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).