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The Black Woman's Guide To Black Men's Health

Warner Wellness

Chapter One

If we are paying attention, we are usually the first to notice when something, even if it is "a little something" is wrong with the men in our lives. We know when he "favors" one side or the other when he walks, because of hip or back pain. We almost always are the first ones to notice when he gains or loses weight. We know when he's not quite himself. As we mentioned earlier, studies show that men who have women in their lives are healthier and live longer than men who are single and isolated.

Even though we have a long way to go before we get straight As on our approach to our own health, we do seem to be doing slightly better than our men. Even with issues of ability to pay for medical care, or access to places to get care, women seem to be better at interacting with their health care providers. Why?

THE MESSAGES OUR CULTURE SENDS

There are many reasons why our black men are not taking the lead on their health care. When we think about why this is, we have to look at the way they have been socialized and the messages that we send them. Margaret Aguwa, DO, and the chairperson of Family and Community Medicine in the Michigan State University College of Osteopathic Medicine, has developed great relationships with her male patients over the years. Dr. Aguwa says, "From all my years of practice, the thing I could detect in men's faces and demeanor is the apprehension. They are apprehensive about being in the doctor's office, about answering questions about their bodies, and about being poked and ordered around. They are even apprehensive about the instructions and recommendations, even simple recommendations like eating healthy and exercise." Dr. Aguwa says she thinks that it is that apprehension that prevents our men from expressing symptoms and concerns associated with their health and well-being, mostly about taking better care of themselves.

Jean Bonhomme, MD, head of the Black Men's Health Network, says that part of the problem is that black men fear being mistreated in the medical system. There are stories of people of color being mistreated, treated with substandard care, or treated as if they didn't exist, so many men avoid health care at all costs. And sadly that choice indeed has a high cost for many of our men who get late diagnosis and treatment of illnesses that could take their lives prematurely.

As a society, we build high expectations of superhero strength of black men. The message that we send our boys and men is that they have to be strong, no matter what. We expect them to push themselves. Our culture tells our men that they aren't really sick until they are doubled over in pain. You will read many stories in this book of men who did not seek out care and treatment until the pain became too much to bear. The pain was what told them that maybe they should get some help. The other thing we know is that men and women get different messages about the medical system and when they should seek out care. Women are more accustomed to dealing with doctors and getting the needed attention for ourselves and our children than men, who mostly show up for medical attention in a crisis situation.

WHY IS THE MEDICAL EXPERIENCE DIFFERENT FOR WOMEN?

Let's look at a woman's interactions with doctors. When we are born, we are on a level playing field when it comes to our health. These days most black boys and girls are delivered by a medical system of some kind. It could be an obstetrician, it could be a nurse midwife. From there, black boys and girls are probably seen by a pediatrician or a nurse in a clinic, who monitors their growth, keeps them up to date on their immunizations, takes care of their ear infections and rashes, and calms down their anxious parents.

Then around adolescence something happens. Children of all ethnicities start seeing the doctor less. They've had their immunizations. They don't get earaches. And they tend not to be that sick. Between the tween and teen years (ten to eighteen), most youth, both male and female, are getting physicals only in order to participate in a school activity or are being seen for an injury from sports. So in fact, during those early teen years, a boy may actually be seen by a doctor or nurse practitioner more often than a girl who is not active in sports.

Of course there are exceptions. Both boys and girls who have chronic illnesses, such as juvenile diabetes, or asthma, which is a huge problem among our black boys and girls, may be seen more regularly to manage their conditions.

Many young black women have their next interaction with a doctor once they become sexually active, if they are planning on using prescription birth control methods, or if they think they have developed an infection or a sexually transmitted disease (STD) that has symptoms. For these reasons, they head to the doctor or to a clinic. Then the next big event that brings a woman to her doctor is pregnancy. Well, this is the true fork in the road for males and females when it comes to their health. There is no event like childbirth that requires a male to seek out medical attention. A man doesn't need a doctor to prevent him from becoming a father or to become one.

The American Academy of Family Physicians says that where doctors usually see women in their peak childbearing years, men don't usually come in for a physical unless their jobs require it, or until they hit their forties or fifties, if then. And if the man is coming in for the first time at that age, you can almost bet that it is at the "gentle encouragement" of a woman in his life. Some men say they got taken to the doctor or hospital kicking and screaming, but they went.

Through watching their fathers, grandfathers, uncles, and buddies, black men actually learn to ignore the messages their bodies are telling them. They learn bad habits that can last them a lifetime.

A Harris study of over 4,000 men and women funded by the Commonwealth Fund says that three times as many men as women don't have doctors. And they aren't getting screened for life-threatening illnesses. The study says that men put off going to the doctor because they are not comfortable discussing their health issues. They tend to show up for medical attention when they are in so much pain or discomfort that they can't ignore the symptoms anymore. And at that point, it could be too late.

Ronald Bishop, MD, is a family medicine doctor who talks to black men about their health on a regular basis. "I think that the state of health for black men is due to lack of early education. We need to get them to understand the value of health care," he says. "They don't understand that what they do in early years will be a reflection of their health when they get old." Dr. Bishop suggests that women keep hammering home the message that almost every disease is either preventable or treatable, if it is caught early. He says this is one of the reasons why it is so important for black men to develop a dialogue with their doctors.

Dr. Bishop recommends an annual physical for all his male patients - at bare minimum, as a part of good health maintenance. He says that the younger they start with this routine maintenance the better. "I like to get them started at age thirty," he says.

By flipping the script on the way our men interact with health care providers, we can help them get the jump on many life-threatening diseases. A man who...