Man denied breast cancer treatment ... because he's a man. Really?

Check out the link here about a man who was denied Medicaid coverage for his breast cancer treatment because he is not a female.

Interestingly, the article points out that the man applied for aid through a breast cancer and cervical screening program that only serves women; that is, the defined mission of the organization is to assist WOMEN with these problems, not men. I find it difficult to swallow that this organization is to blame for his lack of coverage. This is also mentioned in the Jezebel article, so kudos to them.

For example, the Juvenile Diabetes Research Foundation primarily deals with Type 1, or early onset, diabetes in child populations. Suppose the JDRF provided charitable support for individuals with this condition. Now, imagine that someone with Type 2 diabetes, or gestational diabetes, applies for financial assistance from JDRF. The organization is dedicated to a different population, however, and so denies the request. There's really no difference between that and the breast cancer situation described above.

Organizations exist to serve specific populations, and that's OK. The flaw isn't with the breast and cervical cancer screening programs, as the Jezebel article points out. Rather, our system is failing because of its inability to provide comprehensive care to everyone. If the American healthcare system was fortified with more safety nets for populations with health disparities, impoverished men with breast cancer would be less likely to fall through the cracks.

We need to allow organizations to focus on their self-defined mission rather than attempting to dictate morality to them; a women's group doesn't have to provide healthcare to men (just like a fathers' support group doesn't have to allow mothers to join). I'm glad that the editorial attacks the general healthcare structure instead of vilifying the women's health organization.

If those groups weren't allowed to set boundaries, I think it would be a slippery slope into chaotic public health practice. I can see the nature of these conversations:
"You have an AIDS foundation? Give us money to help cancer patients!"
"Um ... no?"

It's not that we shouldn't care about groups with different health problems. Rather, we need to acknowledge and realistically assess the independent ability of non-profit groups to support specific populations, strengthening our overall infrastructure to support these efforts.

Men's health, part II

So, since we're still in June, let's talk a little bit about how Men's Health Month actually does a pretty good job of reaching out to one specific disadvantaged population: Gay men. This population, has struggled with not only communicable disease issues such as AIDS, but more recently, mental health issues such as higher suicide rates. Gay men, then, are obvious targets for this kind of initiative.

What have I learned about in class this year concerning gay men? The study that sticks out in my mind is the Wyoming Rural Aids Prevention Project (WRAPP), which was an Internet-based intervention for gay men in rural communities. You can visit the page here: WRAPP.

You can also check out the program evaluation journal article here: WRAPP program eval

As Internet availability increases in rural communities, we need to consider these non-traditional groups in our intervention schemes. Before attending SRPH, I would have never really thought about intervening in a rural setting with gay men; ignorant me, I assumed that was primarily an urban problem. The fact of the matter is, though, that gay male (and female) populations still need our public health support regardless of whether they live in San Francisco, Santa Fe, or Steamboat Springs ... although the setting may be different, the health issues are largely the same.

The great thing about June is that it's also Pride Month, so we as public health professionals are uniquely positioned to use both of these initiatives to improve the sexual and general health of gay men. Contrary to popular opinion, AIDS isn't going away in this group, and neither are many other maladies. Stay tuned for a discussion of other innovative programs for gay male communities, which are on the docket for this week.

June's almost over, but ...

Did you know that June is both Prevention and Wellness Month, as well as Men's Health Month?

Since we are probably all familiar with at least some basic components of Prevention and Wellness (a kind of nebulous term, don't you think?), I thought it would be good to bring up health problems that are specific to men. As a woman, this is something that isn't exactly on my radar, so we'll be learning together!

The Agency for Healthcare Research and Quality has created a site called Healthy Men that provides educational information for men's health issues. There's no denying that health concerns differ between the genders. The site tells us:

• Men are 24 percent less likely than women to have visited a doctor within the past year and are 22 percent more likely to have neglected their cholesterol tests.
• Men are 28 percent more likely than women to be hospitalized for congestive heart failure.
• Men are 32 percent more likely than women to be hospitalized for long-term complications of diabetes and are more than twice as likely than women to have a leg or foot amputated due to complications related to diabetes.
• Men are 24 percent more likely than women to be hospitalized for pneumonia that could have been prevented by getting an immunization.

Honestly, when I think of men's health, my mind goes right to low testosterone and prostate cancer, not diabetes and cholesterol. I believe that even though men are more likely to have congestive heart failure, more women have heart attacks. It's kind of late at night, so I'm not going to check that fact, but I would never have thought of these specific health concerns as gender-based.

Think of how often we see campaigns to increase screening and awareness about cervical cancer, breast cancer, and other women's issues. Heck, the pink ribbon overtakes our entire society every October. But when was the last time that you heard someone speak candidly about prostate cancer, amputation, or even ED (although that was quite a phase when Bob Dole started discussing it)?

As a card-carrying feminist, I believe I have the right to assert that everyone's health issues should be considered equal; although we ought to acknowledge that men have certain advantages because of their gender (and women have other advantages), we should also recognize that the patriarchy works against some men, as well. I doubt that many have access to appropriate screening or medical care results in poorer urban and rural areas

... and yet, in my public health curriculum, I hear almost nothing about interventions involving grown men. Women and children, yes, or the entire population of an area. But when was the last time we read an article for class, or discussed a program, that was targeted toward men's health? Again, although we may have this concept that the patriarchy allows all men to access all available resources, nothing could be farther from the truth.

Strangely enough, maybe it is time for us to start acknowledging the unique health problems faced by men, which are often exacerbated by their refusal to visit doctors. Let's not forget that public health is here for all of us. Even the feminists can rally around that.