September 19, 2006, is Take a Loved One for a Check-up Day. In 2005, the Department of Health and Human Services wisely changed the logo from Take A Loved One to the Doctor Day, citing the need to more accurately reflect the broad spectrum of healthcare professionals (HCPs) that work to keep the nation's people healthy, including nurse practitioners, and to emphasize the importance of preventive screenings and remove the connotation of seeking help only for illness care. This September, I propose targeting a special population-males. When boys, more than likely taken to HCPs by their mothers, become men, they find a million and one reasons not to seek medical attention:
"I'm perfectly healthy; I feel fine".
"Nothing is bothering me so why do I need to go?"
"If I can work, I must be alright".
Men's Health Important Too
Men were once a forgotten minority on the national health agenda. Federal, state, and local initiatives have generously and systematically targeted women and children, considered vulnerable populations, for special programs and funding. On June 10, 1994, President Clinton issued Proclamation 6700, designating the first National Men's Health Week (Federal Register Doc. 94-14721, June 15, 1994), which encouraged men to access and utilize available health services to the fullest. Specifically mentioned in the proclamation were the detrimental effects of smoking, alcohol abuse, and violence, and the morbidity and mortality associated with prostate cancer. Men are encouraged to take action to improve their health and establish behaviors that will decrease risks of chronic illness, which includes screening and prevention. But why do men still not seek healthcare at the rate that women do?
Machismo a Barrier
Two organizations dedicated to improving the overall health of men advocate for equal access and opportunity, the Men's Health Network (MHN, http://www.menshealthnetwork.org) in the United States and the Men's Health Forum (MHF, http://www.menshealthforum.org.uk) in the United Kingdom. The MHN notes that women outlive men today by an average of 5 years because men die younger and in greater numbers than women from chronic disease, men are more likely to engage in unhealthy behavior, men don't seek medical attention when they need it, men are less likely than women to adopt preventive health measures, men are less likely to have health insurance, and men are more likely to work in dangerous occupations.
The MHF reports results from a study involving approximately 400 men. Basically, the men often felt unwelcome in "feminised" premises in terms of decor and display material, and perceived a gender bias in the provision of some services. Correspondent health professionals in this study suggest their own insights into why men accessed health services less frequently than women. Men were more likely to: "tough" out illness, give priority to work commitments over treatment and rest, feel that illness equals weakness, fear the consequences of illness and disease, and were less likely than women to be prepared to discuss their health.
In my practice, the male to female ratio is 1:3, and I see primarily healthy young adults. I don't have a number, but I imagine this ratio does not equalize as men grow older and the threat of serious health problems increases. This month's issue of The Nurse Practitioner offers two informative articles on men's health: familiar prostate cancer and an erectile dysfunction patient handout. Share the issue with men you know. September is also Prostate Cancer Awareness Month; and you can find helpful suggestions and strategies for increasing screening efforts at http://www.pcacoalition.org.
Jamesetta Newland, PhD, APRN, BC, FNP, FAANP, FNAP, Editor-in-Chief
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