BlogWonks

Tim Russert’s untimely death from a sudden heart attack reminded me of the dramatic 50+-year-long gender disparity against men in health care research and outreach.

Many more men than women die of sudden heart attack and at an earlier age than do women of breast cancer.

Indeed, sudden heart attack is the #1 cause of premature death among men over 40. Yet, more money per capita is spent on breast cancer research.

And regarding outreach, there are a trivial number of prostate cancer ribbons compared with the number of pink ribbons against breast cancer. And have you ever seen even one ribbon against sudden heart attack?

More broadly, men die 5.3 years younger than women, and spend their last decade in worse health. There are more than four widows for every widower.

Yet when I searched PubMed, which indexes 3,000 medical journals over the past 58 years, I found 22,304 articles with the keywords “women’s health,” but only 586
with “men’s health.” That’s 39 articles related to women’s health for every one on men’s.

If women suffer a deficit, for example, the “underrepresentation” of women in engineering, we typically see significant efforts at redress. Yet, when men have the deficit—even the ultimate deficit: they die younger—not only is there not redress, but the opposite occurs: disproportionate amounts of research and outreach are directed at women’s health.

I’ve heard these explanations to justify the double standard:
1. “It wouldn’t happen if, like women, men organized to protest.”
My response: Would you deny redress to women who are “underrepresented” if they hadn’t organized to protest?
2. “Men’s dying younger is their fault—if they’d only take better care of themselves.”
My response: The three major controllable causes of mortality and morbidity are obesity, smoking, and excessive drinking. Men have lower incidences of the first two. In any event, if women are “underrepresented” in engineering, would you deny them the redress by chastising them, “It’s your own fault. Do better in science and math.”?
3. “In the past, most health research was done on men. This only levels the playing field.”
My response: First, as cited, over the past 58 years—the period during which the greatest medical advances have been made—the opposite is true. And with regard to research that’s more than 58 years old, an underreported reason why women were often excluded from many experimental treatments was not lack of interest in women’s health but a concern that an experimental drug or treatment might damage a woman’s fetus.

And en toto, any deleterious effect that came from a smaller percentage of women being subjects in 58+-year-old medical research apparently was small: In, fact, the
life-expectancy gap in favor of women grew during every decade but one from 1900 through 1980.

The big question is why:
— Why do you think that, for the past 50+ years, the overwhelming majority of health care research has been on women’s health, despite men living shorter and in poorer last-decade health?
And consider these other male-death-related questions:
— Why do 92% of workplace deaths occur to men yet we rarely hear that statistic, while we frequently hear statistics such as, “Women earn 79 cents on the dollar compared with men?” (By the way, that statistic is misleading: Most current evidence suggests that for the same work, pay is, on average, roughly equal.)
— Why, still, must only men register with the U.S. military’s Selective Service?
— Why, still, are only men allowed to serve in direct combat? (resulting in the little-publicized fact that 99% of the Iraq War deaths were men.)
— Why do the media emphasize when deaths occur to “women and children?”

I agree with men’s advocate Warren Farrell, who is the author of nine books including The Myth of Male Power and who has taught at Georgetown and the School of Medicine at U.C. San Diego. He believes the main reason is sexism: “Men are the disposable sex.”

Many of us have the opportunity to be gender-neutral or biased toward or against men in our professional lives.

For example, consider all the choices that higher educators can make:

— Which students to admit to your program
— Which readings to assign
— What content to present in class
— What research agenda to pursue
— Who to select as your research assistant
— What student thesis and dissertation topics to encourage
— Who to hire as a faculty member or administrator
— To whom to grant tenure
— Which studies to fund. (For example, should sudden heart attack studies be given higher priority?)

At this point in time, what do you think is the wisest stance for you, personally, to take?