Discrepancies between men’s general perceptions of their personal health and the realities of their health problems have been noted for many years. While men report that they are in better overall health than do women, men lead in most of the top causes of death and consistently die earlier than women.

In Southeastern Pennsylvania in 2002, 17.8% of men 18 years of age and older were in fair or poor health; this percentage represents 239,200 men in the region. Men reported an average of 3.03 days per month when their physical health was not good and 2.83 days when their mental health was not good. The following data from PHMC's 2002 Southeastern Pennsylvania Household Health Survey describe the health status, utilization of services and health promotion behaviors of men 18 years of age and older in the region.

Chronic Health Conditions:

A substantial number of men in Southeastern Pennsylvania are not in good health. The data show that approximately one-quarter of men in the region has a chronic health condition; this percentage represents 337,100 men with an ongoing health problem.

• Of health conditions reported among men, 28.2% have high blood pressure, 26.6% have high cholesterol, 10.2% have a heart condition, 7.9% have diabetes, and 9.4% have a diagnosed mental health condition.
  
• Older men are more likely to have a chronic health condition compared to younger men. Not surprisingly, men ages 60+ are almost twice as likely to have a chronic health condition (47.6%) than are men ages 40-59 (27.3%).
  
• More than one-half (52%) of men 60 years of age and older have high blood pressure compared to younger men ages 40-59 (29.2%).
  
• Asians are the least likely racial/ethnic group to have a chronic health condition (9.4%), followed by whites (25.6%), blacks (27.2%), and Latinos (27.3%).
  
• Asian men are less likely than other racial/ethnic groups to have high blood pressure (12.3%). Black men are the most likely group to have high blood pressure (38.2%).
  
• Poor men are almost twice as likely to have a chronic condition compared to the non-poor (40.3% and 23.9%, respectively).
  
• Four out of ten poor men have high blood pressure compared to less than three out of ten non-poor men  (39.3% and 27.2%, respectively.)
  
• More than one out of five men in the region are obese (22.1%) and 44.9% are overweight; these percentages represent 893,300 men in the region with a weight problem.
  
• Men 40-59 years of age are more likely to be obese (25.1%) than are men 18-39 (20%) and men 60 years of age and older (21.3%).
  
• Slightly less than one-third of black men are obese (31.4%). This is higher than for Latino (26.8%) and white (20.9%) men. Asian men are the least likely racial/ethnic group to be obese (4.2%).

Health Behaviors

• Many prevalent health problems can be prevented or their severity lessened by engaging in healthier behaviors. This includes refraining from smoking and getting regular exercise.
• One in five men age 18 years and older smoke cigarettes (20.9%); this percentage represents 281,000 men in the region who smoke. Of these men, almost half have tried to quit in the past year (46.1%).
• Older men 60 years of age and older are less likely to smoke cigarettes (12.5%) than are younger men ages 40-59 (22.6%). Men 18-39 years of age are the most likely age group to smoke cigarettes. Almost one-quarter of men in this age group smoke cigarettes (24.2%).
• Asian (16.9%) men are less likely to smoke cigarettes compared to other racial/ethnic groups, followed by black (24.0%), Latino (21.8%) and white (20.3%) men.
• Poor men are one and one half times as likely to smoke cigarettes compared to non-poor men (34% and 19.8%, respectively.)
• Almost one-third of men exercise regularly (more than three times per week), representing 454,100 men in the region.

Utilization of Services

Many men do not know they have a health problem because they are not as likely to be regular users of the health care system. In Southeastern Pennsylvania, more than one out of five men did not go to a doctor in the past year (22.5%). Thirteen percent do not have a regular source of care, a critical factor in receiving timely care and preventing many health problems. Among men who have a regular source of care, 88.8% go to a private doctor’s office for their care.

• One-third of Latino men do not have a regular source of care (30.3%) compared to black (14.2%) and white (12.2%) men.
  
• Poor men are less likely to have a regular source of care compared to the non-poor (17.8% and 13.6%, respectively.)
  
• More than one-quarter of men do not have dental coverage (27.6%) and 12.8% do not have coverage for prescriptions.
  
• Greater than eight percent of men do not have health insurance coverage; this percentage represents 113,200 men without private or public coverage.
  
• Nearly one-quarter of Latino men are uninsured (24.2%). This is higher compared to Asian (15%), black (10.9%) or white (6.6%) men.
  
• Poor men are three times more likely to be uninsured (22.5%) than are non-poor men (7.2%).

Health Promotion Behaviors

Receiving routine screenings and exams is critical in preventing or lessening the severity of many health conditions. While the majority of men do get these recommended tests, many men in Southeastern Pennsylvania still fail to receive potentially life saving exams.

• An estimated 165,000 men 18 years of age and older did not have a blood pressure reading in the past year, and 33.6% did not have their cholesterol checked. 
  
• Among men who did not have these tests, the most frequently cited reasons for not having the tests were:  men not thinking they needed the test, not feeling motivated to get the tests, a doctor did not recommend the test, and the cost of the test.
  
• Men 60 years of age and older are more likely to have had a blood pressure screening (97.2%) in the past year compared to men ages 40-49 (88.5%) and those ages 18-39 (81.2%).
  
• Black men were more likely to have had a blood pressure screening in the past year (90.5%) followed by white (88.3%), Latino (79.7%) and Asian (71.8%) men.
  
• Three out of ten men 50 years of age and older have not had a prostate exam in the past year (30.2%) and 8.6% (44,300 men) have never had a prostate exam.
  
• Younger men ages 50-59 were less likely to have had a prostate exam in the past year (58.1%) compared to men ages 60-74 (78.3%) and men 75 years of age and older (76.8%).
  
• Asian men 50 years of age and older were least likely to have had a prostate exam in the past year (39.2%) followed by Latino (55.2%), black (70.8%) and white (70.6%) men.
  
• Nearly one-half of men age 50 years of age and older have not had a blood stool test in the past year (47%) and 16.7% have never had a blood stool test. Almost four out of ten men have never had a sigmidoscopy or Colonoscopy (36.8%).
  
• Older men 75 years of age and older were more likely to have had a blood stool test in the past year (61.4%) compared to men ages 60-74 (57.3%) and those 50-59 (44%).

The above data clearly indicate the need to increase the delivery of targeted health education messages to men with attention focused on how men of varying age, racial/ethnic backgrounds, and income are affected. Attention should also be focused on the psychological, social and economic barriers facing men in order to target appropriate services to this population. For more information about men’s health, contact Francine Axler at (215) 985-2521 or Francine@phmc.org.