Wednesday, August 20, 2014
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Men fall behind women in caring for their health

scott column sig

By
From page B12 | May 24, 2014 |

Men tend to neglect their health. Nonetheless, a congressional health education program designated June as Men’s Health Month.

Good luck with that.

Studies show that women are 100 percent more likely to visit a doctor than men. Life expectancy for American women is 82 years, versus 76 for men. This six-year discrepancy was only one year in 1920, probably in part due to higher rates of pregnancy-associated deaths a century ago. So women are living longer, and men are lagging behind. We must try to do better.

Men’s Health Month, which I researched through the Centers for Disease Control and Prevention, and the Men’s Health Network, is devoted to preventing diseases in men and boys, as well as improving treatment strategies for established disease. The challenge is daunting.

For example, men die at higher rates than females for all of the top 10 causes of death in our country. Men are more prone to heart disease, cancer, injuries, stroke, human immunodeficiency virus (HIV) infection, suicide and homicide.

Women do, of course, suffer disproportionately from breast cancer. Some of the cancer deaths reflect lifestyle issues, such as smoking, but others probably reflect occupational exposures to carcinogens. Men suffer twice as much hearing loss as women, often occupationally induced. To be sure, women may be increasingly prone to such injuries as well, as they continue to enter historically male-dominated fields of endeavor.

With respect to homicides, men get killed at far higher rates overall, but the influence of ethnicity is perhaps even more significant. For example, 1 in 445 white women die due to homicide, compared to 1 in 179 white men, a stark contrast. Among African-Americans, however, 1 in 132 women is killed, along with an astounding 1 in 30 men. Thus, notwithstanding the tendency for men to succumb to violence at a higher rate than women, it is more dangerous to be a black woman than a white man, in terms of homicide risk.

By age 100, there are eight women alive for every one man. If you doubt this, I suggest you visit a nursing or retirement home, where you will encounter many elderly women and an occasional man. Aside from traumatic death due to homicide, suicide and accidents at work, men also are exposed to the injurious hormonal milieu of the male body.

Specifically, testosterone, which is necessary for health and reproductive vigor, also tends to alter the lipid profile in a deleterious manner. So-called “bad cholesterol,” or LDL, tends to rise under the influence of this hormone, while “good cholesterol, or HDL, declines. To be sure, deficiency of testosterone in middle-aged men may be associated with lack of energy and muscle mass. On the other hand, the aggressive direct-marketing for testosterone supplementation prescriptions, pervasive on many television channels, downplays these risks.

What can we do as individuals to recognize Men’s Health Month? I suggest a frank consideration of one’s personal health situation, perhaps with input from a trusted family physician.

Each person is unique, and I prefer not to offer specific prescriptive advice. Obviously, exercise, healthy eating and minimizing stress make sense for most men. In addition, it is easy to forget about routine age-appropriate health-screening tests. These are legion in number, and cannot be covered completely in a brief column.

Examples, however, include considering colonoscopy after age 50 to rule out colon cancer, periodic evaluations of the prostate gland with a blood test (prostate specific antigen) or digital rectal examination, and review of general internal medicine health status with respect to blood pressure, cholesterol, blood sugar and similar parameters.

Men’s Health Week should be about well-being and happiness. I think Bobby McFerrin put it perfectly: “Don’t worry, be happy.” Sage advice, by any reasonable standard.

Scott T. Anderson, M.D. (email stamdphd@comcast.net) is clinical professor at UC Davis Medical School. This column is informational, and does not constitute medical advice.

Scott Anderson

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