Men's healthcare concerns don't receive equal attention

August 1, 2007

The economics and the politics behind the major healthcare problems affecting men, such as cardiovascular disease, cancer, obesity and depression, aren't receiving the attention they deserve. It has been the rule that women make health decisions for themselves and also for their male partners and their children. In contrast, most men have a more casual attitude toward their care: "if it ain't broke, don't fix it."

The economics and the politics behind the major healthcare problems affecting men, such as cardiovascular disease, cancer, obesity and depression, aren't receiving the attention they deserve. It has been the rule that women make health decisions for themselves and also for their male partners and their children. In contrast, most men have a more casual attitude toward their care: "if it ain't broke, don't fix it." That attitude might apply to servicing an automobile but is clearly having a negative effect on the health and well being of their bodies.

There remains a striking disparity in life expectancy and susceptibility to certain diseases between men and women, however, so there is a significant opportunity for payers and providers to help improve the health of men. The average life expectancy at birth in 2001 in the United States was 74.4 years for men and 79.8 years for women, according to a 2005 article published in the Journal of Men's Health & Gender. Although the life-expectancy gap between men and women has gradually fallen over several decades, it remains approximately five years and warrants better understanding and further study.

CARDIOVASCULAR DISEASE

The death rate from coronary heart disease is greater for men than for women, 222.4 vs. 135.8 per 100,000, respectively. The rate for acute myocardial infarction is 99.7 for men vs. 58.8 per 100,000 women, according to the American Heart Assn. Men also develop cardiovascular disease approximately 10 to 15 years earlier than women, resulting in a shorter life expectancy for men.

The risk factors for cardiovascular disease include tobacco use, hypertension, dyslipidemia, diabetes mellitus, obesity, lack of exercise, excessive use of alcohol, and exposure to increased stress levels. Recently a new risk factor has been added to the list: erectile dysfunction (ED). Several studies have identified that men who have diagnosed cardiovascular disease had a history of ED that often predated their myocardial infarction by two years.

A risk factor for ED includes hypertension. In Western societies, increasing blood pressure parallels advancing age; hypertension is estimated to exist in 60% to 70% of the population older than 60 years. Although hypertension is preventable or controllable with drugs, it is often asymptomatic.

DEPRESSION IN MEN

In 2007, nearly 6 million American men will be diagnosed with depression. However, millions of American men are unaware that they have a problem or that an effective treatment might be available.

The failure to recognize and treat depression has huge economic consequences with a loss of productivity in adults approaching nearly $100 billion annually. There are also health consequences of not treating depression in men.

Depression has been linked to heart disease, heart attacks and strokes. These medical conditions may occur more commonly in men with depression and may occur at a younger age than in women. Men with depression and heart disease are two to three times more likely to die than men with heart disease who are not depressed. The suicide rate, which has been known to be related to pre-existing depression, is four or more times higher in men than in women.

PROSTATE HEALTH

Benign prostatic hyperplasia (BPH) is the most common urologic disorder in men and likely would be experienced at some point by most men reaching average life expectancy.