- Email: [email protected]
A Family Health Question: What About Dad?
WCMH Abstracts 218
219
CAN HEALTHCARE BE MADE MORE EFFECTIVE FOR MEN?
A FAMILY HEALTH QUESTION: WHAT ABOUT DAD?
J.J.E. Bonhomme
J.J.E. Bonhomme
Morehouse School of Medicine, National Black Men’s Health Network, Atlanta, GA, USA
Morehouse School of Medicine, National Black Men’s Health Network, Atlanta, GA, USA
E-mail address: [email protected]. Traditional approaches have failed to engage men in the healthcare system at rates comparable to women. A Center for Disease Control study of gender and ambulatory care use found that even after excluding pregnancy-related visits, women visited doctors for such reasons as annual examinations and preventive services twice as often as men. Another major U.S. study has shown that one-third of men as opposed to less than one-fifth of women have no regular physician, and that three times as many men as women have not seen a physician in the past year. Only 18% of males state that if they were in pain or sick, they would seek health care promptly. 24% of males stated that even if they were in pain or sick, they would delay seeking help as long as possible, while 17% stated that they would delay going to a doctor for a week or more. Men’s inattention to health matters does not reflect a lack of intelligence, but an approach unsuitable for men. Public health screenings that evinced substantial adult male participation engage entire families to bring men in and help them understand health and medication regimens, take time to explain and promote understanding of disease processes and management, treat the male individual as a whole person, ‘‘not just a prostate,’’ use multiple and diverse media formats to advertise the event, use a peer-to-peer approach, and treat seeking healthcare as a group event like going to a sports game. Men appear to participate actively when they have motivated partners who use tactful, non-blaming, encouraging approaches tailored to the man’s individual personality. Bringing health screening and treatment to the workplace whenever possible frees men from having to choose between going to work and going to the doctor. Promoting healthcare as a means to maximize performance, achievement and productivity increases its relevance to men. Screening for veteran status must be made routine to identify key health issues related to military service. Health care providers must make special efforts to listen carefully to men given the unique cultural hurdles men must overcome in the act of seeking health care.
E-mail address: [email protected]. Men’s health may be considered a vital but often overlooked aspect of family health. The health status of adult males has often been dismissed as irrelevant to the well-being of the family. However, the family is built on highly interactive relationships such that the health challenges facing fathers frequently have widespread and demonstrable negative effects on the health of the family as a whole. Following widowhood or disability of a husband, a family may face the loss of a long term companion and considerable bereavement, as well as a difficult burden of care for the disabled person. Surviving spouses face an increased risk of dying over the course of the next year. In disability, a family is likely to face increased health care expense in the face of diminished earnings. Poverty is strongly associated with widowhood, with children often bearing considerable financial hardship as well. The prevailing catchphrase ‘‘maternal and child health’’ ignores a growing body of evidence that the health of fathers may have considerable bearing on birth defect risks, healthy psychosocial development of children and adolescents, and future propensities towards medical and psychiatric illness in adult offspring. Advanced paternal age has been associated with increased risk of a number of conditions, including nasal aplasia, cleft palate, hydrocephalus, pulmonic stenosis, and schizophrenia. A father’s tobacco smoking increases risk of cleft lip, cleft palate, hydrocephalus, and ventricular septal defect, while a father’s alcohol increases likelihood of ventricular septal defect. Sexually transmitted infections including HIV, HPV, HSV, and chlamydia may have particularly severe consequences for women and children if not controlled among men. Babies of men exposed to chemicals in the course of their daily work are more likely to be miscarried, stillborn, or to develop cancer later in life. Offspring of Vietnam or Cambodia veterans have significantly increased rates of acute myelogenous leukemia. The crucial role of fathers in the growth and development of socially well adjusted, physically and mentally healthy children must be more widely publicized and recognized, and the more inclusive concept of parental and child health must replace current prevention efforts that focus narrowly on maternal health.
doi:10.1016/j.jomh.2009.09.027 doi:10.1016/j.jomh.2009.09.028
402 jmh
Vol. 6, No. 4, pp. 396–402, December 2009
219
CAN HEALTHCARE BE MADE MORE EFFECTIVE FOR MEN?
A FAMILY HEALTH QUESTION: WHAT ABOUT DAD?
J.J.E. Bonhomme
J.J.E. Bonhomme
Morehouse School of Medicine, National Black Men’s Health Network, Atlanta, GA, USA
Morehouse School of Medicine, National Black Men’s Health Network, Atlanta, GA, USA
E-mail address: [email protected]. Traditional approaches have failed to engage men in the healthcare system at rates comparable to women. A Center for Disease Control study of gender and ambulatory care use found that even after excluding pregnancy-related visits, women visited doctors for such reasons as annual examinations and preventive services twice as often as men. Another major U.S. study has shown that one-third of men as opposed to less than one-fifth of women have no regular physician, and that three times as many men as women have not seen a physician in the past year. Only 18% of males state that if they were in pain or sick, they would seek health care promptly. 24% of males stated that even if they were in pain or sick, they would delay seeking help as long as possible, while 17% stated that they would delay going to a doctor for a week or more. Men’s inattention to health matters does not reflect a lack of intelligence, but an approach unsuitable for men. Public health screenings that evinced substantial adult male participation engage entire families to bring men in and help them understand health and medication regimens, take time to explain and promote understanding of disease processes and management, treat the male individual as a whole person, ‘‘not just a prostate,’’ use multiple and diverse media formats to advertise the event, use a peer-to-peer approach, and treat seeking healthcare as a group event like going to a sports game. Men appear to participate actively when they have motivated partners who use tactful, non-blaming, encouraging approaches tailored to the man’s individual personality. Bringing health screening and treatment to the workplace whenever possible frees men from having to choose between going to work and going to the doctor. Promoting healthcare as a means to maximize performance, achievement and productivity increases its relevance to men. Screening for veteran status must be made routine to identify key health issues related to military service. Health care providers must make special efforts to listen carefully to men given the unique cultural hurdles men must overcome in the act of seeking health care.
E-mail address: [email protected]. Men’s health may be considered a vital but often overlooked aspect of family health. The health status of adult males has often been dismissed as irrelevant to the well-being of the family. However, the family is built on highly interactive relationships such that the health challenges facing fathers frequently have widespread and demonstrable negative effects on the health of the family as a whole. Following widowhood or disability of a husband, a family may face the loss of a long term companion and considerable bereavement, as well as a difficult burden of care for the disabled person. Surviving spouses face an increased risk of dying over the course of the next year. In disability, a family is likely to face increased health care expense in the face of diminished earnings. Poverty is strongly associated with widowhood, with children often bearing considerable financial hardship as well. The prevailing catchphrase ‘‘maternal and child health’’ ignores a growing body of evidence that the health of fathers may have considerable bearing on birth defect risks, healthy psychosocial development of children and adolescents, and future propensities towards medical and psychiatric illness in adult offspring. Advanced paternal age has been associated with increased risk of a number of conditions, including nasal aplasia, cleft palate, hydrocephalus, pulmonic stenosis, and schizophrenia. A father’s tobacco smoking increases risk of cleft lip, cleft palate, hydrocephalus, and ventricular septal defect, while a father’s alcohol increases likelihood of ventricular septal defect. Sexually transmitted infections including HIV, HPV, HSV, and chlamydia may have particularly severe consequences for women and children if not controlled among men. Babies of men exposed to chemicals in the course of their daily work are more likely to be miscarried, stillborn, or to develop cancer later in life. Offspring of Vietnam or Cambodia veterans have significantly increased rates of acute myelogenous leukemia. The crucial role of fathers in the growth and development of socially well adjusted, physically and mentally healthy children must be more widely publicized and recognized, and the more inclusive concept of parental and child health must replace current prevention efforts that focus narrowly on maternal health.
doi:10.1016/j.jomh.2009.09.027 doi:10.1016/j.jomh.2009.09.028
402 jmh
Vol. 6, No. 4, pp. 396–402, December 2009