Office of Men's Health


Menstuff® has compiled information on the Office of Men's Health.

Office of Men's Health – Resource Center
Why Guys Die Sooner
What's Afoot on Capitol Hill
But Who Picks Up the Check?
Avoiding a Battle of the Sexes
Running Your Own Office of Men's Health
HR 632 is introduced in Congress
Why do we need an Office of Men's Health?
Show your support!

Newsbytes

Related Issues: HR632

Office of Men's Health – Resource Center


Answering the need of a specific web location to promote the passage of the Men's Health Act of 2001, a resource center has been established to bring you the latest news in the quest for health parity. Consider putting a link to the Resource Center on your web site.Visit the OMH resource Center at:
Source: www.menshealthoffice.info

Why Guys Die Sooner


Each of the Top 10 causes of death in the U.S. kills men at a higher rate than women. A big reason for this, say experts, is a culture that teaches men, from boyhood on, to ignore their physical well-being. A coalition of politicians and health advocates is hoping a federal Office of Men's Health can help change that. By Sean Martin

From the time they're little boys, guys are taught to be "tough" and not to cry. That social training leads to middle-aged men ignoring chest pains that can warn of heart disease.

"Our culture prizes stoicism and courage among men, and teaches men to be somewhat unresponsive to their own physical pain," says Jean Bonhomme, MD, president of the National Black Men's Health Network.

And here's what that ultimately means: "Simply stated, men live sicker and die younger than women," says David Gremillion, MD, director of the Men's Health Network.

But congressional players and some health advocates are working to get the government into the business of making men tuned in to wellness. 

There wasn't always this disparity. In 1920, for instance, men and women's life spans were only a year apart -- although women now live almost six years longer on average.

Furthermore, men are three times less likely to have visited a doctor in the past year, even after factoring out women's prenatal physician visits.

Men also have a higher death rate than women for each of the nation's 10 top causes of death.

Prostate cancer, which kills more than 32,000 men each year, is the most commonly diagnosed male cancer -- but many men aren't familiar with it enough to say it correctly. Prostate cancer accounts for 37% of all cancer cases, but gets only 5% of research funding.

"Women have more cultural freedom to talk about what hurts them," according to Bonhomme. "We don't have enough public information about male health problems like prostate cancer."

What's Afoot on Capitol Hill

Veteran lawmaker Rep. Randy "Duke" Cunningham (R-Calif.) is a decorated fighter pilot who was shot down in enemy territory during the Vietnam War. But he tells WebMD that his life's biggest scare was hearing from his doctor in 1998 that he had prostate cancer.

Cunningham says that his getting cancer was part of the catalyst behind his introduction of legislation that would establish a new office in the U.S. health department to "coordinate and promote the status of men's health."

Cunningham's ally on the bill, Rep. Jim McDermott (D-Wash.), MD, tells WebMD, "Men tend to deny that they have anything, and they have this 'he-man' attitude which makes them not go for checkups and not do the things that would make their health statistics better. We are trying to make people more aware of what could be done if they would let people know they had a problem."

The bill has 76 co-sponsors in the House, including women and men, Democrats and Republicans.

The idea is to follow in the footsteps of women's health offices; there are at least six such bureaus scattered through the federal health bureaucracy.

No one has stepped up yet in the Senate with the bill, but the Cunningham legislation has an endorsement from the Society for Women's Health Research. "Our quest to improve medical care must include a sex-based approach to meet the unique treatment needs of both men and women," says the society's president, Phyllis Greenberger.

But Who Picks Up the Check?

But the National Women's Health Network is not endorsing the bill, says Amy Allina, the group's program and policy director. At the same time, she says, "We believe there are health issues that are particular to men and we encourage health advocates who are concerned about men's health to work to get more attention for those things."

That given, says Allina, "We still think it's necessary across the medical field to work to get more attention to women's health. We think that women's health has been under-researched. Clinical trials as well as the historical medical practice model have assumed male as normal and female as a small version of men."

However, she adds, "If we can fund offices of men's health without detracting from the work that's being done for women's health, I'm all for it."

But money -- or lack thereof -- is probably the key issue in getting a new office going. 

"There are clearly plenty of people interested in these issues, but nobody wants to put any money up," says McDermott. "That's going to be our biggest challenge, getting anybody to be serious about putting any money forward for this." 

"This is something that can be done by the [U.S. health] secretary, just through reorganization," says Tracie Snitker, spokesperson for the Men's Health Network.

A men's health office wouldn't take anything from the pockets of the women's offices, says Cunningham. 

"That's not the intent, and I assure you, that won't be the final outcome either," he says. "I'm just as dedicated to women's health as I am men's health. It's just that men's health information has been limited and I want to bring it up to parity."

Avoiding a Battle of the Sexes

Politically, the bill's advocates are on more solid ground this year, Allina says. In the previous Congress, she says, the legislation first emerged "from the perspective of saying women are getting too much attention and men need more of it. Obviously we had some problems with that. I appreciate that they've changed their approach to recognize that they can advocate for men's health without detracting from women's health."

Some claim that the U.S. Health Department is already one giant office of men's health, but, says Bonhomme, "The government actually spends more on gender-specific programs for women than they do on gender-specific programs for men.

"A lot of men's health problems affect women and children as well," Bonhomme adds. "If men get sick and die prematurely, then families lose loved ones and income." 

Cunningham is a member of the House's health appropriations panel, so he can have special sway over some health research matters. But he is coy about declaring that the men's office bill is likely to become law this year.

"Unfortunately, things don't move fast around here," he tells WebMD. "You learn that if you want to run through a brick wall the very first day, you're going to come out with a lot of scratches, and you're going to look down the road and you've got a lot of walls to run through, so you'd better pace yourself."

Running Your Own Office of Men's Health

Indeed, Washington rarely surprises us with quick action, so as the politics swirl, what are some do-it-yourself steps for staying healthy as a man?

For starters, says Bonhomme, don't overlook pain. 

"As men, we've learned to ignore pain," he says. "Sometimes that's good, but the same tolerance for pain that can help you win on the football field or the battlefield doesn't help you out when you're dealing with the healthcare field."

According to McDermott, "Ordinary folks should have a physical once a year and have their blood and urine tested, and a chest X-ray, so that they have a recent baseline for the time when something happens. If somebody comes in to the doctor with a major catastrophe and they haven't seen a physician for 20 years, it's very difficult for the doctor to figure out what happened."

And don't forget clean living. A July study in the Archives of Internal Medicine showed that male, vegetarian Seventh-Day Adventists in California lived nearly 10 years longer than other Californians. Even non-vegetarian male members of the religion, which stresses exercise and avoidance of alcohol and tobacco, lived on average more than 7 years longer than other Californians.

Finally, there's always marriage, for you single guys. Studies have suggested that being married is healthful for men, as wives may prompt their husbands to take better care of themselves and to visit the doctor more regularly. (Editor's note: What's missing here is breaking down the single group into "Single" and "Divorced". My bet is that the "Single" group outlives the "Divorced" group, and may outlive the "Married" group, if the true be told.)

Source:WebMD Medical News

HR 632 is introduced in Congress


Congressman Randy "Duke" Cunningham has introduced HR 632 which will establish an Office of Men's Health at the U.S. Department of Health and Human Services. This office would mirror the work of the existing Office of Women's Health, which has helped to save thousands of women's lives and has improved the lives of many more.

Why do we need an Office of Men's Health?

Alarming statistics show that men's health is at great risk. On average, men die 6 years younger than women and suffer higher mortality rates for the top 10 causes of death. The lives of hundreds of thousands of men will continue to be threatened unless immediate action is taken to combat this growing crisis.The Office of Men's Health will coordinate the fragmented men's health awareness, prevention, and research efforts now being conducted by federal and state government.

An Office of Men's Health, styled after the Office of Women's Health, will be well placed to coordinate outreach and awareness efforts on the federal and state levels, promote preventative health behaviors, and provide a vehicle whereby researchers on men's health can network and share information and findings.

Show your support!

You can show your support for the Office of Men's Health by writing a letter to your Senators and Representative. We make it easy. Follow this link to send your letter to Congress. Click Here www.menshealthnetwork.org/omh_letter.html

Newsbytes


Letter to USA Today


We sent a letter to USA Today commenting on their story May 24, 2004 regarding men's health. We're glad it made the paper, and it's impact was substantially deminished by the editorial department. Can you find the major difference?

Our Original Letter May 26:

Editor:

In Rita Rubin's article, "Men's habits, not biology, cause early death," she states "Changing men's health behaviors is nearly as tricky as changing their biology." It seems that changing the behaviors in Congress around men's issues is as even trickier.

There's been an Office of Women's Health for years. But not one for men. And yet men out-die women in all of the top ten causes of death in this country. So, several years ago, Randy Cunningham introduced bill HR 632 to establish an Office of Men's Health. A year later, Strom Thurmond introduced S 2616 in the Senate. Congress was handed an opportunity to save countless lives. Since then, they has been "Out to lunch" on the subject.

As Wanda Jones of the Office of Women's Health at the Department of Health and Human Services says, "It's time to bring us together to recognize and acknowledge and embrace the differences and be prepared to address them." Roughly 700,000 American men have died of treatable diseases each year waiting for Congress to change their behavior toward men's health. When will your Congressperson be ready? Ask them!

What appeared in the paper on June 1, 2004

Congress Fails to Act
USA Today's article says, "Changing men's health behaviors is nearly as tricky as changing their biology."

And it seems that changing the behaviors in Congress is even trickier.

There has been an Office of Women's Health at the U.S. Deparmtnet of Health and Human Services for years. But not one for men. And yet, more men than women are killed by the top 10 causes of death in this country. Several years ago, Rep. Randy Cunningham, R-Calif., introduced a bill to establish an Office on Men's Health. Sen. Strom Thurmond, R-S.C., also introduced a bill. Congress was handed an opportunity to save countless lives. Since then, lawmakers have been "out to lunch" on the subject.

As Wanda Jones of the Office on Women's Health says, "It's time to bring us together to recognize and acknowledge and embrace the differences and be prepared to address them."

Each year, thousands of American men die of treatable diseases waiting for Congress to changes its behavior toward men's health. When will your member of Congress be ready? (Actual Letter.)

*    *    *

The difference is that a large number of unnecessary deaths, 700,000 a year, is only a portion of the 1.1 million men who die annually, was dropped to "thousands". Not even "tens of thousands", or "hundreds of thousands", but "thousands." That's quite a drop. We only wish that Congress would take steps to actually see that number drop from 700,000 to a few thousand instead of continuing to allowing the numbers to increase because of lack of action on their part.

700,000 American Men have Died Waiting for Congress to Act


Want to harass, cajole, and embarrass your congressman into actually doing something for a change?

Last year a bill was introduced in Congress to create an Office of Men's Health within the Department of Health and Human Services. The office would collect data and disseminate information on a variety of diseases that affect men - diseases that may kill a lot of us. It would essentially do what the existing Office on Women's Health does: work to spread the information that helps people manage their health.

Being handed an opportunity to save countless lives, Congress acted just as one would expect. They all went out and had lunch. As a result, the bill has wallowed. Fewer than 90 congressmen have signed on as supporters. And in the time the bill has sat unsigned, roughly 700,000 American men have died of treatable diseases. With an organized effort to alert men to the warning signs of diseases like prostate cancer and testicular cancer, some of those lives might have been saved.

All of them? Of course not. But maybe some of them. Maybe a lot of them. Maybe your father's, your buddy's, your son's. Maybe, next year, yours.

We'd like to shake some trees. But we need your help.Take a second to fill out the information.

You can also download the form here: Office of Men's Health form . Print the form out, fill it in and fax it to us at 610.967.7601 (or mail it to Men's Health, 33 E. Minor St., Emmaus, PA 18098).We need your name, address, ZIP code (that's important), and signature. We'll march down to Washington, identify your congressman, and personally hand him your letter, along with plenty of others. We might even give him a stern look, if we're feeling ornery.

Hey, we're trying to save some lives here. Let's stop screwing around. Thanks for your support. — The Editors, Men's Health Magazine
Source: www.menshealth.com/health2/officeofmh.shtm

Here's a copy of the letter they will be delivering to your congressperson on your behalf: Dear Congressman:

The Men's Health Act (H.R. 632) matters to me. Countless men can be helped with the outreach and education an office devoted to men's health will provide. This is why an Office of Men's Health in the Department of Health and Human Services is important to me.

As a member of your district, I urge you to vote in favor of this measure.

Sincerely, (your name)

Men's Health Act Introduced in the Senate


Sen. Strom Thurmond introduced the Men's Health Act in the Senate. This exciting development means that a bill to establish an Office of Men's Health has been introduced in both chambers of Congress.

The Senate version of the Men's Health Act was assigned bill number S. 2616, and has now been referred to the Senate Committee on Health, Education, Labor, and Pensions ("HELP") for further consideration. The Senate bill matches H.R. 632, which was introduced in the House of Representatives last year.

Please write your Senator at US Senate, Washington, DC 20510, and ask that person to co-sponsor and support the Men's Health Act, S. 2616.

You can follow the progress of the Men's Health Act through the Senate by going to this web site: thomas.loc.gov/cgi-bin/query

Senator Thurmond's floor comments are included below:

In this Nation, there is an ongoing, increasing, and predominantly silent crisis in the health and well-being of men. Due to a lack of awareness, poor health education, and culturally-induced behavior patterns, the state of men's health and well-being is deteriorating steadily. Heart disease, stroke, and various cancers, including prostate and testicular cancer, continue to be major areas of concern. We must address these issues with diligent educational efforts, prevention and treatment as we seek to enhance the quality and duration of men's lives. Improved distribution of information concerning the health challenges men face and the utilization of the appropriate preventive measures are imperative to addressing this need.

As a lifelong advocate of regular medical exams, daily exercise, and a balanced diet, I feel strongly that an Office of Men's Health should be established to help improve the overall health of America's male population. The bill I am introducing is similar to a bill introduced in the House of Representatives. I invite my colleagues to join me in supporting this important measure. I ask unanimous consent that the text of the bill be printed in the RECORD.

There being no objection, the bill was ordered to be printed in the RECORD, as follows: S. 2616

TV show addresses DV against men


Armstrong Williams, one of the nation's cutting-edge commentators, has produced a show on domestic violence against men featuring MHN spokesperson Dr. Alvin Baraff and FEFFI founder David Burroughs. Check TV listings in your area for date and time. Mr. Burroughs says this is a great, must-see show. In a syndicated column, Armstrong Williams addressed the issue of domestic violence perpetrated against men. His mea culpa on domestic violence begins:

"Last week, I began my column by observing that `one woman is battered every 15 seconds.' What I neglected to mention was that the same study found that `one man is battered every 14 seconds.' "In fact, most studies reveal that men are attacked, clawed, beaten, shot and generally abused at equal - if not slightly greater — rates than women."

Read the Armstrong Williams article at:
Source: www.washingtontimes.com/commentary/20020322-1425600.htm

A male victim every 14 seconds!


Did you know that the same data which purported to prove a woman is a victim of DV every 15 seconds, also proved that a man is a victim of DV every 14 seconds? Read about it at:
Source:
www.menshealthnetwork.org/library/FV_117_SR1.html

States cannot discriminate in DV funding


Congress passed intent language as part of the committee report on the reauthorized VAWA which makes it clear that there can be no discrimination in DV funding. An entry in the Congressional Record verifies that funding is to be made available for programs that address DV against men as well as programs that address DV against women. If you have a program for male victims and have been denied funding, hold your state funding agency accountable. You can read about it at:
Source: www.menshealthnetwork.org/library/legintent.doc

Texas Declares DV projects that Focus on Children or Men Ineligible


FEFFI addressed discrimination in funding DV programs. Note that Texas, contrary to Federal intent, declares as "ineligible": "… projects that focus on children or men." Read about discrimination in domestic violence funding:
Source: www.menshealthnetwork.org/library/FV_letter.pdf

"Violent Touch: Breaking Through the Stereotype"


Dr. David Fonts, one of the leading experts on DV, addressed DV against men in his excellent 1999 essay: "Violent Touch: Breaking Through the Stereotype." He writes:"A group of researchers reviewed 72 studies that measure aggressive behavior in both men and women. They found that nearly two-thirds of the studies "did not show the expected higher male than female aggressiveness across all conditions." They also found that when women feel an aggressive act is justified, and they receive permission from society to assault, there is little gender difference in the incidents of aggressive behavior between the sexes." Read "Violent Touch: Breaking Through the Stereotype" at:
Source: www.menshealthnetwork.org/library/fontes2.doc

Distribute a flyer on DV against men


October is domestic violence awareness month, but domestic violence occurs year-round. Join the campaign to end domestic violence against men by distributing a flyer at the courthouse, your place of worship, political events, and other places where literature distribution is allowed. A balanced flyer on domestic violence is at:
Source: www.menshealthnetwork.org/library/DV%20flyer.PDF

Share your DV story with others – join Dads Talk


You can join an informative and sometimes rowdy discussion of men's and fathers' issues, including DV against men. Dads-talk is not moderated and allows you to seek advice or express your opinion. To join, go to
Source: :dadstalk-subscribe@yahoogroups.com

88 sponsors have signed on to the Men's Health Act of 2001


You can express your opinion of this landmark legislation (Office of Men's Health – HR 632) by writing a quick letter to Congress. MHN makes it easy.
Source: www.menshealthnetwork.org/omh_letter.html

Take Back the Campus


Myth: Women have been shortchanged in medical research.

Fact: The National Institutes of Health and drug companies routinely include women in clinical trials that test for effectiveness of medications. By 1979, over 90% of all NIH-funded trials included women.

Beginning in 1985, when the NIH's National Cancer Center began keeping track of specific cancer funding, it has annually spent more money on breast cancer than any other type of cancer. Currently, women represent over 60% of all subjects in NIH-funded clinical trails.

(Essential reading: Cathy Young and Sally Satel, "The Myth of Gender Bias in Medicine," Washington, D.C.: The Women's Freedom Network, 1997.)

Source: www.shethinks.org/SheInvestigates/a000000029.cfm

The Exclusion of Women from Medical Research Perception vs Reality


It has often been asserted, but not proven, that women were routinely excluded from research studies conducted by the National Institutes of Health. As early as 1993, Marcia Angell, MD, associate editor of the New England Journal of Medicine, alleged, "There is little doubt that women have been systematically excluded as subjects for study . . . it is not surprising that most clinical trials have been heavily, if not exclusively, weighted toward men". (New England Journal of Medicine 1993 329: 271-272). At a public health conference on January 28, 2000, NIH acting director Ruth Kirschstein informed a startled audience that the Framingham Heart Study was "all-male."

The statements by Angell and others were based on the fact that certain studies such as the Coronary Primary Prevention Trial, the Multiple Risk Factor Intervention Trial (MRFIT), and the Physicians' Health Study were all-male. But the NIH sponsors thousands of studies every year, and one must question the logic of generalizing from the sex composition of a handful of studies to the universe of all NIH research.

But to this point in time, the claim of the routine exclusion of women could never be definitively refuted because no one had actually done a count of sex-specific enrollments in medical research, especially prior to 1990. Recently Curtis Meinert, PhD of Johns Hopkins University and colleagues undertook an exhaustive review of all 342 clinical trials published in 1985 and 1990 in five leading medical journals (Controlled Clinical Trials 2000; 21: 462-475). They tallied the number of enrollees in these trials: 126,234 males and 343,675 females. Hardly an example of the routine exclusion of women.

In my research, I have undertaken Medline database searches of the epidemiological literature. I used the search delimiters "Epidemiology," "United States," "Human," "1966-1990," and "Male" or "Female." These are the results for the five leading causes of death in the United States:

Male
Female

Heart Disease

2,226
1,741

Stroke

346
294

Cancer

4,650
5,059

Injuries

1,814
1,659

COPD

345
294

Total

9,381
9,047

Overall, it is seen that there were 334 more epidemiological studies that included men than included women, representing a 3.7% difference. I have analyzed a broader range of conditions, and found very similar findings. Again, it is hard to find evidence that women were shortchanged by epidemiological research.

As far as the claim that the Framingham Heart Study was "all-male," women represented 51% of the research cohort at the inception of the study in 1948. Due to sex-specific differentials in mortality rates, the percentage of women eventually rose to 60%. (Journal of the American Medical Women's Association 1993; Vol. 48, No. 5).

Unfortunately, the widespread perception that women were neglected by medical research has overshadowed the reality. As a result, laws have been passed, regulations have been promulgated, and new reporting requirements instituted. More significantly, women's health research has enjoyed a rapid expansion.

Now, attention to men's health research has begun to lag significantly. According to the NIH, male participation in all extramural research studies in 1994 was 44.9%. By 1998, that percentage had dropped to just 32.2%. According to the recent GAO report on Women's Health, NIH now devotes 15.5% of its budget to women's health, vs. 6.4% on men's health.

For the sake of good science and for the sake of fairness, it would seem that we need to reconsider the belief that women were routinely excluded or generally underrepresented in medical research studies sponsored by the NIH.

Source: American Public Health Association, Epidemiology Section, Spring 2001, Edward E. Bartlett, PhD, Senior Policy Advisor, Men's Health America, Rockville, MD www.apha.org/sections/newsletters/epispring2001/htm

DHHS Proposes $0 for Men's Health, $27 million for Women's Health


April 10, 2001 - Department of Health and Human Services Secretary Tommy Thompson has just released his proposed budget for Fiscal Year 2002 www.hhs.gov/budget/pdf/hhs2002.pdf His budget includes $0 for an Office of Men's Health.

While the Office of Men's Health is still being debated in congress, the DHHS has slated for a whopping $10 million increase, from $17 million in FY 2001 to $27 million in FY 2002 for the Office of Women's Health.

In January, Men's Health America documented that men's health programs in DHHS lag by a 5:1 margin. If approved, Thompson's budget request would only worsen that disparity.

Our message is simple: We support women's health, but men's health deserves equal attention.

Please send the following letter (modify it to reflect your experiences) to your elected officials in Congress. And send it to Secretary Thompson, too, at Dept. of Health and Human Services, 200 Independence Ave. SW, Washington, DC 20201.

*    *    *

The Honorable _____________
US House of Representatives
Washington, DC 20515

or

The Honorable _____________
US Senate
Washington, DC 20510

RE: Neglect of Men's Health

Dear Congressman _________________,

On February 14, 2001 Representatives Duke Cunningham and Jim McDermott introduced the Men's Health Act (H.R. 632). This bill now has 68 co- sponsors in the House of Representatives.

The Representatives also requested that DHHS Secretary Tommy Thompson administratively establish an Office of Men's Health, and include that in his funding request for FY 2002.

On April 9, Secretary Thompson released his proposed budget for Fiscal Year 2002. His budget includes $0 for an Office of Men's Health.

In contrast, the DHHS Office of Women's Health is slated for a whopping $10 million increase, from $17 million in FY 2001 to $27 million in FY 2002.

In January, Men's Health America documented that men's health programs in DHHS lag by a 5:1 margin. If approved, Thompson's budget request would only worsen that disparity.

I support women's health. But men die 4+ years sooner than women in this country. Don't men deserve an equal chance at life?

Please contact Secretary Thompson and demand that the DHHS establish the Office of Men's Health, and pay equal attention to the health needs of men.

Sincerely,

MORE

Women and Research


Sexual politics has spilled over into debates about government-funded medical research in recent years. For instance, a recent report of the U.S. Commission on Civil Rights claimed "women have been excluded from clinical trials for decades." And last June the Harvard Women's Health Watch proclaimed "nearly all drug testing has been done on men."

But the National Institutes of Health (NIH), which stated in 1997 that "women were routinely excluded" from its research, recently retracted this claim. It's about time, says Sally Satel, a medical doctor, because women have been routinely included in clinical trials.

For instance, in 1979, 268 of the 293 NIH-funded clinical trials contained female subjects.

Food and Drug Administration surveys in 1983 and 1988 found "both sexes had substantial representation in clinical trials."

And data from the NIH's Office of Research on Women's Health show 68 percent of subjects in all clinical trials funded in 1998 were women.

Indeed, a recent study by Curt Meinert and colleagues at Johns Hopkins University, published in Controlled Clinical Trials, found female subjects outnumbered males at a rate of 13 to 1 across all cancer trials. One reason for the preponderance of women is that breast cancer research has received more money than any other cancer since 1985, the earliest we have good records of disease-specific NIH funding.

Before that, according to Cathy Young in the New Republic, from 1966 to 1986 there were more than 400 breast cancer trials, compared to just 121 trials for prostate cancer.

Satel says the notion that women have been given short shrift in medical research "has been used to lobby for policies and resources that waste money and, worse, unwittingly harm women."

Source: National Center for Policy Analysis www.ncpa.org/pi/health/pd032101f.html For text interactive.wsj.com/articles /SB984012316295048875.htm Also, Sally Satel (American Enterprise Institute), "Feminism Is Bad For Women's Health Care," Wall Street Journal, March 8, 2001. Satel is author of "PC, M.D. -- How Political Correctness is Corrupting Medicine" (Basic Books, 2000).

Feminism is Bad for Women's Health Care


By Sally Satel , The Wall Street Journal , March 8, 2001, Page A22

That women are second-class citizens of the medical research establishment is a claim much trumpeted. Hillary Rodham Clinton once remarked on the "appalling degree to which women were routinely excluded from major clinical trials of most illnesses." A recent report of the Commission on Civil Rights claimed that "women have been excluded from clinical trials for decades." Last June the Harvard Women's Health Watch proclaimed that "nearly all drug testing has been done on men."

But what we know is wrong. Last week the National Institutes of Health, which had stated in 1997 that "women were routinely excluded" from its research, issued a retraction of this claim. The Institutes' recognition of this error (made in two letters to a Rockville, Md.- based group called Men's Health America) is most welcome.

But don't expect the women's health lobby -- the network of public "offices of women's health" that exist on the state and federal levels, and the university-based "women's health centers" -- to admit it any time soon. For these groups must make women appear embattled and shortchanged if they are to gain government support, raise funds and justify themselves in the eyes of the public.

The NIH retraction comes a few months after the publication of a study by Curt Meinert and colleagues at Johns Hopkins University. Writing in the journal Controlled Clinical Trials, Mr. Meinert debunks an enduring feminist myth: that there is gender bias in medical research. His review of major medical journals in 1985, 1990 and 1995 found that female subjects outnumbered males at a rate of 13 to 1 across all cancer trials, with the vast bulk of the women participating in trials specifically for breast cancer.

Yet the myth found its way into Al Gore's campaign platform: "Throughout my career I have fought for more research funds for those diseases so recently considered less important because they befell only women, such as breast cancer. . . . I pledge to you: women's health will always be at the top of my agenda."

It's hard to know what more any president could do, especially regarding breast cancer. Breast cancer research has received more money than any other cancer since 1985, the year the National Cancer Institute began keeping good records of disease-specific funding. Using the yardstick of "years of healthy life lost," breast cancer is one of the five most generously funde illnesses, according to a 1999 article in the New England Journal of Medicine. The other four are heart disease, dementia, AIDS and diabetes.

And breast cancer is not an exception. Women were routinely included in all trials for years. Back in 1979, 268 of the 293 NIH-funded clinical trials contained female subjects. Food and Drug Administration surveys in 1983 and 1988 found that "both sexes had substantial representation in clinical trials."

Why is it important to topple the myth that women are shortchanged by medical research? Because the notion that women have been denied their fair share of breakthroughs has been used to lobby for policies and resources that waste money and, worse, unwittingly harm women.

Recall the great mammography debate in the U.S. Senate. In 1997 an NIH consensus group declared that women in their 40s need not undergo early mammograms. The group reasoned that the relatively high rates of false diagnosis in 40-50 year-old women -- and the needless surgery that may accompany such a diagnosis -- did not outweigh the small reduction in mortality that the mammograms would yield. Women under 50, then, were advised to make a decision with their doctor.

Reasonable enough, but the lack of firm guidance incensed a cadre of women senators and Health and Human Services Secretary Donna Shalala. Sen. Olympia Snowe (R., Maine) led the crusade to pressure the NIH to change its recommendation to one of annual mammograms for all. During the debate, Ms. Snowe boasted to the Washington Post that "it was my female colleagues and I who led the charge to put an end to clinical trials entirely on men -- even for breast cancer."

Breast cancer is a serious matter, but women's health suffers when the emphasis on breast cancer overshadows the five-fold larger risk of death from heart disease. This is where responsible women's health advocates come in, to educate women about relative health risks and the importance of timely screening for blood pressure, diabetes, and cervical and breast cancer.

Finally, the notion that women need to be compensated for being left out has led to the expenditure of millions of federal and state dollars to create "offices of women's health" within health agencies to oversee various expenditures and create new programs for women's health. Instead of building bureaucracies, the money would be better spent on research or direct delivery of care.

An exception, in my view, is the NIH's Office of Research on Women's Health. Ably run for about a decade, that office has been collecting the data that show how widely women's health has indeed been studied. Thanks to its efforts, we know that the composition of subjects in all clinical trials funded in 1998 -- the last year for which there are data -- was 68% women. In fact, despite its self-defeating rhetoric about exclusion, the NIH was the very font of decades of outstanding research in which women were routinely included.

The NIH's official declaration that women have not been shortchanged by no means denies that progress still needs to be made in the health of women. But it is wrongheaded to confuse the need to know more -- an imperative that will always be with us -- with the myth that women are given short shrift by medical research.

Source: Dr. Satel, a fellow at the American Enterprise Institute, is the author of "PC , M. D. -- How Political Correctness is Corrupting Medicine" Basic Books, 2001

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