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HP 2020 Regional Meeting : May 14, 2008

Regions I and II
Alexander Hamiliton U.S. Custom House

Remarks of Andrew Porter Men’s Health Network

We are requesting that HP 2020 continue the unfulfilled mission of HP 2010 to address gender disparities in health among our population, requiring that both federal and state government agencies examine the inequities in wellness among males and females and determine how best to address those inequities.

Those agencies should also review their health education, outreach, and research programs to determine if those programs adequately meet the needs of the population. Based on the data we present below, it is apparent that the public health system is failing men and, by extension, their families.

The failure to adequately engage men in the health care system is reflected these discouraging statistics:

Men die of the top causes of death, with the life expectancy gender gap being larger than the race/ethnicity gap
Women are 100% more likely than men to visit the doctor for preventative health care
Men on all economic levels are less likely to have health insurance than their female counterparts ,
Over 14% of women who marry men approximately their own age may enter their early retirement years (age 65-69) as widows , and
More than one-half the elderly widows now living in poverty were not poor before the death of their husbands

Gender disparities in health were added as a key element in HP 2010.

Goal 2: Eliminate Health Disparities

The second goal of Healthy People 2010 is to eliminate health disparities among segments of the population, including differences that occur by gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation. This section highlights ways in which health disparities can occur among various demographic groups in the United States.
Gender

Whereas some differences in health between men and women are the result of biological differences, others are more complicated and require greater attention and scientific exploration. Some health differences are obviously gender specific, such as cervical and prostate cancers.

Overall, men have a life expectancy that is 6 years less than that of women and have higher death rates for each of the 10 leading causes of death. For example, men are two times more likely than women to die from unintentional injuries and four times more likely than women to die from firearm-related injuries. Although overall death rates for women currently may be lower than for men, women have shown increased death rates over the past decade in areas where men have experienced improvements, such as lung cancer. Women also are at greater risk for Alzheimer’s disease than men are and twice as likely as men to be affected by major depression.

How has the federal government responded?

Overall, there has been little if any noticeable response. Some federal agencies have added men’s health links to their web sites, but programs are virtually nonexistent.

There are at least 8 offices of women’s health, and each HHS region has an office of women’s health, but no offices of men’s health.
Women greatly outnumber men in clinical trials research, especially Phase lll protocols. Men outnumber women only in the initial, small-scale safety trials.
The disparity among federal programs is quite clearly illustrated by funding levels:

Funding for gender research at NIH:

$ 4,376,000,000 for women’s health (breast cancer, cervical cancer, ovarian cancer, and “women’s health”)
$ 345,000,000 for men’s health (prostate cancer)

Funding for programs at the Centers for Disease Control and Prevention (CDC):

$ 200,832,000 for breast and cervical cancer
$ 13,243,000 for prostate cancer

CDC also has a well-funded WISEWOMAN (Well–Integrated Screening and Evaluation for Women Across the Nation) program for women. There is no WISEMAN program for men.

How have the states responded?

Most have not responded at all.

Based on a recent comprehensive survey by the Men’s Health Network, only 10 states have responded to the HP 2010 goal by initiating men’s health outreach programs. Of those, two states have only recently assigned men’s health outreach to a health department staffer (one is Nebraska) and are in the process of determining what they might do, another of the 10 responded that their men’s health program focuses on “reproductive health”, and one more responded that they have a prostate cancer outreach program.

Unrelated to HP 2010 initiatives, the state legislatures of a few other states have passed legislation creating men's health commissions or programs under various names or have created men's health positions within their department of health.

California initiated a research project that looked at gender disparities by race and ethnicity, providing valuable insight as to the needs of the state. However, they have not yet acted on those findings. California’s report can be found in the Men’s Health Library at www.menshealthlibrary.com .

How have states in Regions l and II responded?

A quick review of health programs in Regions l and ll finds a pattern similar to that in the remainder of the country. There are comprehensive and very effective programs for women, but few programs for men.

The failure to address men’s health needs is illustrated by the male to female ratio as women enter their early retirement years. Premature mortality among men leaves many women without life partners as they enter those golden years.

The following pages provide information on state health programs for men and those for women. The information comes from the MHN survey of state health programs, a comprehensive audit of state health department web sites, and follow-up telephone calls and email communication with those same health departments. The analysis of the number of men per 100 women at retirement is derived from data published by the U.S. Census Bureau.

Region 1:

Connecticut:

Men’s programs – None

Women’s programs – The state has a Women’s Health Coordinator, a Permanent Commission on the Status of Women that includes a health component, a women’s health web page, a State Coordinator designated as a contact for the federal Office of Women’s Health, and the state has a WISEWOMAN program.