Talking About Men's Health™

We’ve had a few requests here at TAMH to give a brief overview of the recently passed House health reform bill, and I thought that the APHA Conference would be a good backdrop to also talk about some of the public health provisions in the language. From insurance coverage to market innovation and chronic disease management to health education, the Affordable Health Care for America Act attempts to address some of the most fundamental shortcomings of our health care system.

Health insurance coverage expansion is a central focus of the bill, and is particularly important to men who have much higher rates of being uninsured compared to women. Adequate insurance coverage is inherently linked to health care access and overall health, especially for men who don’t make use of preventive services and proper chronic disease management. The bill contains requirements for individuals to obtain and large businesses to offer health insurance coverage, while providing tax credits for low-income individuals and small businesses to help make it affordable. New regulations will prohibit insurance companies from denying or rescinding coverage because of a pre-existing condition, and the bill creates a national Health Insurance Exchange where individuals and businesses can compare and purchase insurance policies that fit their needs. Medicaid will also be extended to all individuals up to 150% of the Federal Poverty Level, which is of great benefit to low-income, single men who were previously ineligible. Medicare reform will also eliminate the prescription drug coverage “donut hole,” which currently prevents many men from obtaining and adhering to necessary medications.

Numerous provisions attempt to improve the health of men and their families through lifestyle initiatives. A Prevention and Wellness Trust Fund provides $34 billion over 10 years for community-based programs, employer wellness programs, and child obesity programs. These would be particularly effective for men, as increased understanding of personal wellbeing is paramount for men to take greater control of their health. Increased funding for community health centers and the establishment of school-based health centers will also allow men to more easily access needed services, and can instill a sense of responsibility at an early age. The bill will also require chain restaurants and vending machines to display calorie counts and nutrition information on menus and displays, in hopes to make individuals more aware of the how they balance their diet.

These are just a few of the major provisions affecting men, and though the bill isn’t perfect it sets an important precedent. By making health a priority on the federal level, we can use the newfound national momentum and capacity to improve the wellbeing and quality of life of all Americans.

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

With health reform sound bytes swirling across the media as ferociously as a September hurricane, I thought it would be helpful to assess some of the real proposals on the table.

Most elements of the reform effort will surely benefit men’s health outcomes. Health insurance subsidies and ending harmful insurance market practices will allow men to get the coverage and care they need without breaking to bank. Expanding Medicaid to childless adults and expanding the CHIP program will allow men and boys to benefit from continuous insurance coverage, thus reducing lapses in needed care. Employer shared responsibility requirements and small business insurance subsidies will finally provide men in the low wage workforce with proper coverage. Changes in Medicare will incentivize more coordinated care, reducing hospital acquired infections and readmission rates for men. New population foci on minority and gender health disparities in the population will allow researchers to analyze why men experience worse health outcomes and die younger.

There are other legitimate concerns though, the most recent focusing on the degree of preventive care coverage in the forthcoming “minimum benefits package” of health reform. This benefits package will be the lowest amount of coverage that can legally be offered by insurance companies, and the U.S. Preventive Service Task Force (USPSTF) will recommend the list itself. Men’s health advocates have fought hard for the inclusion of prostate cancer screening benefits across the nation, and 37 states now require insurers to include the test. These strides may be threatened in reform, as the USPSTF does not currently recommend the procedure to be provided as a benefit. In the coming months, it will be important to address secondary effects of reform like the prostate cancer benefit in order to preserve successful past efforts and continue to support preventive services for male-specific diseases.

As you may or may not be aware, health reform is THE topic of the summer in Washington, DC and men’s health has a lot to gain (and lose) in the talks. There are two bills making their way through Congress that deal specifically with men.

First the good news! The resolution H. Con. Res. 142: Supporting National Men’s Health Week passed the House on July 8, 2009. This resolution accompanies the Senate version (S. Res. 190, passed June 25, 2009) as an official recognition of this incredibly important week of concentrated efforts for men’s health.

Now for the tough one. The second bill to keep an eye on (and call on your representative for their support) is H.R. 2115, “Men and Families Health Care Act of 2009” which would officially establish a federal Office of Men’s Health. The bill was introduced on April 27, 2009 and was referred to the House Committee on Energy and Commerce, where it currently waits. The creation of such an Office would be incredibly beneficial for coordinating awareness campaigns and prevention programs, disseminating materials, and establishing clinical registries for research. Multiple Offices of Women’s Health are present, yet there is no federal Office of Men’s Health. It seems only fitting to establish such an office in this year of reform as:

• Men are leading in 9 out of the top 10 causes of death
• The life expectancy gap between men and women has increased to 5.3 years
• 1 in 2 men versus 1 in 3 women in their lifetime will be diagnosed with cancer
• studies show that women are 100% more likely than men to visit a doctor, have regular check-ups, and obtain preventive screening

These issues are undoubtedly a concern for men, but should be just as equally important to a woman’s father, brother, son, and husband.Read the bill here, http://www.thomas.gov/, and be sure to contact your local congressperson to voice your support!

An article by USA today (click here for article) reported that retail chains are making progress towards reducing tobacco use in the US. More specifically, New Hampshire, Illinois, and Tennessee all have Bills pending to bar pharmacies with walk in clinics from selling tobacco products. New York has a Bill that would ban all pharmacies, including Wal-Mart from selling tobacco products. This is a large step towards eliminating many risks that are associated with the use of tobacco products. As it is right now, many grocery stores no longer carry tobacco products. They don’t want to be associated with the sale of carcinogens.

Many argue that the government should not step in and tell people what they can and cannot sell, but they have already done this fairly successfully with the sale of alcohol products. It is more than likely to be successful with the sale of tobacco products. There was an interesting quote in the article from Bill Phelps, spokesman for Philip Morris the number one cigarette maker in the world. He doesn’t think that the government should impose bans on tobacco products, ‘we think retailers should be able to decide’. I am sure the beer companies felt the same way when the drinking age was raised from 18 years to 21 years. But this policy has helped save many lives in the United States.

Since there isn’t a magic pill that is going to reverse the damage that cigarette smoking does to the body, society is going to have to change its views towards tobacco use. It is a choice and an unhealthy one at that. If people start to perceive tobacco use as being a stigma, then they will be less apt to use it. For those who have already started using tobacco, there is an option to stop. Quitting will only put wealthy companies like Philip Morris out of business and help greatly reduce your risk of preventable death.

The Los Angeles Times reports that restaurants that ban smoking also help reduce the number of youths who light up.  (click here for article).  When young adults are not given an environment where they can openly partake in an unhealthy habit, they are less likely to continue the behavior.  This article is a good example of how a simple policy change can have an impact on the overall health of the people in the community.  By eliminating an opportunity to light up, the risk of developing lung cancer can be reduced.  More policies need to be implemented in order to cut down on the number of smokers in the United States.