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The formation of the federal Office on Women's Health (OWH) a
decade ago has brought immeasurable benefit to American women
through its numerous outreach and awareness campaigns. Ten years
later, health advocates are asking for a similar office for men.
The need for an Office of Men's Health is acute, and the
evidence that men's health is being ignored can't be ignored.
According to the Centers for Disease Control, adjusting for age,
men lead in all of the 10 most common causes of death in the
United States, and women live on average six years longer than
men.
Indicative of what activists call men's "silent health crisis"
is the way research and outreach on prostate cancer, which is as
likely to kill the average American man as breast cancer is to
kill the average woman, has been underfunded. Prostate cancer is
the most frequently diagnosed cancer in men, accounting for 36%
of all cancer cases. An estimated 180,000 men will be newly
diagnosed this year, and 37,000 will die.
However, the federal government spends four times as much on
breast cancer research as prostate cancer research, and the
money raised by private charities for breast cancer is estimated
to outnumber that for prostate cancer 20 to 1. Commendably,
women's health advocates led the campaign for the breast cancer
postage stamp, which has raised over $25 million for breast
cancer research since 1998. Unfortunately, a bill proposing a
similar stamp for prostate cancer research, introduced in
Congress in 1999, was unsuccessful.
Jean Bonhomme, an Atlanta physician and founder of the National
Black Men's Health Network, says men's ignorance about prostate
cancer is a major problem and "many men are dying unnecessarily
from completely preventable and treatable causes."
In a 1995 survey, 90% of the men questioned didn't even know
where the prostate is located. In another survey, offered a
choice of answers, only 37% of men knew that the correct
function of the prostate gland is to maintain healthy sperm. Two
out of every five men over 50--who should be getting a prostate
exam every single year--have never been screened for prostate
cancer.
Men's inattention to their own health needs goes far beyond
prostate cancer. According to San Francisco area physician Jim
Eichel:
"Surveys show that men are 30 percent less likely than women to
visit a doctor [not counting women's prenatal visits], only half
as likely to have a regular physician, and significantly less
likely to have check-ups and obtain preventive screening tests
for serious diseases. It is difficult for me as a primary care
practitioner to intervene--if a man won't come to see me,
there's no way I can help him."
Last Valentine's Day, the Men's Health Act was introduced in
Congress by Representatives Randy "Duke" Cunningham (R-CA),
himself a prostate cancer survivor, and Jim McDermott (D-WA).
Since then the bill, which mandates that the Secretary of Health
and Human Services establish an Office of Men's Health to
"coordinate and promote the status of men's health in the United
States," has drawn considerable support across party and gender
lines. The bill currently has 82 sponsors, including California
representatives Howard "Buck" McKeon, a conservative, and
Barbara Lee, a liberal. The bill currently resides with the
Subcommittee on Health of the House Energy and Commerce
Committee, and is one of many which has been temporarily pushed
aside in the aftermath of the September 11 terrorist attack.
Part of the reason a Men's Office of Health has been so long in
coming is the common but nonetheless false perception that the
government and the scientific community have paid more attention
to men's health than to women's. In 1990 Senator Barbara
Mikulski (D-MD) made national headlines by citing the fact that
women-specific health research comprised only 14% of the budget
of the National Institute of Health (NIH). She called it
"blatant discrimination" and led the successful campaign for the
creation of the OWH. What Mikulski and many in the media who
publicized Mikulski's claims didn't understand was that only
6.5% of the NIH's budget went to male-specific research--the
vast majority of the NIH's research was gender neutral.
Today the disparity between men's and women's NIH research has
grown from 2 to 1 in favor of women to 2.5 to 1. The ratio of
female to male enrollments in studies, and in gender specific
studies, which slightly favored women before the creation of the
Office of Women's Health, by the late 1990s had grown to favor
women three to two and three to one respectively. At the time
the Office of Women's Health was formed and even more so today,
more money was spent on women's medical research and issues than
on men's at every level of government.
Megan Smith, the Director of Project Development for the Men's
Health Network in Washington, DC, stresses that the purpose of
the proposed Office of Men's Health is not to compete with the
Women's Office, but to work with it.
"Many in the scientific community are moving away from the
boilerplate, gender-neutral approach to research," she says.
"The trend now is toward a gendered approach, which they believe
will benefit both men and women. The Men' Health Act can make
important contributions, which is why it has received
significant support from many women in the health field. The
Office of Men's Health should have been formed 10 years ago. It
needs to be formed now, for everyone's benefit."
This column first appeared in the
Los Angeles Daily
Journal and the
San Francisco Daily Journal (12/18/01).
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