The Endangered Species - Men?

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Men Live Sicker and Die Younger, yet They Shun Healthcare


The health gap between men and women widens every year. Men die sooner. Each of the 15 leading causes of death is more likely to kill them. Men have growing rates of psychological problems. Men are more likely to die as crime victims. Men shun doctors when they are sick and avoid checkups when they are well.

Are men going extinct? That's the provocative question posed by the First World Congress on Men's Health, being held this week in Vienna, Austria.

"Will men be needed at all?" wonders conference chairman Siegfried Meryn, MD, in the Nov. 3 issue of the British Medical Journal. "With the advent of sperm banks, in vitro fertilization, sex-sorting techniques, sperm-independent fertilization of eggs with somatic cells, human cloning, and same-sex marriage, it is reasonable to wonder about the future role of men in society."

The problem doesn't seem to be in men's genes. When figures first started being kept in 1920, women only outlived men by one year. Ever since, women's life expectancy has increased faster than that of men.

"The question is not why women live longer than men. It's why did the increase in male life expectancy fail to keep pace with improvements in women's life expectancy," Emory University researcher Jean Bonhomme, MD, MPH, tells WebMD. Bonhomme is a board member of the nonprofit Men's Health Network and president of the National Black Men's Health Network.

The answer, Bonhomme suggests, is that men don't get the same kinds of regular, preventive healthcare as women. They don't get it partly because they don't seek it.

"Since childhood, the sexes are taught to deal with physical pain differently," Bonhomme says. "A boy who scrapes his knee is told to stop crying and be a man. But when that boy is 50 years old and having chest pain, he will say, 'It's just indigestion,' because he's been taught to minimize his pain. ... A lot of men who don't feel good don't pay it any mind. When it comes to disease, early treatment is critical. Men miss out on this opportunity."

A lot of this has to do with how men define themselves in Western culture.

"Part of what we consider manliness has a lot to do with being free and in charge of one's own destiny -- and there's a certain stoicism," historian and American culture expert John F. Kasson, PhD, tells WebMD. "Men are taught not to complain, to grin and bear it. That has implications for how men see healthcare."

And yes, men's famous unwillingness to grapple with their emotions plays a role.

"Often for both physical issues and emotional issues, men have trouble dealing with their emotions," says Kasson, professor at the University of North Carolina, Chapel Hill. "I don't go along with all the men-are-from-Mars-women- are-from-Venus stuff, but it is true, by and large, that men find it difficult to get in touch with their own emotions and confide in others. There is this problem with admitting the need for help and seeking help -- it isn't seen as manly."

Bonhomme says men are more likely than women to have jobs requiring dangerous and/or strenuous exertion. When this is the case, denying pain becomes a necessary part of earning a living -- and it carries over into the rest of a man's life. This helps explain why black men tend to have poorer health and shorter life expectancy than white men.

"Not only do men have more dangerous jobs than women, but African- American men have more dangerous jobs than white men," Bonhomme notes. "To do some work, you have to detach from your pain. African-American men are over-represented in manual labor that necessitates indifference to pain. And for African-American men, there is also an element of distrust in the healthcare system."

What can be done? Fear campaigns will backfire, Bonhomme predicts. It is not honorable for men to be afraid. Instead, the healthcare system has to become more relevant to men.

"Men want to be better men," Bonhomme says. "We have to reverse the paradigm. Men see going to a doctor now to be admitting some kind of weakness or personal failure. Instead, they should see it as an ally of masculinity, something that can help you manage their independence, their vigor, and their functionality. And we need to stop shaming men and boys to always have to deny their pain."
Source: Daniel DeNoon at content.health.msn.com/content/article/1728.92831  

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