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A push for a federal focus on men's health

The government has an Office of Women's Health. Advocates say now it's men's turn.
Sen. Mike Crapo, R-Idaho, shown in this 2004 file photo, is trying to get a federal Office of Men's Health.Jeff T. Green / AP file
/ Source: contributor

Frank Greenhalgh admits he had a problem.

"I'm 68 years old and in pretty good health now, but I abused my health a lot in the past as far as overeating and drinking too much," he says. "At 50, though, I would never have gone to see a doctor."

Unfortunately, run-ins with gout, diabetes and high blood pressure changed all that, says Greenhalgh, a retired electronics design engineer living in Amityville, N.Y.

"I used to believe — and it appeared to be true — that I could eat and drink and not get sick or have any problems," he says. "Then, about age 50, I started to notice that there were cracks in my regime."

Encouraged by his wife and two daughters, Greenhalgh saw a series of specialists and now gets the regular check-ups and tests he knows can help keep him healthy. He's also eating better, exercising more — and feeling better.

"I've become a total believer," he says.

It's a lesson millions of other American men are learning the hard way — even powerful political leaders like Sen. Mike Crapo, R-Idaho.

"I'm a prostate cancer survivor, and I've learned through my experience how important preventive efforts are in terms of maintaining a strong, healthy lifestyle, as well as the importance of early detection," Crapo says. First diagnosed five years ago, Crapo says he's now cancer-free and "cautiously optimistic" he'll stay that way.

Seeking an Office of Men's Health
Crapo's experience got him thinking about how vulnerable men are to serious illness, and how many don't know where to go for the information they need.

That's why he's sponsoring the Men's Health Act of 2005 — a bill aimed at creating an Office of Men's Health at the Department of Health and Human Services.

The new office would be a centralized information clearinghouse mirroring HHS's Office of Women's Health. That agency was first established in 1991 to help increase the number of women involved in clinical trials.

Besides helping to achieve that goal, the Office of Women's Health has expanded its role over the past 14 years to include coordination and outreach on a full range of health issues. "They coordinate all the strategic operations of all the offices of women's health throughout the whole federal government — the NIH, the CDC, all the key organizations," explains Scott Williams, a spokesperson for the Washington-based Men's Health Network, which advocates for a stronger focus on male health issues.

The group looks to the Office of Women's Health as a useful model. "It's become the strategic and educational resource center that everyone thinks to go to when they have a question, or when they want to put together a program," according to Williams. "It's our hope that a men's office would do the same thing for men."

Crapo is also hopeful that a "brother" agency at HHS would act as a booster for men's health initiatives — and help turn some grim statistics around.

"Right now, of the 15 leading causes of death in the country, men lead women in all 15 of those," he says. "We also have an average lifespan that's six years less than that of women. So there really is a need to help men become more aware of making those healthy lifestyle choices, to take preventive therapies and to go for early detection. Things that women right now are so much better at."

The data bear that out: One recent Commonwealth Fund study found men to be much less likely than their wives or girlfriends to see a doctor, especially in their younger years.

"The majority of men surveyed also stated that even if they were sick they would delay seeing a doctor as long as possible," says Dr. Jean Bonhomme, an Atlanta-based consultant to the MHN and president of the National Black Men's Health Network.

He places the blame for men's poor health habits on a culture that applauds a stoic masculinity.

"From the time that boys are young they are taught that it's brave and strong to ignore pain," he says. "The result is that men have been taught to minimize and ignore the symptoms of their own bodies."

A new focus
Dr. Durado Brooks, executive director for prostate and testicular cancer at the American Cancer Society, agreed that there's a medical care "gender gap." Routine ob/gyn care, such as annual Pap smears and mammograms, "mean that, beginning in their teens, women are used to going to the doctor."

On the other hand, "we've never trained men to come in and get early-detection testing in the way we have for women," he says. "There's this feeling among men that if they aren't on their deathbed, they're not going to seek medical care."

When men do come down with a serious illness, their need for a clear, accurate source of information comes sharply into focus, however.

"For example, with prostate cancer, there are benefits and limitations to PSA testing that are important for men to understand before they head down that testing cascade — to find out what the potential outcomes of testing are," Brooks explains.

"Right now, we don't have a lot of good information on how to educate men so they can make a choice based on the best information available," says Brooks. An Office of Men's Health dedicated to filling that knowledge gap would be ideal, he says.

The total man
Some advocates for men's health are even lobbying for a board-certified "andrology" specialty within traditional medicine. While urologists look at the prostate or urinary tract and cardiologists focus on a man's heart and arteries, "there's no specialty that takes the time to look at the patient from the 'whole-man' point of view," notes Dr. Ken Goldberg, a Dallas-based pioneer in the field who for years ran the country's first and only Men's Health Center.

While a man's primary care physician can take care of his general aches and pains, too few men get in the habit of seeing them regularly, Goldberg says. On the other hand, male-oriented specialists such as urologists don't always have the insight or training to link erectile or urinary dysfunction with broader conditions such as cardiovascular disease.

This means that "men's health problems are being addressed piecemeal, across several subspecialties," Bonhomme says. "If a man finally does decide, 'OK, I have a problem, I better go see a doctor,' who does he see? Who has a sense of him as a total being, not just a prostate?"

But the establishment of a men's health specialty remains a dream for advocates such as Goldberg and Bonhomme. According to the MHN's Williams, some U.S. universities have well-established women's health studies but "there's been nothing that’s developed specific to men, although we'd love that."

Bonhomme believes the creation of an Office of Men's Health would empower both men and women, because a man's illness impacts on his entire family. "If a woman is widowed, her chances of dying over the next year increase dramatically," he points out. "If she's widowed she's also much more likely to slip into poverty — more than half of elderly women who are now living in poverty weren't poor before the death of their husband."

In the meantime, groups like MHN try to fill the gap. "We sponsor disease awareness campaigns — we've done them around benign prostatic hyperplasia [enlarged prostate], erectile dysfunction, low testosterone," Williams says. "We also go into corporate workplaces and do health fairs — screening men for cholesterol, glucose, prostate trouble."

MHN even distributes a "Get It Checked" wallet card that Williams says "gives a man benchmarks, based on his age, as to when it's appropriate to get tested for certain disease markers."

Call to action
Crapo says he remains cautiously optimistic the Men's Health Act will pass, though not this year. "Right now, because of the budget pressures we've faced over the last couple of years, there's been difficulty in getting almost any new endeavor underway because of the belief it will create an additional budget pressure," he says.

But the Idaho senator dismissed those concerns, pointing out that the agency as planned would piggyback on resources already set up for the Office of Women's Health. "The objective of this isn't to create some new bureaucracy," he says.

Action is needed to keep the legislative ball rolling, however. "We need to get strong pressure and organization around the country to try and get hearings next year," Crapo says.

Back in Amityville, Greenhalgh says his own experience proves that any effort to get men to focus on their health can pay off.

"I go to my doctor every three or four months now, and I always have a copy of my results given to me so I can take them home and look at them," he says. "I treat myself better now. I know it's made me a better person."

E.J. Mundell is a freelance writer in New York City.