleaver until they reached university which obviously impacted how they saw themselves, maybe still how they see themselves. The self-esteem of girls in selective same-sex schools can be difficult.

The facilities at the schools were good, but the really glamorous private school facilities tend to be sports based for boys schools, not academic girls’ schools. The breadth of subjects was broader initially, a choice of languages to learn, music and art as real subjects with dedicated time and teachers, but the academic pressures to perform pushed the children down fairly traditional academic routes.

I am genuinely sorry that this woman feels forced to move her child from her private school at 16. It must feel very disruptive. Her family must be quite angry and quite sad.

But that’s her problem. I don’t think that people struggling to get by in life should be asked to pay more tax to afford her a tax break on private schooling for her children whilst their own go to the local state school. I could afford the luxury of private education. Alas, she no longer can. Capitalism sucks.

She didn’t feel sorry for the neighbours who could never afford to send their children to private schools or at least not enough to send her child to the local state school in solidarity, to work within the system to improve the local state school. She is cross to have to give up the privilege that her child is enjoying, though to be honest the benefit is probably mostly in those years through to GCSE at 16. Many people choose to move their children at 16 within both state and private education.

She feels cross and maybe a bit reduced to her neighbours’ level.

She is not wealthy enough. Not now.

Ho hum.

Am I the hypocrite, or is she?

The NYTimes is running a series of articles to encourage creativity and one of them asks the reader to use a set list of words to create a poem.

In the comments to the article, there is a series of poems, long and short. People have engaged with the challenge but also want to share their creation.

Creation within constraints seems so much more achievable to people, and ever more meaningful if it can be shared.