In honor of Armed Forces Day today in the United States, TAMH will be posting 2 posts this Monday, with one especially for those in the military written by the nationally recognized parenting expert Armin Brott, also known worldwide as Mr. Dad (http://www.mrdad.com/).

We at TAMH want to express and stress the amount of love and appreciation for those who are currently serving and/or have completed their service in the military. May these heroes all return to loved ones safely and be remembered for the greatness that they have achieved in serving for others. Thank you for protecting and defending us and allowing us to continue our work in helping men and those surrounding them to live better and healthy lives.

Thanks for your service and we hope you will enjoy our piece on Monday.

By Dr. Michael J Rovito

The opening moniker for any of my lectures on men’s health, “Being a man is harmful to one’s health”, routinely elicits a few chuckles or some questioning glances. However, I repeat the statement and claim that, generally, it’s true. If you are a man, chances are you are less likely to talk about important issues like prostate, testicular, and/or sexual health. Why? For many men, discussing issues of sickness, vulnerability, and death with others (especially other men) is perceived as a breach of their masculinity. It is this reluctance to discuss such important issues that is having a direct effect upon our health and wellbeing.

A recent study by Winterich et al (2009) suggested that men experience digital rectal exams and colonoscopies negatively (DRE’s more negatively than colonoscopies) due to their association of said preventative behaviors with homosexuality. Men also perceived anal penetration via DRE or colonoscopy as an “affront to their masculinity”. (p. 300) The literature on testicular cancer parallels these findings. Any given cross sectional study on male perceptions of testicular health will surely suggest that most men are hesitant to discuss their testicles to anyone (e.g. Trumbo, 2004). Generally, men feel uncomfortable discussing such inherently male-centric topics such as testicular, prostate, rectal, or sexual health for fear of seeming ‘womanly’, ‘girly’, ‘queer’, or ‘weak’.

So how and why did this behavior among men begin? Apparently, the forces that defined masculinity have therefore shaped and molded an idea of a man as one who should not demonstrate vulnerability or weakness in any kind of visible form. The idea of a man being vulnerable is viewed as a gateway of losing their masculinity. The social construction of “manliness” does not allow for an Achilles’ heel, especially when dealing with health and wellbeing topics. Therefore, when men seek medical advice or require medical attention, they may be somewhat hesitant to fully disclose their discomfort or suspicions. If you factor into this discussion a man’s prostate, testicles, rectum, or sexuality, the more reserved a man gets. Because men generally value, or abide by, this socially constructed notion of being a “man’s man”, they are predisposed to not want to talk about any health or wellness topic concerning their “manhood”.

Should men want to: (a) learn how to perform testicular self-examination and then perform it regularly, (b) want to discuss their digital rectal examination results with their physician, or (c) openly discuss sexual health with other men? They should, but generally, they don’t. Can these reservations have an effect upon health outcomes? Of course they can. Looking at any testicular or prostate cancer data, many diagnoses for such preventable diseases occur post-diaspora from the prostate or testicles, thereby making treatment and/or recovery that much more difficult. For example, Wynd (2002) suggests that later detection results in worse health outcomes, with 15% to 50% of (testicular) tumors being metastasized at time of discovery. The later the stage of discovery, the higher the risk of mortality.

This veil of silence prohibits any quality communication between men and their physicians, friends, colleagues, and/or family about testicular, prostate, rectal, or sexual health. This is not only limiting quality of life, but also length of life. We must support and encourage men to have open dialogue about their health concerns. It could mean the difference between a long, healthy life and a critical, deadly diagnosis. So yes, being a man may be harmful to one’s health but as long as we continue to communicate the importance of men’s health perhaps we can give that old adage a critical diagnosis of its own.

References:

Trumbo, C. (2004). Mass-mediated information effects on testicular self-examination among college students. Journal of American College Health, 52(6), 257-262.

Winterich, J., Quandt, S., Grzywacz, J., Clark, P., Miller, D., Acuna, J., & Arcury, T. (2009) Masculinity and the Body: How African-American and White men Experience Cancer Screening Exams Involving the Rectum. American Journal of Men’s Health. 3(4), 300-309

Wynd, C. (2002). Testicular self-examination in young adult men. Journal of Nursing Scholarship, 34(3), 251-255.

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Blurb about today’s Guest Blogger:

Michael J Rovito received his M.A. in Geography and Ph.D. in Public Health from Temple University in Philadelphia. Michael currently is an Assistant Professor of Public Health at Temple University. His research specializes in health behavior change, men’s health, and audience segmentation. His most recent research developed the “Control Identity” Personality Typology that aims to assist health education and intervention efforts for tailoring messaging strategies. Michael is a Fellow of the Foundation for Informed Medical Decision Making, the Albert Schweitzer Foundation, and the Information Technology in Society Research Group. His interests include military and World War II history, outdoor sports, and political strategy.

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.

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

12:33 pm – Monday, November 9, 2009

This is an exciting time for men’s health! At this point, day two of the APHA conference, we have met a handful of new researchers in the field of men’s health. Innovative community-based interventions are being developed with the potential to reach an extremely underserved subgroup of the population. For example, there is growing attention on transportation workers and health implications of their prolonged travel schedule. As a result, health education and awareness programs specifically tailored to this population will provide opportunities to improve health outcomes. Additionally, new men’s health programs are being offered at various colleges and universities throughout the nation.

MHN is extremely excited to see the growing interest in men’s health among public health professionals who have stopped by our booth in the past few days!
-Ramon

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 Saturday, November 7, 2009 – Health IT and History of Health Reform
3:42 pm

Just finished attending the packed Student Assembly meeting where the topics discussed were Health IT and History of Health Reform. Kesa Bond, MHA, RHIA, PMP, did a great job on explaining what the future for America holds in using the electronic health records (EHR).

There are two main benefits of using the electronic health charts: 1) it improves patient care and 2) it improves quality of health care.  Electronic health records (EHR) allows health professionals to access up to date information and helps with ensuring accuracy in data presented when you see the doctors. With EHR, you don’t have to be asked the same typical questions such as are you allergenic to anything. EHR also allows professionals to have access to information being caputred such as lab results, and it enables communities to have query, which clusters data received in similar areas to see if there’s common symptoms and/or common diagnoses. This will bring a better surveillance program that will help prevent disease outbreaks within communities.

President Obama agrees that EHR is the future for America and made a promise similar to President Bush by declaring America to have EHR in 10 years. However, President Obama took it a step further by allocating money behind his promise. He has allocated 10 billion dollars each year over 5 years into EHR.  By 2014, America will have EHR and there will financial incentives to help the transition to EHR. For example, if you move to EHR by 2011 then you will be able to have enable to get 100% of incentives. This is the prize of being an early adopter. There will be pentalies if you do not reached EHR by the 2014 target date. Every year after 2014, you will lose additional 1% of your money.

What do you think of EHR and are you using it? I know my doctor uses it and he says it helps him to explain things easier and with diagrams.

-Sonny

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11:35 pm – Friday, November 6, 2009 – Welcome to Philly!

After a long plane ride and a 2 hour shuttle, I am finally here in the city of brotherly love. I hope this city holds true to it’s nickname  as I looking forward to Men’s Health getting a lot of love during this conference.

-Sonny

Welcome to Philly

By Luke Manley

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.

]]> http://www.talkingaboutmenshealth.com/2009/09/01/not-seasonal-affective-disorder/feed/ 0 http://www.talkingaboutmenshealth.com/2009/07/27/all-about-the-numbers/ http://www.talkingaboutmenshealth.com/2009/07/27/all-about-the-numbers/#comments Mon, 27 Jul 2009 16:24:23 +0000 Sonny Patel, MPH http://www.talkingaboutmenshealth.com/?p=34

All about the numbers

By Ramon Llamas

For a majority of men, it is all about the numbers especially sports fans.  They can recite statistics of their favorite teams and players without hesitation:  Lebron James, the 2009 NBA regular season MVP averaged 28 points, 7 assists and 7 rebounds last year; the Los Angeles Lakers won their 15^th NBA championship, 2 behind the Boston Celtics; Peyton Manning passed for over 4,000 yards winning his 3^rd MVP last year; Albert Pujols is batting .325 with a league-leading 34 home runs this year; Wayne Gretzky ended his career with 2,857 total points; Tony Stewart leads the Sprint Cup Series by 192 points; and Pele scored 77 goals in international games over his career.

But there are also important health numbers that most men never remember and these numbers may even describe their personality. Here are some numbers you should be aware of:

Normal Body Mass Index (BMI) range is 18.5 – 24.9 (calculate yours here – http://www.nhlbisupport.com/bmi/)

Normal Blood Pressure is anything 120/80 mmHg and below (more information here – http://www.americanheart.org/presenter.jhtml?identifier=4473)

Total cholesterol should be below 200 mg/dl (more information here – http://www.americanheart.org/presenter.jhtml?identifier=183)

Glucose levels should be below 100 mg/dl when fasting (more information here – http://www.nlm.nih.gov/medlineplus/ency/article/003482.htm)

Prostate Specific Antigen test results below 4.0 ng/mL is normal (more information, including PSA velocity here – http://www.cancer.gov/cancertopics/factsheet/detection/PSA)

So, how do your numbers compare? Are you living within healthy numbers?

Other stats to think about:

Men have a life expectancy of 5 or more years less than women, regardless of race.

Men have higher mortality rates in 9 of the top 10 causes of death.

The ratio of men to women is 85:100 by the age of 65.

1 in 2 men will be diagnosed with cancer in his lifetime.

Prevalence rates for HIV/AIDS in men outnumber women 3:1.

Monday Fresh Start

Where Can You Find Useful Nutrition Information?

By Jennifer Jackson, MPH

I always think that Mondays are the perfect day to start or learn something new. We’ve hit the reset button while out of the office over the weekend and Monday presents a chance to start fresh. Not only that, but researchers suggest that changes you make on a Monday are more likely to be repeated throughout the week. This blog post begins the first in a series of monthly Monday Fresh Start where I will explore positive and meaningful ways in which you can learn more about your nutrition and health and take small, active steps towards the best possible you!

One of the most difficult obstacles to overcome in your road to a more nutritious diet and healthier you is knowing which sources to believe and where to look for them. In this Monday Fresh Start, I will be highlighting some important information to know and sources to help you make your fresh start.

Which Food Pyramid should you use?

The Food Guide Pyramid most of us have heard about was created by the United States Department of Agriculture (USDA) and modified in 2005 to be more flexible for each individual. Additionally, there are multiple versions of this food pyramid that incorporate the needs of different cultures or food preferences. If you would like to learn about and use one of these pyramids, make sure to check out Healthy Living Nutrition Information for Men which gives handy tips on understanding portion sizes. It has very useful analogies!

As a Registered Dietician student, we are taught about this food pyramid and how to help individuals meet its daily requirements. My public health, cancer research, and nutrition experience leaves some doubts in my mind when I think about what seems “healthy” based on common sense, research, and what this pyramid recommends. I personally recommend taking a look at the Healthy Eating Pyramid which combines research from multiple disciplines and recommends a drastically modified food pyramid. I try to use this guide in my own life and have found that my mental attitude has become more positive and I feel healthier. It is wonderful to be encouraged to eat healthy, exercise, and feel healthy without having to worry about specific calories or amounts of food.

What is a Portion Size? A Serving Size?

I have always been confused by portion sizes and serving sizes. Recently, I have discovered why they are so different. The portion size (found on the Food Guide Pyramids) are created by the USDA and serving sizes (found on nutrition labels on food products) are created and monitored by the Food and Drug Administration (FDA). No wonder they’re so different! So if you were wondering, like I was, why the portion sizes of the food pyramid don’t match the serving sizes on your food labels – it’s because they are regulated differently and by different government agencies.

Where can I find accurate and easy to understand nutrition information?

There are countless websites touting nutrition information relating to the products they sell. It’s important to seek nutrition information from independent sources that are not biased by the possibility of selling you a product. There are two main independent resources that I consult regularly:

Center for Science in the Public Interest has the largest circulation health newsletter, Nutrition Action Healthletter, that focuses on nutrition, health, food safety, and a variety of related topics. Each month’s newsletter focuses on a specific health topic and thoroughly uncovers the truth about nutrition and health research, what we have already learned, and which areas are still left to be further researched. The back page also includes Food Stars and Food Porn, which highlight the best and worst processed foods. Although it costs a small yearly fee to subscribe to the monthly newsletter, their website is a wonderful source for independent nutrition information and includes many helpful guides, PDFs, and the latest nutrition and health news. They even have an e-Book on Six Arguments for a Greener Diet for those of us who are environmentally conscious and want to incorporate that into our eating habits.

Nutrition Data is my ultimate source for nutrition information. They have many easy to use resources and extensive nutrition information. As I learn more about individual nutrients in different fresh foods, I check what I’m eating in this database. Check it out!

Future blogs will be more focused on specific nutrition and health topics, but as part of National Fruit & Vegetable Month I wanted to make sure all the men who read this blog post have a place to start.

I hope all your Mondays this month are full of fresh starts!

- The Nutrition Nerd

Feedback, Suggestions, Questions

Each month I will be exploring nutrition resources, specific foods, recipes, and how nutrition can easily and simply be incorporated into your way of thinking to improve you and your family’s health. If there is a specific nutrition topic that is important to you, please send suggestions for future Monday Fresh Start to nutritionnerdalerts@gmail.com

For more information between blog posts on this site, please direct your web browser to:

Nutrition Nerd Blog: http://nutritionnerdalerts.blogspot.com

Nutrition Nerd on Facebook: http://www.facebook.com/pages/Los-Angeles-CA/Nutrition-Nerd/100885132783?ref=ts

Nutrition Nerd on Twitter: http://www.twitter.com/NutriNerd

Today’s Legendary Sources:

Food Guide Pyramid – http://www.mypyramid.gov/
Healthy Living Nutrition Information for Men – http://www.hap.org/healthy_living/mens/nutrition.php
Healthy Eating Pyramid – http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/
Center for Science in the Public Interest – http://www.cspinet.org/
Nutrition Data – http://www.nutritiondata.com/
National Fruit and Vegetable Month – http://www.ageducate.org/news/fruit-veg_month.html

Title: Forget GM, Where’s the Bailout for Our Moral Bankruptcy?

By Luke Manley

Exclusively for www.talkingaboutmenshealth.com/

It’s a unique phenomenon of perception that causes us to be de-sensitized to small changes that occur over long periods of time.  We’ve all fallen victim to this at some point in our lives.  The extra slice of pizza each night during college that gave you the “Freshman 15”, that extra coffee at Starbucks every morning that drained $600 from your savings by the end of the year (and that’s just the small, excuse me, Tall), or perhaps even the Ambien prescription for your occasional insomnia that has now become a weekly habit. However, it has recently dawned on me that this culture of chronic neglect of proper health has reached truly frightening proportions.  What makes this even worse is the fact that the vast majority of those in society whose job it is to help us safeguard our health have seemed frustratingly indifferent and, in the case I’m about to make, have actively chosen to make the situation worse.

With Independence Day nearly upon us I felt it would be appropriate to honor our soldiers by focusing on a problem of particular importance to them. I speak of course of the massive increase in the medication provided to our fighting men and women abroad. A recent article in Men’s Health magazine provides a chilling tale of the enormous increase in prescriptions to active duty soldiers and the potentially disastrous consequences of heavily medicating a fighting force in the unpredictable and volatile areas of Iraq and Afghanistan.

Valium and Klonopin for anxiety; Zoloft, for depression; Ambien, for insomnia; Thorazine and Seroquel, anti-psychotics, used off-label to treat nightmares, and a host of other narcotics. In fact, the article goes on to include data from the Department of Defense that as of last year around this time, these prescriptions had reached nearly 50,000 a month, a 52% increase since October 2003.  Many of these soldiers are acutely aware of the side effects of these drugs on their ability to function at their posts, but are still ordered to continue their duties regardless. Corporal Michael Cataldi, who had been prescribed a regiment of Klonopin, Zoloft, Ambien, and narcotic painkillers, recalled having a fellow soldier kick the back of his seat every five minutes to keep him awake after being directed to drive a 14-ton armored personnel carrier, complete with canon, machine guns, and ammunition.  Each of these medications came with written directions warning against operating heavy machinery. To place this in perspective (as if it needs any), a U.S. Air Force flight surgeon interviewed for the article went on to point out that “even in peacetime, people in the many combat-support positions…would not be allowed to take such medications and continue to work in their sensitive, demanding jobs.” Indeed, even a civilian construction company would not allow an employee to operate heavy machinery who was taking even one of the four prescriptions used by Corporal Cataldi.

Perhaps even worse than deploying over-medicated troops, is re-deploying them.  Officially, Pentagon policy states that soldiers receiving treatment for psychiatric conditions must have proven stable for a minimum of 3 months before being allowed to return to combat.  However, in practice this is not often the case.  One staff member of a team sent by the Army Surgeon General to investigate medicated soldiers who have returned to battle, admitted “many of these soldiers are sent to Afghanistan…despite a doctor saying they shouldn’t go or leaders knowing they shouldn’t deploy.”  One particularly heartbreaking example is that of Michael R. De Vlieger, a gunner with the 101^st Airborne.  After surviving a grenade attack that drove his knee through a Humvee door, De Vlieger’s mental health slowly deteriorated to the point of complete psychotic breakdown.  After spending two weeks at a psychiatric hospital and prescribed four different prescriptions to treat his symptoms, De Vlieger found himself headed back to the combat zone a mere 18 hours after his release.  He admits, “I was in no condition to leave, I’m an infantryman.  If I’m screwed up in my head, it could cost my life or the lives of the men with me.”  In other words, De Vlieger was forced to choose between his own mental well-being and the safety of his fellow soldiers.  He threw his pills away.

It is true that soldiers have been medicated in various ways since the dawn of civilization, most often with alcohol and decidedly self-administered. However, in recent decades the steady rise in prescription medications in our armed forces has reached a critical point where it presents a serious threat, not only to individual soldiers, but to national security as well.  In these days of an all-volunteer Army, fighting in a distant land, it has become shamefully apparent how easily the American public has forgotten about their men and women in uniform.  It was outrageous enough that we allowed our troops to go for so long without adequate protection for their bodies, so why should we be any less furious about not securing their minds?  Regardless of how you feel about the war itself, the sacrifice that these men and women make on our behalf speaks volumes about them.  If we send them to perform their duty being anything less than all they can be, what does that say about us?

In light to President Obama’s speech today at AMA in Chicago, prevention seems to be the main thing I took away from listening to his speech. Of course, there were words directed to those doctors who haven’t been helping out to our frail health care by “tycoon-ing” the industry for profits, but preventive health are the key words to keep in mind. This Sunday when you are celebrating Father’s Day, you should give your Father a similar Presidential speech on his personal health and well being reform.

On crafting your speech to your Father, your main goal is to urge your father by helping them take care of their health. (If like to joke around, you could say you are “returning the flavor”). I did some research and found “Dads difference in child development:” in the MHN’s library. (http://www.menshealthnetwork.org/library/ddcd.pdf). I thought it would be great to use the first two bullet points and adjust them a little bit to help you in your speech and things to keep in mind for Father’s Day.

In order to tailor your health concerns to your fathers on Father’s Day,  you must be ADAPTIVE and have problem solving abilities.  Just as when you were an infant and “having a father around during the first eighteen to twenty-four months of life a more secure in exploring the world around them,” you must be around to support them through lifestyle changes or I like to call them, lifestyle adjustments. FOR EXAMPLE, on this Father’s day, let’s try eating sugar free items if your Father has diabetes. If he sees you doing it, maybe he will like it more. That leads me to EMPATHY. “The strongest predictor of a child’s empathic concern for others in adult life is a high level of paternal child care.” Social support has been known to help elderly men when dealing with health issues. By giving good care to your father, you will be able to lower his risk for depression and isolated feelings along with know that you love him.

Of course, he may not listen or comprehend your whole speech, but let’s just hope he can take away the same message I did with President Obama’s speech: prevention. If he can focus on including preventive measures to his everyday activities, he won’t have to worry about curative measures later on, especially in the hospitals. Let Father’s Day be reminder of how he helped you develop throughout the years. Empower yourself to return the favor to Father by helping him to survive longer than the U.S. average male mortality age of 75.2 (National Vital Statistics System 2005 Data, all races combined). With your support and guidance, your Father can change; just give them time to grow and foster their strives like they did for you-your entire life.

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