Talking About Men's Health™

Socioeconomic status, discrimination, housing, physical environment, food security, child development, culture, social support, health care services, transportation, working conditions, age, gender and race.  What do they have in common?  The factors listed above are believed to contribute, in one way or another, to our overall health status.  In essence, the aforementioned factors, collectively called the social determinants of health, can shape our health on the most subtle level.  For example, living in an urban city with limited resources for parks and recreation combined with heavy traffic conditions could affect an individual’s decisions on exercise.  Rather than expending energy dodging cars and inhaling unsafe emissions from cars, individuals may elect to spend most of their leisure time in the comfort of their homes watching television or surfing the internet.  It would seem that this alone would not significantly affect an individual’s health status.  Lack of regular exercise, however, can place an individual at higher risk for cardiovascular disease, cancer and other chronic diseases.  Therefore, I believe that addressing social determinants of health, combined with timely medical care can significantly improve the health of the population and as a result, enjoy a better quality of life.

At the Men’s Health Network (MHN), we focus on how gender differences reinforce socially accepted health disparities between men and women.  For example, at health fairs or presentations, we ask people, “who is healthier, men or women?”  Without hesitation, men and women emphatically answer women.  It is well documented that women are twice as likely to seek preventive health care.  As a result, women have outlived men for the past 80 years.  Women currently outlive men by an average of 5 years across all races.  Society knows it.  We have asked them.  However, MHN is not satisfied.  We continue to ask questions.  Why are women healthier than men?  Why isn’t there more attention to this disparity in life expectancy?  Why aren’t there programs to address a man’s unwillingness to stay masculine at all costs?

We have a long list of questions.  But one of the main problems is that not many others are asking those questions.  Why is that?

If you are interested in being a local leader to discuss men’s health in your community, please, please, DO NOT hesitate to contact me at ramonl@menshealthnetwork.net.

Football games are a time for indulgences like burgers, brats, and beer but even then we can still find ways to promote a cause for a health condition that effects one in six American men. This past Sunday, the Men’s Health Network collaborated with the Washington Redskins at their season home opener in support of Prostate Cancer Awareness Month.

Employees and volunteers of MHN fanned across the stadium gates to distribute over 10,000 informational cards with a blue ribbon for fans to wear during the game. We were not only able to spread the word about the impact of prostate cancer, but also able to hear from survivors themselves in support of continued research and screening awareness in the population. In addition, the halftime program contained a segment on prostate health, and recognized the great efforts of organizations like the Men’s Health Network. Thanks for everyone who came out in support!

In other awareness efforts, the Democratic National Committee passed an important resolution during their annual fall meetings. The recent diagnosis and treatment of Senator Chris Dodd’s prostate cancer shows just how important early detection and timely treatment are, and has prompted the cause to rightly be a national priority.

Resolution Urging Action to Promote

Prostate Cancer Screening and Testing

WHEREAS, one in every six men in the United States will be diagnosed with prostate cancer; and,

WHEREAS, nearly 30,000 men in the United States will die of prostate cancer this year; and,

WHEREAS, nearly 200,000 men in the United States will be diagnosed with prostate cancer this year; and,

WHEREAS, prostate cancer is the second most common cancer in American men; and,

WHEREAS, Senator Chris Dodd was recently diagnosed with prostate cancer and received timely treatment because of early detection; and,

WHEREAS, the American Urology Association recommends prostate cancer screenings such as PSA’s and other diagnostic tools as part of a detection and treatment protocol;

THEREFORE BE IT RESOLVED, that the Democratic National Committee urges action to promote prostate cancer screening and testing

This past weekend, the Prostate Cancer Research Institute held its annual conference in Los Angeles, hosting over a dozen experts on prostate health and 600 participants.  According to PCRI volunteers, the purpose of the conference is to provide an avenue for those with prostate cancer and their loved ones to get more information about managing the disease.  The theme of this year’s event was “Making a Positive Impact on Quality of Life,” and among the topics discussed were the benefits and pitfalls of interventions such as chemotherapy, radiation, surgery, and hormone therapy.  Understanding effective diet choices and dealing with erectile dysfunction as a consequence of certain treatment options were also highlights of the agenda.  Throughout the weekend, attendees were encouraged to ask specific questions of the speakers. 

It was also evident that this conference is a gathering place for support, where old friends and new ones have come to share their stories with each other – sometimes just to talk to someone who understands, and sometimes to share information that may be useful to another.  Many of these men have joined support groups in their own communities and have been strengthened by the understanding that they do not need to go through this alone.  Indeed, this is one of the big issues that men suffering from prostate cancer – and other health issues – must overcome.  We are not trained to seek help, but to solve problems in isolation.  On the other hand, drawing on the resources, knowledge and care of others – whether they be friends, family, medical professionals or those who simply understand what we are going through – is what gets both men and women through their most difficult health and life challenges.

Not coincidentally, the PCRI conference is held during September, Prostate Cancer Awareness Month.  One of the big messages I heard from those who stopped at the MHN table during this event was that men need to start thinking about their prostate health – and their health in general – at a much earlier age than they do now.  One of our goals in educating men about their health must be to reach them with effective information and support, early and often, so that these messages stay with them as they mature. 

Those present at the event are certainly doing their best to get these messages across.  Since its founding in 1998, PCRI has contributed to a significant increase in the number of doctors involved in prostate cancer research, as well as public education about the disease.  The organization offers a quarterly newsletter with new developments in prostate cancer research, as well as a helpline for patients who need some support finding the right resources.  Their website, which includes a wealth of information about prostate cancer, can be found at http://www.prostate-cancer.org/. 

With summer rapidly drawing to a close, I pose a riddle, particularly relevant, as the days get cooler and daylight dwindles. When are competitiveness and ambition not competitiveness and ambition? When they’re depression. Okay, so it’s not much of a riddle, but as it turns out neither is the reason why 24,000 of the 31,000 people who commit suicide each year are men or why nearly four times more men kill themselves than women. Think you’re immune?

It is often touted that male depression is not as much of an issue as it is with women because depression in women occurs more frequently. However, the most recent research indicates that this is grossly inaccurate. Why? Unsurprisingly, the discrepancy appears to come from the fact that men and women may in fact exhibit symptoms of depression in different ways (shocking, I know). Men it seems do not display the traditional indicators of depression such as feeling sad, tired, or disinterested in once-pleasurable activities. Instead they express it primarily through aggression and most often channel this aggression into intense physical activity and/or extreme ambition. It may begin as an occasional hobby and then slowly accelerate until it spirals out of control, often leading to a point where the person hopes for injury or death as a means of escape. In 2008, Men’s Health magazine highlighted a former Ironman and power-lifter Raymond Britt who would routinely arrive at the hospital with blood pressure readings of 90/50 and would need four bags of IV fluids to rehydrate. Men’s Health reported “He eventually did 42 marathons, 27 Ironman Triathlons, and six ultra-marathons in 11 years, covering 42,000 miles, the equivalent of running, swimming, and biking around the world 1 1/2 times.” However, Raymond Britt admits that nothing about his behavior seemed odd and more often than not, individuals who achieve such feats are looked upon as heroes and role-models and are given impressive labels such as “ultra-competitor” and “Ironman”. Given that these traits are generally what society considers as normal male behavior, it is not surprising that researcher and professor of psychiatry at Harvard University, William Pollack, has estimated that between 50 and 65 percent of men go undiagnosed, suffering from what many refer to as “covert depression”.

What could be responsible for such an under-reported and potentially fatal phenomenon? The most obvious culprit is the way in which men in our society are expected to behave. As reported by Men’s Health magazine, Terrance Real, an expert in male depression and a marriage and family therapist, wrote “There is a terrible collusion in our society, a cultural cover-up about depression in men…Men have about a milli-second’s tolerance for feeling [this type of] pain, and then they spring into action. A flight from shame into grandiosity lies at the heart of male covert depression.” Quite often we are led to believe that there is not as much pressure on “21^st century men” to be the strong, stoic, emotionally-distant individual, all-but resistant to pain and suffering. Unfortunately most recent studies indicate that this does not in fact reflect reality. A German study published in the Journal of Affective Disorders found that the male-gender role is still characterized by all the traditional qualities such as invulnerability, aggressiveness, and fighting for control, dominance, and power. Furthermore, in the journal New Psychology of Men, research shows that while women and girls describe themselves in terms of positive traits such as caring, compassionate and an able to connect with others, men define themselves primarily through negatives. Men most often cited what it means to be masculine as not being weak, not being dependent on others, and not having a close connection to their mothers. This stigma has persisted despite countless studies dating back all the way to the 1950’s that “contact, affection, emotional communication, and genuine closeness are necessary for…humans, to maintain our health.” Additionally, men are conditioned to put less emphasis on creating and maintaining social support networks and it has been shown that isolation can have adverse effects on all systems of the body, including the brain.

The good news is that, once diagnosed, depression is easily treatable and no, I’m not talking about just with drugs. Therapy, healthy hobbies, good old family and friend support, or a combination of these can be just as effective and create a solid, lasting emotional base. Raymond Britt took up photography after being treated for his chronic depression and admits, “I never cared before. I never noticed the colors of a sunset. The electricity in a lightning strike. The glow of moonrise over a lake. They’ve always been there. But only recently have I begun to see them.” The really good news though is that we all have the ability to change the way we think, act and treat one-another. Let’s retain some of that traditional male independence and not let ancient societal dogma tell us how we ought to behave. From one 21^st century man to another, I think it’s finally time we let go of the unrealistic, nauseating, and unhealthy aspects of the traditional male machismo to which we all tend to fall victim. Our physical health wants us to, our mental health wants us to and goodness knows the ladies in our lives want us to. I challenge you this Labor Day weekend to watch some football, drink some beer, and then watch I Love You, Man. After all, if you’ve seen Forgetting Sarah Marshall, you know Jason Segel is a pretty secure guy and if he can say it so can you.

References

Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Moller-Leimkuhler, AM. J Affect Disord. 2002 Sep;71(1-3):1-9

Men’s Health magazine. Exercising Your Demons.