Twitter - Will Courtenay - The Men's Doc

 

AFRICAN AMERICAN MEN EXPERIENCE
DISPROPORTIONATE RISK FOR DISEASE & DEATH

We're hearing more about the gender gap in longevity, with women outliving men by more than 5 years. But Dr. Will Courtenay demonstrates in his work and research that the longevity gap between African American men and women — as well as Black and White men — is even bigger.

On average, African American men die 6 years younger than White men and 7 years younger than African American women. The gender gap among African Americans remains true for most diseases. Black men, for example, are almost twice as likely as Black women to die from cancer.

Compared to White men, Black men experience disease earlier, suffer more severe disease, have more complications, and less access to medical care

Black men are also less likely than White men to receive state-of-the-art treatments

Black men are nearly 2½ times more likely to die from prostate cancer than White men and more than 5 times more likely than Asian men to die from the disease.

African American men are 8 times more likely than European American men — and 24 times more likely than Asian American men — to die from HIV disease

Homicide ranks among the 5 leading causes of death only for African American men — not for men of any other ethnic group.

Despite their high risks, 45% of Black men do not have a doctor they see regularly, compared to 33% of White men — which contributes to why Black men are more likely than White men to be first diagnosed with advanced-stage cancer

Among boys, 25% of Blacks and 17% of Whites have no usual source of health care

Among men ages 20 to 29, Whites have 1½ times more doctor visits than Blacks

In his new book, Dying to Be Men, Dr. Courtenay pulls back the curtain on how Black men's beliefs about masculinity directly influence their health. In general, the more traditional a man's beliefs, the greater his health risks — but not always. Some traditionally masculine traits can actually improve Black men's health.

 

African American Men's Health

Men in general have higher rates of mortality than women for all of the leading causes of death. This remains true for African American males who have higher mortality rates than African American females for all of the 10 leading causes of death except diabetes, which kills almost equal numbers of males and females. Many of these differences are significant. Death rates for African American males are at least twice that of African American females for most of the leading causes of death — and up to 5 times greater for some causes. In fact, the differences between African American males and females is greater for most of the leading causes of death than the differences between African American males and Caucasian American males. Women in general in this country outlive men by 5 years; African American women outlive African American men by 7 years. Women living longer is not a universal phenomenon — there are countries in the world where men outlive women. In fact, in 1920 there was no difference in the life expectancy of men and women.

The biggest gap in the mortality of men and women occurs between 15 and 34 years of age. For the college-age population, those 15 to 24 years old, 3 out of every 4 deaths are male. For African Americans, 5 out of 6 deaths in this age range are male. The death rate (per 100,000 population) for college-age African American males is nearly twice that of college-age Caucasian American males. In the very least, 86% of all college-age African American male deaths are preventable — and violent — the result of an accident, homicide, or suicide. This is 36% more than their Caucasian American peers. Among college-age Caucasian American males, half of all deaths are due to accidents, homicide, and suicide combined. Males in general are more often both the perpetrators and the victims of homicide. Homicide is the leading cause of death for college-age African American males who are nearly 7 times more likely than their female peers to be victims of homicide and 9 times more likely than their male Caucasian American peers. African American males account for half of all homicide deaths in this age group. In fact, half of all the deaths of college-age African American men are due to homicide. Everyday, 8 college-age African American males are victims of homicide.

Accidents are the second leading cause of death for college-age African Americans and they claim 3 times more lives than the next leading cause of death. Accidents are responsible for nearly half of all college-age male deaths. College-age African American males are 4 times more likely to die an accidental death than their female peers. Everyday, 4 college-age African American men die accidental deaths. Three out of every 4 accidental deaths among those of college age are due to motor vehicle accidents. The motor vehicle death rate for college-age African American males is nearly 4 times that of their female peers. Drowning is the second leading cause of accidental death. Among college-age African Americans, 12 times more males than females die from drowning. Drowning accounts for 10% of all accidental deaths of college-age African American males — a percentage twice that of college-age Caucasian American males.

Males also have significantly higher injury rates than females. For males in general, aged 1 to 44, injuries account for more death and disability than all communicable diseases and other conditions combined. There are, for example, an estimated 3 to 5 million sports injuries annually and the vast majority are sustained by men.

Suicide is the third leading cause of death for college-age African Americans. While the suicide rate for the total population has maintained a flat trend since 1946, rates for those of college age has increased 250%. Five out of every 6 suicides among those of college-age are males. The death rate for suicide among college-age African American males is 6 times that of their female peers. Everyday, a college-age African American men intentionally takes his own life.

Cancer is the fourth leading cause of death for African Americans of college-age. African Americans in general have higher cancer incidence and mortality rates than Caucasian Americans. Males, in general, also have higher incidence and mortality rates for nearly every type of cancer common to both sexes. While there is a 19% excess of African American male rates of cancer over Caucasian American males, among females the rates are higher for Caucasians Americans. The cancer death rate for all African American males is nearly double that of African American females and the cancer death rate for college-age males is nearly one and a half times greater than that of their female peers.

For all African Americans, lung cancer is the leading cause of cancer death. Over twice as many African American males than females die from lung cancer. Prostate cancer is the second leading cause of cancer death among all African American males and is responsible for more deaths among African Americans than female breast cancer. Incidence rates for prostate cancer are 40% higher for African American males than Caucasian American males. Incidence rates for colon and rectum cancer, the third leading cause of cancer death among African American males, appear to be declining for all groups except for African American males. Rates for cancer of the esophagus are over 3 times higher among African Americans than Caucasian Americans and the death rate for all males is 4 times that of females. Pancreas cancer is 30% more common in males and occurs about 40% more frequently in African Americans than Caucasian Americans. For all cancers combined, the 5-year relative survival rate is 10% lower for males than females and 16% lower for African Americans than Caucasian Americans.

Among college-age African Americans, leukemia is the leading cause of cancer death. While often thought of as a childhood disease, leukemia will strike 10 times more adults than children this year. The death rate for leukemia among African American males of college-age is one and a half times that of their female peers. The second leading cause of cancer death for college-age African American males is non-Hodgkin’s lymphoma. Their death rate from this cancer is over twice that of African American females. Testicular cancer represents the most common solid tumors for men of college age. The death rate from testicular cancer for college-age African American males is the same as that of breast cancer for college-age Caucasian females.

 

For college-age African Americans, heart disease is the fifth leading cause of death. The heart disease death rate for African American males is one and a half times greater than that of their female peers and over 2 times greater than that of their male Caucasian American peers. The incidence of stroke (a form of cardiovascular disease and the tenth leading cause of death for college-age African Americans) is 30 percent higher for men than women and 60% higher for African Americans than Caucasian Americans. High blood pressure and hypertension contribute to these higher mortality rates from cardiovascular diseases. Nearly twice as many African American males than females have high blood pressure and one and a half times more males have hypertension. Compared to Caucasian Americans, African Americans have moderate high blood pressure twice as often and severe hypertension 3 times as often.

HIV infection is the sixth leading cause of death for African Americans of college-age. Males in general account for 83% of these deaths in this age group. One out of every 4 males who die from HIV infection is African American. The HIV infection death rate for college-age African American males is over 3 times that for both African American females and Caucasian American males. The proportion of those with HIV infection who are under 30 has increased from 22% to 43%. One out of 5 males who die from HIV infection is between 20 and 29 years of age.

Surprisingly, most African Americans and most men rate their own health as excellent or very good. In fact, more men than women rate their health as excellent or very good despite their consistently higher rates of mortality.

Alcohol and Other Drugs. Alcohol and other drugs are implicated in many of the diseases, injuries, and deaths of men. In fact, the use of all substances is greater among men than women and for some substances the rates are significantly higher. Men far outnumber women in terms of problem use and addiction, and negative social consequences resulting from use. Three times as many African American males as females use alcohol once a week or more. And death from liver disease reflects this. The death rate for African American men are more than one and a half times that of Caucasian American men and almost two and half times that of African American women. Alcohol is also implicated in nearly half of all deaths caused by motor vehicle accidents and fatal intentional injuries such as suicides and homicidess — which college-age African American males are particularly at risk for. Cocaine is also used more by African American males. Twice as many African American males than females use cocaine once a week or more. Cigarette smoking too is greater among men than women and initiation peaks at 17 to 19 years of age. One in 5 college-age African American males are current cigarette smokerss — more than twice the number of their female peers.

Violence. Violence poses a major threat to everyone. And young men are responsible for much of this violence. Arrests of males under age 24 account for nearly half of all arrests for serious crimes, including those for murder, rape, robbery, and assault. But while men are most often the perpetrators of violence, they are also most often the victims. In fact, males in general are nearly twice as likely as women to be victims of violent crimes. This is when rape is included and murder isn’t. And males are 3 and a half times more likely to be murdered.

African American men are particularly at risk. Everyday, 16 college-age African American males die and 14 of these deaths are violents — the result of a homicide, accident, or suicide. The number college-age African American males who die from violence is more than 5 times the number of females. Physical fighting is the most typical precursor of homicides and most victims are killed during an argument, many by persons they know. In fact, the risk of violence in general is greatest among acquaintances, friends, and family. The most common form of family violence occurs between siblings and more sibling violence occurs in families with only sons. Almost half of all college students with siblings report having been victims or aggressors of violence.

Prevention. Most disease, injury, and death among men is preventable. The male gender role plays an important part in men’s health. In fact, most of the difference in the life expectancy of men and women can be accounted for differences in gender role behaviors. Uncontrolled lifestyle habits are the most significant contributors to men’s mortality. Men are more likely than women to engage in all kinds of risk-taking behavior, whether in work or play

.Men’s higher lifetime intake of tobacco products in now considered the foremost reason for their higher cancer rates and a principal reason for their higher heart disease rates. Smoking, for example, is responsible for 90% of lung cancer cases among men and more than 1 in 3 African American males smoke cigarettes. Men’s greater alcohol intake also contributes to their higher rates of heart and liver disease. And African American males have death rates from liver disease nearly twice that of Caucasian males. Health Behavior and Help-Seeking. The health and help-seeking behaviors of men also contribute to their disease and death. Men in general underestimate their illness more than women. For example, most males in general, and more males than females, rate their own health as either excellent or very good. Men engage in less preventive health care than women do and are less likely to restrict their activities. And men are less likely to seek help from medical or mental health professionals.

Men’s delays in seeking help and their fewer check-ups can have a significant impact on their prognosis. With early detection, about 90% of men with various cancers would survive. But men don’t get the help they need. For example, an annual digital rectal exam is the number one recommended procedure for the early detection of prostate cancers — the second leading cause of cancer death among African American males. Yet, over half of African American men ages 40 or older have never had a digital rectal exam and most of these men have never heard of the procedure. And while testicular cancer can be successfully treated when detected early, the vast majority of male college students do not know they’re in the high risk age group and don’t know how to perform a self-testicular exam.

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