Health disparities plague minority men

New public health initiatives are aimed at drawing males, especially those who are minorities, into the health care fold.

By Susan J. Landers, amednews staff. May 19, 2003.

Washington -- Actor Robert Guillaume didn't know what hit him one morning in January 1999 when he found himself floundering on the floor of his dressing room as he prepared to be called to the set to film a scene in a new Disney production.

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The fact that he was having a stroke hadn't occurred to him until later when he was sitting on a hospital gurney. As a man who considered himself pretty savvy when it came to his health, he thinks he should have known more about his risk of stroke. But he didn't.

"I don't think it was denial," he said. "It might have been 'the show must go on.' "

Now he knows that he should have gotten himself to the hospital right away, he said at an April 29 press briefing on men's health. The event was sponsored by the American Public Health Assn. and the W.K. Kellogg Foundation.

American men typically die 5 years before women; black men die about 12 years before white women.

Likewise, Miami Heat basketball player Alonzo Mourning wasn't aware of the damage he was doing when he tried to treat his various sports-related aches and pains with a variety of over-the-counter pain relievers. He popped the tablets like they were candy, he said. Now he knows that the pain relievers probably aggravated a genetic kidney disease he didn't even realize he had.

Guillaume and Mourning, who are both black, believe they are typical of many minority men in failing to take responsibility for their health.

And they are probably right, agreed American Public Health Assn. Executive Director Georges Benjamin, MD. The May issue of the American Journal of Public Health is devoted almost entirely to men's health issues, particularly the health of minority men.

The Kellogg Foundation calls men's health care a "silent health crisis adversely affecting the well-being of men of color." The foundation is funding six model programs that provide health care to men. The programs were begun as part of the foundation's initiative, Community Voices: HealthCare for the Underserved.

High death rates

The need is apparent, notes the foundation. American men typically die almost five years before women, and black men die on average 11.8 years before white women. Forty percent of black men die prematurely, often from strokes, as do 37% of Latino men. The figure stands at 21% for white men, according to the Kellogg Foundation.

"Men have higher age-adjusted death rates than women for the 15 leading causes of death in the United States, with the exception of Alzheimer's disease," said David R. Williams, PhD, MPH, senior research scientist at the University of Michigan's Institute for Social Research in Ann Arbor and author of one of the journal articles.

Black men are more likely to have their legs amputated because of diabetes than white men.

Often the reasons for the disparities are obvious. Lack of health insurance makes care unaffordable for many men. But other times it has more to do with behavior patterns that are set very early in life, said Alwyn Cohall, MD, director of the Harlem Health Promotion Center in New York City.

Smoking, drinking and unsafe sex practices are likely to begin in adolescence and young adulthood, said Dr. Cohall, precisely the time for increased access to doctors, not less. But less is what they generally receive.

Former Health and Human Services Secretary Louis Sullivan, MD, who also spoke at the briefing, said physicians should be less forbidding and more welcoming toward their male patients. "We must make the health care system less threatening," he advised.

Care also must be taken to ensure that black and other minority men receive the same treatment as do white men, said Joseph Betancourt, MD, MPH, senior scientist at the Institute for Health Policy at Massachusetts General Hospital-Harvard Medical School, Boston.

"African-American men are less likely to get vaccinated for the flu," he said. "And they are more likely to have their legs amputated as a result of diabetes," he added. This must change, all agreed.