Proponents of new legislation that would establish an Office of Mens Health at the U.S. Department of Health and Human Services say that men are suffering a "silent health crisis." U.S. Rep. Randy "Duke" Cunningham (R-Calif.) introduced the Mens Health Act of 2003 in April in the House and Senator Michael Crapo (R-Idaho) offered the companion bill in the Senate in May. Both men are prostate cancer survivors.
To illustrate the need for an Office of Mens Health, advocates point to the most recent figures from the National Center for Health Statistics: The life expectancy at birth for men is 5.4 years shorter than for women in the United States, and for all leading causes of death except Alzheimers disease, men have higher rates than women.
A general reluctance among men to get medical care may contribute to the disparity. A 2000 study on mens health practices commissioned by the Commonwealth Fund, a private foundation that supports research on health and social issues, concluded that men are "dangerously out of touch" with the health care system. More than half of the men surveyed had not had a physical in the past year, compared with 39% of women who reported not having a physical in the previous year. According to the Agency for Healthcare Research and Quality, among Americans who have not visited a doctor in the last 5 years, seven of 10 are men, and men are less likely than women to be screened regularly for high blood pressure, cholesterol, and cancers.
Supporters envision an Office of Mens Health similar in purpose and function to the existing Office of Womens Health within the Department of Health and Human Services that some advocates say has contributed to a marked improvement in the health of American women. "The Office of Mens Health will coordinate the fragmented mens health awareness, prevention, and research efforts now being conducted by federal and state governments," according to a statement from the Mens Health Network, a nonprofit organization promoting the proposed office.
Leslie Michelson, chief executive officer and president of CapCURE, a non-profit public charity that supports prostate cancer research, pointed to prostate cancer rates and research as an example of how such an office could be useful. "Baby boomer men are starting to get prostate cancer now," Michelson said. "The epidemiologists tell us very strongly that we will see a 50% increase in the next 10 years. At the same time, the research scientists are telling us that we have made more progress in the last 5 years than in, probably, the 25 years before that. We have amazing things happening. We have much more opportunity than weve ever had, and yet we have a greater need. So if a Mens Health Office can help us reconcile those two things, then Im all for it."
Lean Legislation
The bill language itself, which simply calls for an office, a director, and a report after 2 years, is purposefully lean. "[Senator Crapo] wants to leave that as flexible as possible so that it has a broad opportunity to address a fairly broad problem," said Susan Wheeler, Crapos director of communications. "Its somewhat problematic to set out, Heres what we want you to do, when there hasnt been something doing that before. But by using the Office of Womens Health as a modelstarting with those activities[we can] determine if those are the appropriate functions to increase mens awareness of their health. And if those arent, it gives the Office of Mens Health the opportunity to look at something else rather than being specifically bound in legislation to do certain things that may not be working."
Bill sponsors in the House and Senate say they have not encountered any opposition to the bill. "Everyone thinks its a good idea," said Harmony Allen, Cunninghams press secretary. However, at press time, neither bill had seen much forward progress beyond amassing co-sponsors, and the legislation may get lost in the sea of competing priorities.
Although men are heavily involved in setting the health policy agenda, they tend not to see their personal health as a priority and this may translate into a hesitance to advocate on their own behalf for public health issues, advocates say. Wheeler agreed. "Men have traditionally lagged behind women in recognizing the need for advocacy. I get a sense that this is changing, though."
Obstacles
The legislations supporters say that the major obstacle facing the establishment of an Office of Mens Health is the resolve of the Department of Health and Human Services to hold the line on bureaucratic expansion. Tracie Snitker, director of public affairs for the Mens Health Network, said that her organization has discussed the concept with officials at the department. "They are interested in mens health, but are trying to streamline government, and they see this as extra." Wheeler also sees this as a problem, but not an insurmountable one. "In general, I think you will find that Republican administrations are not supportive of adding to the bureaucracy, but were willing to take on that challenge and work on some persuasion."
The Department of Health and Human Services has not taken a position on the legislation. Cunningham, who is a member of the House Appropriations Subcommittee on Labor, Health and Human Services, and Education, raises the subject of setting up an Office of Mens Health every year when the committee holds appropriations hearings. This year Health and Human Services Secretary Tommy Thompson responded that he would "consider it." Christina Pearson, a spokesperson for the department, said the concept of an Office of Mens Health is still under consideration.
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