Men’s Health Caucus in the American Public Health Association
By rllamas | March 3, 2010
Men’s Health Caucus in the American Public Health Association
Ramon P. Llamas, MPH
On February 24, 2010, Dr. Georges Benjamin, executive director of the American Public Health Association (APHA), announced the Association’s support for the Men’s Health Caucus, which will draw awareness to an emerging and cross-cutting public health concern. Scott Williams, Chair of the newly formed Caucus and Vice President of Men’s Health Network (MHN), explained that “The Men’s Health Caucus is necessary to bring together academic institutions, health departments, non-profit organizations and others with a common interest in improving the health and well-being of men and their families. This field is in desperate need of a diverse, multi-disciplinary, and coordinated approach to better tackle this public health issue within our communities.”
This caucus will allow APHA members and other individuals interested in the field to coalesce around the impact of poor health outcomes and premature death in men as it pertains to public health. Men of all races, on average, live about 5 years less than their female counterparts because they are less proactive and less engaged with the healthcare system, illustrated by CDC reports that women are 100% more likely than men to seek preventive care. Additionally, poor health outcomes in men cause significant financial burdens on the health care system; higher prevalence rates of chronic disease result in premature death and disability which ultimately affect utilization and rates of health care services. Moreover, the ramifications of chronic disease transcend beyond the individual, often affecting immediate family members as well as members of the individual’s social network. As a result, MHN agrees with the following statement from Dr. Benjamin that “protecting and improving the health of men and their families is essential to improving the health of our nation.” It is MHN’s strong belief that strategic and gender-specific outreach can, in fact, improve health outcomes in men. The formation of an official caucus to facilitate dialogue between health professionals, public health practitioners and researchers will create opportunities for progress in the field.
If you are interested in becoming involved with the Men’s Health Caucus, please do not hesitate to contact me at ramonl@menshealthnetwork.net.
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Topics: Public Policy, Well-being | No Comments »
Asking the Tough Questions
By spatel | February 22, 2010
By Adam Dougherty, MPH
This week’s deadly plane crash in Austin, Texas raises important questions regarding national security, anti-government violence, and aviation licensing. One could also make the argument that at the core of the tragedy are questions regarding failure in mental health management. As is frequently mentioned at TAMH, the ability for men to come to terms with personal health issues proves extremely difficult. Mental health is no exception, and in some ways is an even tougher condition to discuss, let alone seek treatment for.
No doubt the above incident is an extreme case, but it nevertheless can act as a learning experience of how best to deal with the demons that we all face. No one piece of the puzzle is to blame, as everything from self-assessment to family support to organizational therapy could have played a larger role. Though the attacker had a history of anti-government sentiments, he reveals in his suicide note that he would write about his disdains ‘as a form of therapy.’ Writing is a common tool for psychotherapy and should be encouraged, though in this case Mr. Stack’s anger management reached a breaking point stating that violence ‘is the only answer.’ With decades of simmering hatred, it is hard to fathom how those close to him could not have seen warning signs at some point. Numerous run-ins with tax officials and auditors could have also raised concerns.
This examination is not meant to highlight the failures that led to the tragedy, but rather raise awareness of the very real sensations that we face every day. No matter the antagonists in our life, it is important to be able to cope with our reactions through personal processes, healthy support from our loved ones, and if needed professional expertise. This is especially relevant during tough economic times. How can I better manage my own trepidations? Would I be able to ask for help if I needed it? How can I act a source of support for a troubled loved one? What other ‘checkpoints’ can be utilized to give people opportunities to work out their thoughts in healthy ways; occupational health systems, government points of contact, or other social services? How does the equilibrium of incarceration versus rehabilitation come into play? To break the social norm of men’s emotional internalization, we must be able to have more thoughtful discussions regarding questions such as these.
Topics: Well-being | No Comments »
Latest Men’s Health in the News
By spatel | February 16, 2010
By Brandon Leonard
Men’s Health issues are featured in an article by Teddi Dineley Johnson in the current issue of The Nation’s Health, a print and online publication of the American Public Health Association. You can access the article here: http://TheNationsHealth.AphaPublications.org/content/40/1/28.full. This piece, which quotes both MHN Vice President Scott Williams and Advisory Board member Dr. Perry Karfunkel, is a call to action for men to consider and improve their health. It’s also a reminder that men’s health issues do not always show up on the radar in discussions about national health in general.
One of the key points in the article is the gap of 2-3 decades in which a large percentage of men have very little contact with health professionals. Having passed through high school and possibly college, men in their 20s, 30s and even 40s become alienated from the healthcare system. This can be attributed to a combination of factors, including fear and the classic tough-guy belief that you don’t need to see a doctor unless you’re in extreme pain. Also, unlike women, men have much less frequent contact with doctors during their adolescence for routine care and never get into a healthy habit of regular check-ups to detect potential problems. When men finally do present themselves in a medical facility, perhaps years after developing mild pain or a nagging health condition, many have missed the chance to catch a serious ailment early.
If this sounds like you, don’t wait any longer to see a professional about any health issues that are bothering you. And if you know someone who is struggling with an ailment, let them know you care enough about them to ensure they get the help they need. Finally, be sure to share information like this article with those you know, and to advocate for more coverage of men’s health issues in both publications and public policy debates. MHN is excited to see this article published in The Nation’s Health and looks forward to engaging in more educational activities about men’s health around the country.
Topics: Education | No Comments »
Happy Pills Or Dummy Pills? Just Don’t Let Them Be Ignorance Pills
By spatel | February 9, 2010
By Luke Manley
I wanted to draw your attention to an article published in the February 8th issue of Newsweek magazine that highlights recently released research that solidly confirms the nearly imperceptible difference between the effectiveness of medications and placebos for the treatment of mild, moderate, and even severe depression. Drawing primarily from a met-analysis published in the January issue of the Journal of the American Medical Association (JAMA), the article explains how it was discovered that after analyzing just published research it was shown that patients taking a placebo improved 75% as often as those taking the actual medication. However, only sixty-percent of clinical trials performed on the main drugs for the treatment of depression have ever been published. After using the Freedom of Information Act to gain access to the remaining 40% of unpublished studies, this number rose to 82%. In addition, when combining both the published and unpublished trials, researchers found that over half showed “the drug alleviated depression no better than a placebo”. Further, in the trials that did show an improvement with those taking the actual medication, it successfully reduced severity of depression by only 1.8 points on the 54-point scale. The final conclusion of the meta-analysis was that the true effect of antidepressants was “nonexistent to negligible” in 87% of people. The only statistically significant drug benefit was in individuals with very severe, chronic symptoms. Just in case there was any doubt remaining, researchers exposed that even the very basis of the effectiveness of antidepressants is based only on a single study from the 1950s. This study showed that a drug called Iproniazid increased serotonin and norepinephrine levels in the brain and seemed to help a number of people with depressive symptoms. Therefore it was decided that it was an imbalance in these two chemicals that must be the cause of depression. Yet a new drug sold in Europe has been shown to be as effective as most current antidepressants and actually lowers levels of serotonin. One of the authors of the ineffectiveness studies puts it plainly, “If depression can be equally affected by drugs that increase serotonin and by drugs that decrease it, it’s hard to imagine how the benefits can be due to their chemical activity.”
Strangely enough, the arguments against this study revolves not around the accuracy of the science, which is admitted even by physicians as well as drug proponents, but whether or not it is morally right to overturn the belief of hundreds of millions of people about the effectiveness of their treatment. It is argued that, even if the improvement truly is fantasy, this belief is necessary for the benefit to continue. Further many fear that exposing the truth might even cause those receiving treatment to abruptly stop taking their medication, which can cause severe withdrawal symptoms such as nausea, vision problems, tremors, and even depression and anxiety. That is certainly an understandable and noble stance if it is indeed patient well-being and not a financial bottom-line influencing such a stance. However, this could easily be the most slippery of slopes. Is it really the moral option to continue to allow millions of people to spend thousands of dollars on drugs that serve no actual benefit? Who is it that is qualified to determine what is best for each of us? Physicians? Pharmaceutical companies? Do the lobbyists for Prozac have depressed people’s best interests at heart?
Both the news and journal articles focus primarily on the lack of a difference between the effectiveness of pharmaceuticals and placebos and the potential consequences. However, it does mention documented methods for successful alternatives, such as psychotherapy, which has been shown to be highly effective for all levels of depression, including very severe. It also makes the case for how the combination of medication and psychotherapy can be even more effective for some people, but warns that this may also be due to the expectation for success.
All this research has important implications for men’s health since men are equally as likely to suffer from depression as women, but are much more likely to successfully commit suicide because of it. The National Institute of Mental Health estimates that depression affects approximately six million men in the United States and between three and five-percent of men worldwide. Additionally, a number of sources confirm that worldwide sales of antidepressants are currently over $20 billion. Therefore any decisions about the distribution and use of these drugs will have profound effects not only on people suffering from depression and the economics that support their treatment, but also the functioning of mental health care systems throughout the world.
References
Begley, S. The Depressing News About Antidepressants. 29 January 2010. Newsweek.
Fournier JC, DeRubeis J., Hollon SD; et al. Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis. JAMA. 2010;303():47-53.
Topics: Medical Research | No Comments »
Time to reassess
By rllamas | January 28, 2010
Time to reassess
By Ramon P. Llamas, MPH
“Health is the soul that animates all the enjoyments of life, which fade and are tasteless without it.” – William Temple
I recently read “Wake-up Call” by Erika Lovley in Politico this week and my suspicions have been confirmed through anecdotal evidence: people working in Washington, especially those working on Capitol Hill, are extremely stressed out. Having moved to DC last June from California, I first noticed it back in 2008 when I spent a summer here as an intern. It’s the culture to work non-stop. And it’s hard not to. Just take a look around – people almost jogging to the metro because they walk so fast; reading reports on the metro and constant communication through their trusty smartphone, among others. The death of Paula Nowakowski, Chief of staff for John Boehner, serves as a wake up call for everyone in Washington. Slow down and relax, people. Paula passed at the age of 46 from a heart attack. Lovley describes that her lifestyle probably contributed to her passing because “she smoked, she didn’t always eat well, and she often worked seven days a week.” Other Hill staffers have developed health problems as well. From Type 1 diabetes to high blood pressure, the consequences of constant, unrelenting stress can take its toll. Despite one’s passion for the job and work, is it worth the health consequences you develop in return? Is there anything you can do?
A publication from the National Institute for Occupational Health and Safety (NIOSH) recommends the following: maintain a balance between your professional and personal life; have access to a supportive social network of friends and family and maintain a relaxed, positive outlook on life. Early warning signs of job-induced stress include headaches, sleep disturbance, difficulty in concentrating, short temper, upset stomach, job dissatisfaction and low morale. If left untreated, the following health problems have been correlated to job-induced stress: musculoskeletal disorders, psychological disorders, workplace injury, ulcers, impaired immune function, cancer , heart disease and suicide. The first step to solving a problem is to acknowledge that it is there. From that point you can plan accordingly. Mayoclinic.com offers some ideas to relieve stress:
*Keep a log. Track everything you do for one week. Include work-related and non-work-related activities. Decide what’s necessary and what satisfies you the most. Cut or delegate activities you don’t enjoy and don’t have time for. If you don’t have the authority to make certain decisions, talk to your supervisor.
*Learn to say no. Whether it’s a co-worker asking you to spearhead an extra project or your child’s teacher asking you to manage the class play, remember that it’s OK to respectfully say no. When you quit doing the things you only do out of guilt or a false sense of obligation, you’ll make more room in your life for the activities that are meaningful to you and bring you joy.
*Leave work at work. With today’s global business mentality and the technology to connect to anyone at any time from virtually anywhere, there’s no boundary between work and home — unless you create it. Make a conscious decision to separate work time from personal time. When with your family, for instance, turn off your cell phone and put away your laptop computer.
*Communicate clearly. Limit time-consuming misunderstandings by communicating clearly and listening carefully. Take notes if necessary.
*Fight the guilt. Remember, having a family and a job is OK — for both men and women.
*Nurture yourself. Set aside time each day for an activity that you enjoy, such as walking, working out or listening to music. Unwind after a hectic workday by reading, practicing yoga, or taking a bath or shower.
*Set aside one night each week for recreation. Take the phone off the hook, power down the computer and turn off the TV. Discover activities you can do with your partner, family or friends, such as playing golf, fishing or canoeing. Making time for activities you enjoy will rejuvenate you.
*Protect your day off. Try to schedule some of your routine chores on workdays so that your days off are more relaxing.
*Get enough sleep. There’s nothing as stressful and potentially dangerous as working when you’re sleep-deprived. Not only is your productivity affected, but also you can make costly mistakes. You may then have to work even more hours to make up for these mistakes.
If you’ve been able to find a great balance between work and personal life, share your story with me at ramonl@menshealthnetwork.net!
Topics: Lifestyle Issues, Well-being, Workplace Issues | 2 Comments »
Beyond Health Care
By spatel | January 25, 2010
By Ramon P. Llamas, MPH
Health reform has been a topic of great importance here in Washington for the past few months since discussions and debates have intensified in June, 2009. Health reform, however, has primarily focused on one aspect of health – health care. In the broader sense, though, health encompasses a wider reach. For example, health professionals are more likely to acknowledge that culture, race, gender, socioeconomic status (SES) and education, among others, all contribute to an individual’s health status in one way or another. These factors, known collectively as the social determinants of health, continue to gain interest. The Office of Minority Health (OMH), under the Department of Health and Human Services, has issued the National Plan for Action, which sets out a framework to reduce health disparities that result from the various social determinants.
During my brief time here at MHN, I have been fortunate enough to attend two large conferences – the Virginia Health Equality Conference in September and the American Public Health Association’s Annual Conference in November. As a result of attending these events, I met and had discussions with researchers in the field. I highlight a few of them below:
“Sex in Medicine Week: A student-organized educational intervention and its assessment” by Francesca I. Decker and Michael A. Joseph, PhD, MPH from SUNY Downstate.
Background – There is a lack of provider initiative regarding patient sexual health which decreases quality of patient care. Many studies describe this problem but few programs exist to address its causes, and few tools exist to assess existing programs’ effectiveness.
Methods – Student-organized series of lectures and workshops on patient sexual health to educate medical students in order to increase their quality of care post-graduation.
Results – Over 100 students attended and found workshops interesting (100%) as well as useful (98.3%).
“Health Literacy Education and Communication in the Philadelphia Immigrant Community” by Anna M. Quinn, Maura A. Murphy and Katie E. Thomas of Thomas Jefferson University.
Background – Immigrants are less likely to speak to their healthcare providers about diet and exercise than those born in the U.S.
Methods – MPH students worked with two to three ESL students for a specified time and conducted health education and promotion. The sessions discussed local resources for medical care and culturally sensitive health behaviors for each ESL student. Additionally, the MPH students provided ESL students with reviewed health materials.
Results – ESL students reported higher comprehension as well as improved language skills. Additionally, ESL students became more familiar with local resources such as clinics, food banks, farmers’ markets and government services.
Health is an immensely important part of our lives – it is essential to live, work, play and pray, therefore, we should each treat it as a higher priority. We can no longer depend on health care to determine our health status. We must each take a more proactive role in becoming and staying healthy.
If you have any questions or have any ideas on how to empower individuals to take charge of their health, please do not hesitate to contact me at ramonl@menshealthnetwork.net.
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The Business Case for an Office of Men’s Health
By spatel | January 19, 2010
By Adam Dougherty, MPH
Below is an excerpt from a forthcoming study that I authored, which investigates the federal costs associated with excess disease burden in men in an attempt to substantiate the need for a federal Office of Men’s Health.
Despite the increased risk of disease and injury, the health of men is oft an overlooked subject. Men have significantly higher death rates in nine of the ten top leading causes of death, higher rates of smoking and overweight/obesity, are more often uninsured, and are far less likely to receive routine preventive care. While the moral imperative is evident in reducing health disparities, merely stating the effort is “the right thing to do” often may not provide sufficient motivation to act. Linking the issue to financial incentives, though, gets many more people talking, especially when it’s your tax dollars at work.
The resulting costs of premature morbidity and mortality in men are substantial, particularly so to the federal government in the form of direct medical costs and survivor benefits. Men are at worse health as they enter Medicare, causing substantially higher costs to the program. Excess Medicaid hospital payments for uncompensated care to uninsured men and lost federal revenue as a result of disease burden, disability, and death contribute to excess federal costs. Public benefits for low-income widows and families are substantial as a result of premature death in men including Social Security survivor benefits, Medicaid and Medicare low-income subsidies, and the Food Stamp program.
Across the nation we should dedicate our efforts to improve the health and wellbeing of men, though no organized federal entity is present to provide sustained leadership and national directives. A commitment to prevention and health promotion in men will help curb this expenditure growth and create effective social norms by breaking through the stigma associated with men who avoid seeking care. The time has come for the creation of a federal Office of Men’s Health. A recognized federal focus can act as the apex of promoting healthy lifestyle, workforce safety, and male-specific research advocacy. For more information on the creation of a federal Office of Men’s Health, see H.R. 2115 “The Men and Families Health Care Act of 2009”, Hill [D-ID] and Murphy [R-PA].
Topics: Public Policy | No Comments »
More Money, More Problems
By spatel | January 1, 2010
By Ramon P. Llamas, MPH
First of all, Happy New Year!
USA Today featured a comprehensive story on college football coaches and their total salaries (breakdowns of base salaries and bonuses, etc.) in early November. The highest paid coaches in 2009 lead the most prestigious football programs in the country, including Pete Carroll of Southern California, Bob Stoops of Oklahoma and Urban Meyers of Florida, among others. The aforementioned coaches made at least $4 million dollars in total salary in 2009 (access the full list here). $4 million. A salary of $4 million is higher than most professions, but unfortunately the pressures of receiving such a salary can take their toll. Urban Meyer, for example, recently resigned from his coaching job at the University of Florida due to recent health problems, in which Meyer lost consciousness and was admitted to the hospital. Fortunately for Meyer, there was no heart damage. But he had been experiencing chest pains for the past two years. He reportedly lost 20 pounds during a 10-day period around the SEC title game against arch-rival Alabama. A competitive drive and relentlessness such as Meyer’s are shared, to some degree, by many. It is this same drive that leads to burn out and potential health problems. It is important to be aware of warning signs and symptoms and to discuss any concerns with a physician. Take note of changes and the duration of those changes. For example, weight loss in the past 10 days resulting from a loss of appetite. It is important that each of us takes a more proactive role in maintain our health and well-being, both physically and mentally. Physicians cannot be relied upon to solve all of our health care problems; their job is done more accurately and efficiently when we are fully engaged and assist them in the process.
For this new year, I encourage each of you to reflect on what your health means to you. Remember that health is a resource for living. It is our vehicle to enjoy all that life has to offer, whether it’s traveling, sports, cooking, music or the arts. I wish each of you a healthy and prosperous 2010!
If you have any questions or comments, please drop me a line at ramonl@menshealthnetwork.net.
Topics: Family Issues, Lifestyle Issues, Medical Issues, Sports Issues, Well-being, Workplace Issues | No Comments »
Head Injuries in the NFL and Beyond
By spatel | December 14, 2009
Head Injuries in the NFL and Beyond
by Adam Dougherty, MPH
There are few things more satisfying than watching a rival quarterback receive a blind-side sack or seeing your team’s DB lay out a receiver on an incomplete pass in slow-mo. Of course, this is only true as long as the recipient is able to get up and walk off the field, as nobody would actually wish physical injury on another person no matter how hated the opponent. Beyond their immediate well-being, though, physical health needs to be thought about in longer-term scenarios, particularly on the topic that has recently received some much-deserved attention: head injuries.
In 1994, the NFL began a comprehensive clinical research study of mild traumatic brain injury analyzing data between 1996 and 2001 by gathering information from team physicians, studying game video, and experimenting the biomechanics of an impact. Though useful in terms of understanding the injuries themselves and improving protective equipment, the study was inconclusive in establishing a link between football and later head/brain injury. Since the investigation, the NFL has received ample criticism for not adequately addressing the possible link between football-related head injuries and mental decline later in life, and the debate finally came to fruition; several weeks ago, the House Judiciary Committee held a hearing to investigate football-related head injuries and their long-term effect on the brain. Testimony was received from NFL Commissioner Roger Goodell, members of the NFL’s Mild Traumatic Brain Injury Committee, former football players, and several prominent neurosurgeons. The committee concluded that the NFL needs to take better responsibility for its players given the organization’s profitability and exposure, and research needs to focus on the later cognitive effects of sustained head impacts, such as dementia, depression, and mental degradation.
You may ask, why am I focusing on a workforce of some 2,000 active professional football players and 10,000 retired players? Why would a Congressional Committee and numerous media outlets invest their time and money into the health of this handful of millionaires? I would answer you that the NFL is the spearhead of sports behavior for millions of athletes from the college level to high school to peewee football, and the organization should act as an industry leader promoting healthy social norms. I would also answer you that this subject matter can be used as an example for employee health across a spectrum of ‘risky’ employment, of which men are much more likely to be a part. Be it a coal miner, construction worker, military officer, or any other paying job subject to physical hazard, it is important to understand how these professions affect the mental and physical health of the workforce. Employers have a responsibility to recognize and protect the individuals sustaining their business, and foster research of safe and health workplace practice.
Resources:
House Judiciary Committee Hearing on Legal Issues Relating to Football Head Injuries, 10/28/2009, Hearing Information at http://judiciary.house.gov/hearings/hear_091028.html
ELLIOT J. PELLMAN, M.D., AND DAVID C. VIANO, DR. MED., PH.D. Summary of the research conducted by the National Football League’s Committee on Mild Traumatic Brain Injury, Neurosurgery Focus, 2006, 21, (4) E12 1-10 http://thejns.org/doi/pdf/10.3171/foc.2006.21.4.13
McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, Santini VE, Lee H-Y, Kubilus CA, Stern RA. Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury. J Neuropath Exp Neurol, 2009, 68(7): 709.735. http://www.bu.edu/alzresearch/team/faculty/documents/CTE-JNENJuly.pdf
Topics: Uncategorized | 2 Comments »
Surviving the Holidays
By spatel | December 7, 2009
by Brandon Leonard, MA
It seems the holiday season starts earlier every year. Even before Thanksgiving, retailers had taken the opportunity to roll out the lights and specialty goods for a host of upcoming holidays. In some ways, this can be exciting: many people associate this time of year with favorite traditions, time with family and old friends, and a good excuse to enjoy lots of food and entertainment.
On the other hand, the stretch from now till early January can also be daunting or even depressing for some people. Getting everything perfect for family get-togethers or concerts and doing all that last minute shopping is often stressful, and tight budgets this year will further complicate things. This is also a difficult time of year for those who have lost loved ones and wish they could be here for the holidays, or for those who have strained relationships with family.
Through the challenges, as well as the frantic celebration, it’s good to keep some perspective on what these holidays are all about. It was never supposed to be a time to see how many perfect gifts you could buy for others, or to find out who has the best yard decorations. No matter what your faith tradition, these weeks are a little sliver of the year that we cut out to be grateful for what we have. It’s important to take some time out of the schedule for yourself and think about what really matters to you, and what you are grateful for in that moment. Maybe that’s your child, your job, your partner, your health, or a commitment that you can make to yourself to improve some area of your life.
I hope that you’ll take that time out this holiday season – a time we are told to think of others (a very noble suggestion) and consider your own well-being. After all, if you are coming to life from a place of poverty or ill health, it is hard to make others comfortable and well. For some more tips on taking care of yourself at this time of year, the Mayo Clinic has given great tips to prevent the holiday stress and depression:
- Acknowledge your feelings.
- Reach out.
- Be realistic.
- Set aside differences.
- Stick to a budget.
- Plan ahead.
- Learn to say no.
- Don’t abandon healthy habits.
- Take a breather.
Source: http://www.mayoclinic.com/health/stress/MH00030
Here’s a link to the rest of the article from the Mayo Clinic where you can read more about the bullet points and about handling holiday stress. Be well, and don’t lose sight of what the season is all about: gratitude.
Topics: Family Issues, Well-being | No Comments »
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