Men: The Weaker Sex?
By Sean Martin
Sept. 17, 2001 -- From the time they're little boys, guys are taught to be "tough" and not to cry.
That social training leads to middle-aged men ignoring chest pains that can warn of heart disease.
"Our culture prizes stoicism and courage among men, and teaches men to be somewhat unresponsive to their own physical pain," says Jean Bonhomme, MD, president of the National Black Men's Health Network.
And here's what that ultimately means: "Simply stated, men live sicker and die younger than women," says David Gremillion, MD, director of the Men's Health Network.
But congressional players and some health advocates are working to get the government into the business of making men tuned in to wellness.
There wasn't always this disparity. In 1920, for instance, men and women's life spans were only a year apart -- although women now live almost six years longer on average.
Furthermore, men are three times less likely to have visited a doctor in the past year, even after factoring out women's prenatal physician visits.
Men also have a higher death rate than women for each of the nation's 10 top causes of death.
Prostate cancer, which kills more than 32,000 men each year, is the most commonly diagnosed male cancer -- but many men aren't familiar with it enough to say it correctly. Prostate cancer accounts for 37% of all cancer cases, but gets only 5% of research funding.
"Women have more cultural freedom to talk about what hurts them," according to Bonhomme. "We don't have enough public information about male health problems like prostate cancer."
What's Afoot on Capitol Hill
Veteran lawmaker Rep. Randy "Duke" Cunningham (R-Calif.) is a decorated fighter pilot who was shot down in enemy territory during the Vietnam War. But he tells WebMD that his life's biggest scare was hearing from his doctor in 1998 that he had prostate cancer.
Cunningham says that his getting cancer was part of the catalyst behind his introduction of legislation that would establish a new office in the U.S. health department to "coordinate and promote the status of men's health."
Cunningham's ally on the bill, Rep. Jim McDermott (D-Wash.), MD, tells WebMD, "Men tend to deny that they have anything, and they have this 'he-man' attitude which makes them not go for checkups and not do the things that would make their health statistics better. We are trying to make people more aware of what could be done if they would let people know they had a problem."
The bill has 76 co-sponsors in the House, including women and men, Democrats and Republicans.
The idea is to follow in the footsteps of women's health offices; there are at least six such bureaus scattered through the federal health bureaucracy.
No one has stepped up yet in the Senate with the bill, but the Cunningham legislation has an endorsement from the Society for Women's Health Research. "Our quest to improve medical care must include a sex-based approach to meet the unique treatment needs of both men and women," says the society's president, Phyllis Greenberger.
But Who Picks Up the Check?
But the National Women's Health Network is not endorsing the bill, says Amy Allina, the group's program and policy director. At the same time, she says, "We believe there are health issues that are particular to men and we encourage health advocates who are concerned about men's health to work to get more attention for those things."
That given, says Allina, "We still think it's necessary across the medical field to work to get more attention to women's health. We think that women's health has been under-researched. Clinical trials as well as the historical medical practice model have assumed male as normal and female as a small version of men."
However, she adds, "If we can fund offices of men's health without detracting from the work that's being done for women's health, I'm all for it."
But money -- or lack thereof -- is probably the key issue in getting a new office going.
"There are clearly plenty of people interested in these issues, but nobody wants to put any money up," says McDermott. "That's going to be our biggest challenge, getting anybody to be serious about putting any money forward for this."
"This is something that can be done by the [U.S. health] secretary, just through reorganization," says Tracie Snitker, spokesperson for the Men's Health Network.
A men's health office wouldn't take anything from the pockets of the women's offices, says Cunningham.
"That's not the intent, and I assure you, that won't be the final outcome either," he says. "I'm just as dedicated to women's health as I am men's health. It's just that men's health information has been limited and I want to bring it up to parity."
Avoiding a Battle of the Sexes
Politically, the bill's advocates are on more solid ground this year, Allina says. In the previous Congress, she says, the legislation first emerged "from the perspective of saying women are getting too much attention and men need more of it. Obviously we had some problems with that. I appreciate that they've changed their approach to recognize that they can advocate for men's health without detracting from women's health."
Some claim that the U.S. health department is already one giant office of men's health, but, says Bonhomme, "The government actually spends more on gender-specific programs for women than they do on gender-specific programs for men.
"A lot of men's health problems affect women and children as well," Bonhomme adds. "If men get sick and die prematurely, then families lose loved ones and income."
Cunningham is a member of the House's health appropriations panel, so he can have special sway over some health research matters.
But he is coy about declaring that the men's office bill is likely to become law this year.
"Unfortunately, things don't move fast around here," he tells WebMD. "You learn that if you want to run through a brick wall the very first day, you're going to come out with a lot of scratches, and you're going to look down the road and you've got a lot of walls to run through, so you'd better pace yourself."
Running Your Own Office of Men's Health
Indeed, Washington rarely surprises us with quick action, so as the politics swirl, what are some do-it-yourself steps for staying healthy as a man?
For starters, says Bonhomme, don't overlook pain.
"As men, we've learned to ignore pain," he says. "Sometimes that's good, but the same tolerance for pain that can help you win on the football field or the battlefield doesn't help you out when you're dealing with the healthcare field."
According to McDermott, "Ordinary folks should have a physical once a year and have their blood and urine tested, and a chest X-ray, so that they have a recent baseline for the time when something happens. If somebody comes in to the doctor with a major catastrophe and they haven't seen a physician for 20 years, it's very difficult for the doctor to figure out what happened."
And don't forget clean living. A July study in the Archives of Internal Medicine showed that male, vegetarian Seventh-Day Adventists in California lived nearly 10 years longer than other Californians. Even non-vegetarian male members of the religion, which stresses exercise and avoidance of alcohol and tobacco, lived on average more than 7 years longer than other Californians.
Finally, there's always marriage, for you single guys. Studies have suggested that being married is healthful for men, as wives may prompt their husbands to take better care of themselves and to visit the doctor more regularly.
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