PowerPoint; Dying to Stay Alive: The Health Issues of Men; Male Denial Factor

Production and broadcast of PowerPoint is made possible in part by a grant from the Corporation for Public Broadcasting and by the National Legacy Foundation. This is PowerPoint, an information -age clearinghouse for news, issues, and ideas that impact the African -American community, the nation, and the world. In general, men rate their health as excellent, despite their higher rates of mortality. According to men's health consulting, African -American men have higher death rates than any other population. In the U .S., men have higher rates of mortality than women for all of the leading causes of death. I'm Carmen Burns and next on PowerPoint, dying to stay alive, the health issues of men. But first, the news. This is the news on PowerPoint. I'm Fonda Smith. NPR's Don Gagnet says the White House reports

there is no timeline or date established for the handover Saddam Hussein to authorities of the incoming Iraqi government. President Bush says there are details regarding security that still need to be worked out. All the White House is saying at this point is that discussions are underway. In effect, they're negotiating the handover of Saddam Hussein to the incoming Iraqi government. The concern the White House has is one of security. The president at this news conference in the Rose Garden said that he wants to make sure that the Iraqis have a plan in place so that Saddam will be held securely before he goes on trial. And the president stressed Saddam Hussein needs to be brought to trial. The American General formerly in charge of the Abu Jarab prison says she was told she could mistreat Iraqi detainees. Brigadier General Janis Carpinski told the BBC that the permission came from the man now in charge of U .S. prisons in Iraq. NPR's Jackie Nordham

has more. Both serious charge that she's making is that her successor, a major general Jeffrey Miller, told her that detainees should be treated, quote, like dogs. And then if you don't treat them that way, then you lose control of them. Serious allegations here and ones that were responded to very rapidly by a spokesman for the detention operations in Iraq. They say these statements made by General Carpinski are categorically false that detainees are not treated that way. And certainly that major general Miller never made these statements. State Department officials say 10 countries could face sanctions because they are not taking steps to prevent trafficking in human beings. But Secretary of State Colin Powell says there is progress in some nations. We're pleased that some countries have moved up and out of tier three status. Belize, Bosnia and Herzegovina, the Dominican Republic, Georgia, Greece, Kazakhstan, Suriname, Turkey, and Uzbekistan. Unfortunately,

several countries have slipped downward to take their place. The Justice Department has charged a Somali man with plotting to bomb a shopping mall in suburban Columbus, Ohio. Attorney General John Ashcroft says Nouraddin Abdi is also charged with helping Al Qaeda. Material support of terrorists is a serious crime that places the lives of innocent people at risk and endagers our nation's security. Our citizens are threatened as much by the financier, the trainer, the planner of the terrorist attacks as they are by those who actually carry the attacks out. The U .N. Security Council established a new expert panel Thursday to assess Liberia's compliance with sanctions that include embargoes on diamond and timber exports. The interim Liberian government led by Gayo Bryan, who replaced Charles Taylor after he fled into exile in August, once the embargoes lifted. The sanctions were imposed on Taylor's regime beginning in 2001. Last week, the council decided that peace in Liberia was still too fragile to lift the sanctions, but

acknowledged that the West African country had made progress toward beating the conditions for ending the embargoes. A U .N. Tribunal trying the alleged masterminds of Rwanda's 1994 genocide convicted a former Rwandan mayor at Thursday for his role in the slaughter sentencing him to 30 years in prison. Sylvester E. Guma -Statis, 57, was convicted by the International Criminal Tribunal for Rwanda of Genocide, extermination, and rape for ordering the killings of minority tootsies in the southeastern commune of Rosomal, where he was mayor. From September 23 through the 26th, the City of Atlanta, already a 21st century portal to the world, will be the setting for Ghana Expo 2004, a trade, investment, and cultural affairs conference focusing on Ghana the gateway to Africa. The City of Atlanta and Ghana's national government have made strong commitments to the event, which will include participation of more than 400 international businesses, dignitaries, and officials from the U .S., Africa, and United Kingdom.

That is the news on PowerPoint. I'm Fonda and welcome back to PowerPoint, I'm Carmen Burns. Before we continue with the program, we'd like to take some time on Father's Day to honor a special father who recently passed away. Ralph Wiley died from heart failure last Sunday at the age of 52. Some of you may recognize him as one of PowerPoint's original hosts, but Ralph was well known

before he anchored this program. As a writer, his stories and ideas were read and seen everywhere from the Oakland Tribune to sports illustrated and ESPN. His resume also includes collaborations with Spike Lee, Johnny Cochran, Dexter Scott King, and other prominent African Americans. Whether the subject was sports, culture, or race, Ralph's straight no -chaser style brought simple clarity to complex issues. Reporter Charles Edwards has this tribute. Hard work and having a loving mother pays off. If that's not true, then Ralph Wiley would have never gained the skill of telling it like it is. Thanks to his mother Dorothy, reading to him at an early age, Wiley was exposed to works of Richard Wright and others. His love for literature and writing carried him through school where he played a number of sports and write to his first journalism job as a copyboy for the Oakland Tribune. After a year, he was promoted to sports writer and later moved on to sports illustrated. For nine years at SI,

his 28 cover stories showed America the human side of professional athletics. Roy Johnson, the magazine's assistant editor, says Wiley bypassed the scoreboard and game stats and focused on using sports as a way to report on society. Tony Regusters agrees. Ralph and his inimitable style always was able to be a hot knife through butter and cut right to the point. As co -founder of Powerpoint, Regusters recruited Wiley to host the program in the late 90s and right off the bat, Ralph's voice stood out. His delivery, much like his writing, was hard, strong, and straightforward. Here he is setting up one conversation about Black women. For the African -American community, the primary architect who has designed the way for us to enter the psychological, intellectual, and emotional promise land, called the 21st century must be women of color, particularly Black women. Yes, but make no mistake, Black men have strived accomplished and suffered mightily, yet the Black woman has been the

wellspring of history. And another discussion on the Black family. Must pay attention to ideas in the now, which promote the kinds of positive family values needed to help transform our community. As his career evolved, Ralph Wiley maintained a passion for literature, in particular the works of Mark Twain. Powerpoint co -founder Tony Regusters says Wiley viewed Twain as an essayist and writer who had such a sharp wit. And he also gave the concept of the Black male as more than just a chattel

and hated the concept of racism. And Ralph saw that and recognized it, started getting into Mark Twain and started getting other Black people who were friends of his to, you know, read Mark Twain. He was always talking about, you know, you got to read Mark Twain. You want to find out what's really happening, read Mark Twain and he'll break it down for you. And Ralph was a person who constantly broke it down. Through his career, Ralph broke it down by writing more than five books, including his most famous why Black people tend to shout. But he never raised his voice while hosting Powerpoint. In fact, he had a signature way to end every show. Our Powerpoint listeners and callers. Join us again next week. This is Ralph Wiley. We're out. For Powerpoint, I'm Charles Edwards. We'd like to wish everyone a happy Father's Day. I'm Carmen Burns and welcome back to Powerpoint. This is Men's

Health Week. And did you know that compared to women, men are less likely to see themselves as ill or susceptible to disease or injury. No less about health and take responsibility for it. Take less responsibility for it. Represent 50 % of the workforce, but account for 94 % of all on the job fatalities and have higher death rates for all 15 leading causes of death and die six years younger than women. Why do men think they're at the top of their game? Well, to discuss the health disparities apparent in men, Powerpoint welcomes by phone, Dr. Lewis Sullivan, former U .S. Secretary of Health and Human Services, founding Dean, director and current president of the Morehouse School of Medicine. Also joining us by phone in Atlanta, Dr. Kevin McGowan, who is a general and laparoscopic surgeon with an emphasis on health education and health behaviors. Gentlemen, welcome to Powerpoint. Thank you. Thank you. I'd like to remind

our listeners that the Powerpoint Hotline number is 1 -800 -360 -1799 -1 -800 -360 -1799. Dr. Sullivan, let's start with you. What is the number one health risk for men? The number one health risk for men is heart disease. And let me also say, Carmen, I've now president emeritus at Morehouse School of Medicine since July of 2002, but still very interested and very active in various health issues, including men's health. But coming back to your question, heart disease is the number one killer for men of all racial groups. But there are a number of other causes of death that men suffer to a much greater degree from than do women, certainly injuries, cancer and a number of other conditions. So men's health is a very important health challenge. Why is it that men don't really pay attention to

the risk factors for heart disease? Well, I think it's a number of factors. First of all, it's the macho complex that men have, feeling that they really are not susceptible to all of these things. Secondly, that to be concerned about health is not really a masculine. Three, they are distracted by concerns of job security, earning wages for their family, etc. So all of these factors combine so that for men, they really do not give the attention to their own health that they should. And in many families, it's really the woman who sees that the men do come in for checks on their health. And that really is a very important resource when it comes to men's health. Our number is 1 -800 -360 -1799 -1 -800 -360 -1799. Joining us also in studio tonight, Dr. Jean Bonhomme, president and co -founder of the National Black Men's Health Network,

and senior faculty associate in the School of Public Health at Emory University. Dr. Bonhomme, high blood pressure is considered the silent killer. And according to the American Heart Association, one in four adults has high blood pressure and don't know it. At what age should people pay particular attention to their blood pressure? You know, we're actually seeing cases of elevated blood pressure in people in their teens, especially among African Americans. This is common knowledge. African Americans are more susceptible to high blood pressure. So really, screening should begin in the teens and definitely continue all throughout life. I would definitely recommend a yearly blood pressure check for everyone. You mean starting at like 13, 14, 15, 15, 15? Okay. 1 -800 -360 -1799 is our number. Now, Dr. McGowan, why is it that Dr. Sullivan went into some details about why he believes that men think they're so healthy and can't, and oh, just it'll pass or I'll feel better tomorrow sort of thing.

What is it going to take for us to get more men to see their doctors on a regular basis? That is a million dollar question, and that is why folks like your panel tonight, guests tonight, we're spending our college hours and efforts and energy is trying to figure out why men think the way we do. We have numerous statistics on the disparity in health in regards to the various races as well as men versus women, and I just keep thinking and understanding it. We're not talking about people who don't have education or degrees of higher learning or even have good jobs and good benefits. We're talking about folks who would be considered upper middle class or even lower upper class who still don't come to the doctor, and that is, it is the mean dollar question. That's what we're trying to help target. Dr. Bonom, you wanted to address that also. Yeah, I think one of the things we need to recognize is that the genders are taught to deal with pain differently from childhood. The way I like to put it is that if a boy skins his knee when he's eight years old, they tell him big boys don't cry. When he gets hurt playing sports, they tell him to take it for the team. So when

he's 50 and having chest pain, he says it's just in digestion. I think that it, but it's not a matter of intelligence or capability because you see how men take care of their cars. If it makes the slightest odd noise or burns one drop of oil, they're right on top of it. It's what men have been taught is important. Boys have been socialized for the most part to believe if something hurts, don't pay it any mind. It'll go away. In childhood, that's usually true. But in middle age, early symptoms can be the signs of progressive disease states like heart disease, a cancer, which can go from treatable to incurable if they're not addressed properly. Now, do those, the numbers that we talked about earlier that men are, they die younger, they represent 94 % of all the, on the job fatalities. Are these numbers just denial or is it just built into their DNA, Dr. Sullivan? I think a significant part of it is denial that it is not macho to really be concerned about a little pain or a little discomfort. Secondly, men are so distracted

by the challenges and the really look at their health that they should. And as I said before, increasingly we find that the sentinel in the family for health issues is really the woman. It is frequently the wife or the girlfriend who brings a man in for evaluation or for check or for care. So it is something that we have to really address in a way to say that it indeed is a responsible thing to see that your health is good because you have so many people depending upon you. And it is actually irresponsible not to be concerned and not to take those measures. See that you have good health. Our number is 1 -800 -360 -1799 -1800 -360 -1799. I'd like to hear from the audience, our listening audience, about why you think men don't go to the doctor as they should

or are some story about how maybe that little indigestion turned out to be something much worse than what you thought. Dr. Bonham, you wanted to add something in there as well. Yeah, I think what Dr. Sullivan was saying about the pressures of the workplace, I think I'd like to piggyback that and say that there are some jobs for which you need to learn to tolerate pain. I don't know if you've ever tried to work on the roof of your house in the summer, but I tried and it's hard to breathe up there. And you can feel the heat burning you through your shoes. So men who have to do heavy physical labor work tend to shut off their pain. And I think that's part of the problem. When you work at a job where you ignore your aching back, you don't necessarily turn your senses back on when you come home from work. But if something, if you know, I mean, intelligently, you know the symptoms of, or at least most people do now because they've been beaten into us about what the symptoms are for heart attack. And a lot of times what you might think is indigestion isn't if you have sharp chest pains,

you know, it's, everyone has been beaten over the head. I think to go see a physician to see someone one right away. But why is it that it just seems to conflict with your upbringing or that male psyche? Dr. McGowan, what do you think? Once again, it's the kind of thing that I see on a pretty regular basis. As you stated earlier, it's either the wife or the mother or girlfriend that brings the gentleman into to be seen by a physician. And once in our office, we're able to help prevent or at least diagnose things before they get too far gone and able to help educate them on some of the warning signs. And we see a lot of gentlemen, for example, who come in with, for example, rectal bleeding and they are prescribing to hemorrhoid disease. When, in fact, they may have a strong history, temperature, colon cancer, and those are the kinds of things that give me heartburn as a surgeon. Trying to get men to understand that prostate exams are not challenging their manhood and their sexuality, but in fact, making sure they don't

have any symptoms of any severe, serious diagnosis. I tell all the gentlemen that we see that anything I'm going to do to them is nothing compared to what we're trying to prevent happening to you. Dr. Sullivan, this kind of really transcends race. Yes, yes, we see this in men of all races. Denial is really, or suppression of symptoms is really very common because it's felt that it's not masculine to really admit to having pain or discomfort, concerned that if indeed there is something there, it'll go away and I will not actually be disrupted in terms of my job where I have to earn these dollars to support my family. So, so there are a lot of things that young boys and men are taught and a lot of things in the environment that suggest to them that they should ignore or

suppress these symptoms, but we need to turn that around and that's a challenge that all of us have. Well, it might help if mothers are allowed to say don't take one for the team and don't, you know, if you hurt, let us know. And I have to say that I did that with my son and as it turned out with a stomach ache, it turned out to be appendicitis as opposed to, you know, we continue to take him to follow up and take him to the hospital and it consists that he was seen after and now any little pain that he has, he comes to me and says this is hurting, is this wrong. So, I think that mothers need to get involved and start teaching their young boys early on and step in and say, if it hurts, let us know. I much rather see you and talk to you and examine you, your son, wherever he is in your family and reassure you that there's nothing really wrong. Right. That's much better than getting a call at three in the morning that you have a rupture appendix and you need to come in and take care of it. Oh, absolutely. 1 -800 -360

-1799 is our number 1 -800 -360 -1799. Terry and Ellen Wood, Georgia, listening to WCLK. Good evening, Terry. Thanks for holding. Thank you. I was just wondering your guests have mentioned that they were working toward educating men in their health. And I'm just wondering what's happening through sports programs in the schools? Wouldn't that be a good place? I mean, shouldn't coaches sort of instill some of this? Dr. Bono? Yeah. As a matter of fact, one of the things that connects women to the healthcare system early on is obstetrics and gynecology. I think that women get socialized. Some women don't go for their check -ups, but a lot of women get socialized to get their yearly exam when they may pick up high blood pressure and other problems. I think that sports would be an excellent way to connect boys to the same type of thinking that you get checked out in regard to sports for your suitability to play for possible injuries and maintain contact with the healthcare system by that means. Terry, have you seen any education in school at all as far as or outside

of the school where people are trying to instill in boys and youngsters that their health is so critical? No, not at all. Not at all, because coaches, a lot of times, will insist as Dr. Sullivan said, oh, just shake it off, just put some dirt on it, run and keep going, and that kind of continues that cycle. That is the wrong message, but I do know some people who do get the boys involved in check -ups. They're few and far between, but they do. And that would be excellent if we could get more people to do that. Absolutely, Terry. Does that answer your question? That does. All right. Thank you so much for your phone call. Now, the numbers tell us, as you mentioned earlier, Dr. Bonoam, that African American men have the highest rate of mortality in this country. Now, not having health insurance is one thing, but all the African American men that die aren't uninsured or poor. And that's absolutely true. As a matter of fact, there are some statistics that show that men in upper and middle

class income levels go to the doctor even less than women in the poorest cohort, so it's not just the money. But I think for African American men, there are those attitudes of being taught to ignore pain, being taught to be more concerned about your job than you are about yourself. Also, one thing I've seen in African American men is distrust of the healthcare system. I hear black people say, oh, when black people go to that hospital, they don't come out again. And that's a self -fulfilling prophecy, because if you delay, because you don't trust doctors of the healthcare system, you may come there too sick to do anything about. I think things like the Tuskegee experiment have really hurt us in terms of trusting the healthcare system. And I think the healthcare system has to woo people back and earn their trust. Dr. Sullivan? Oh, I fully concur with that. There really is a fair amount of distrust in the healthcare system. Will we get the best healthcare that's available? Will we be treated with dignity and respect? So that is an ongoing concern.

And we in the health professions have to work very hard to say that one, it is positive to seek health evaluation. It is responsible to yourself and to your family to ensure that you have a good health. And three, it'll be to your benefit to have an evaluation. So those are messages that we have to work very hard to get out because African American men have the shortest life expectancy of any group in our society of some 66 years on average, as opposed to white women who have a life expectancy approaching 80 years. So there's a tremendous gap there between black men and white women. There's a gap of around seven years between black men and white men. So clearly we have a lot of ground to make up, but it can be made up if we are able to get the right kinds of interventions. Dr. McGowan?

Yes, I agree with Dr. Southern saying it's going to take programs like yours coming that's going to help get the word out. We're not going to save everybody. We're not going to say there are going to be some folks that hear what we've been saying. We've been seeing this for as long as I've been living. There's not going to come, but there are lots of folks who just don't know. And once they hear and note that they have an opportunity and availability to access the care, they will come. So if we can all, and healthcare professionals, one of the things that I was taught very early on in medical school for one of my former mentors was that everyone can't be helped, but those who can be helped, you do your best to help them. So if I take it as a personal challenge to try to help as many men and women as well, but nice conversation, as many men as possible in educating them, and we're always available to help with seminars and consultations and whatever it takes to get people to come in. Sometimes we get the perception from the community that all we are about the money. And that is not true. I'm doing what I was chosen to do, what I've been picked to do long before I even hit the scene. So it's not the mind that drives me to do things like help with this effort. So we're trying to once again educate our

people in particular that that we are here for you. And yes, that in the past things may have happened that may not have been fair, may not have been upward, upstanding and forward. But at the same time, that is a new day. And we know it takes about three generations to change people's attitudes and sort of forget where they come from. So we're just about the point now where we can get some of these negative references from health care, you know, out of the system and get to go on again and let folks see that you have the sovereigns of the world who are giving their time to help. Our number is 1 -800 -360 -1799. 1 -800 -360 -1799. We'll continue in just a moment. Stay tuned to this public radio station. Give us a call. You're listening to PowerPoint. PowerPoint is funded in part by

PowerPoint's Affiliate Station Consortium, KTSU FM in Houston, WRVS FM in Elizabeth City, North Carolina, Baltimore's WEAAFM, and WNCU FM in Durham, North Carolina. PowerPoint's Affiliate Station Consortium, committed to the continuation of quality public radio programming. And welcome back to PowerPoint. I'm Carmen Burns.

We're talking about men's health on this father's day. Joining us by phone, Dr. Lewis Sullivan, former US Secretary of Health and Human Services, founding Dean, Director and President Emeritus of the Morehouse School of Medicine. In studio, Dr. John Bonom, President and co -founder of the National Black Men's Health Network. And he's a senior faculty associate in the School of Public Health at Emery University in Atlanta. Also joining us by phone, Dr. Kevin McGowan, who is a general and laparoscopic surgeon with an emphasis on health education and health behaviors. And we'd love to have you phone in with your questions or comments. Our PowerPoint hotline number is 1 -800 -360 -1799 -180 -360 -1799. Now, to HIV and AIDS, which is a huge problem, even though we don't hear as much about it on the news as we used to just 10 years ago, why is it that the Black

community continues to be devastated by this horrible disease, Dr. Sullivan? Well, AIDS is a very interesting viral infection that started out in the early 80s as a disease, primarily among white gay males. But over the last two decades, this virus has migrated so that now the group that is most affected by it are Black, both female and males. So this really has been a virus that has really affected minorities and low -income people to a significant extent. We have within the country approximately 850 ,000 infected individuals with this virus, and whereas Blacks comprise only 12 or 13 percent of our population, they are now comprising almost 60 percent of the new HIV infections that we are seeing in our country. So this is an infection that is a great interest

and concern to the Black community, and whereas it was primarily among homosexual males, we have increasing infections that are passed heterosexually, and so Black females are also quite susceptible to this infection. This means we have to really do a much better job in educating all of our citizens and certainly our minority citizens about this virus, how does it spread, how do we protect ourselves against it, and also letting individuals know for those who do get the infection, we now have a whole range of drugs that are able to suppress the virus so that people who are infected are able to live more normal lives. Dr. Bonhomme, what do you think about that? Why is it that the Black community continues to be devastated by this disease? Well, AIDS has been portrayed as a disease of groups. I learned it as the four Hs, the

homosexuals, the hemophiliacs, the heroin addicts, and the Haitians, but it's really a disease of behavior, and I think that the initial portrayal of AIDS is a disease of specific groups, it gave the Black community a false sense of, well, I'm not like that, so that's not going to happen to me. And I think that what basically happened was I think the Black community was kind of blindsided. One of the differences between AIDS and the Black community and AIDS and the White community is that lower percentage is attributable to homosexual transmission, to gay men having sex with men. I think in the White community, it's on the order of 59%, but in the Black community, it's on the order of 31%, and it's more involvement with heterosexual transmission and drug use transmission. Now what about, but as far as, when you say heterosexual transmission, we did a show some time ago about men on the download with Black men who are actually bisexual and who certitiously passed the disease on to their female partners without them being aware that they had homosexual sex.

And that does occur, but I don't think it's only a phenomenon of the Black community. Dr. McGowan? Yes. What's your take on all of this? I, because for this evening, it really has affected us despairingly so, and once again Dr. Sullivan mentioned earlier that it is a level of understanding and education and I agree a whole heartily, we can't be afraid to speak about these things, you know, to our young folks and try to help educate them at an early age so that they know what behaviors. It's very disturbing when I did a career day, one of the local middle schools and Snow Mountain month or so ago, and just sort of talking to kids about health as a profession and things that nature. And we had some very keen the conversations and I encouraged them to be frank and to be open and to be honest and to get in trouble and we just had a good conversation because I really want to know what was on the mind about 13, 14 -year -old young men and women today. And they of course, as most 13, 14 -year -olds do, didn't have a problem

speaking their mind and some of the things they said were just so erroneous. For example, I had a young man tell me that he thought that the only time a young lady could get pregnant was when she was on her medical side. Now that's the furthest from the truth and then to learn that health classes aren't necessarily mandatory. I'm not sure I haven't looked at the Georgia code yet for the educational system. I recently moved back to Atlanta. Aren't mandatory as they once were when I was in school many, many years ago in the real square. So we have kids out there today who are basically getting information from from MTV and BET and other video sources and it is erroneous information. So this young man is going to put himself at risk because he thinks the only time a young lady can get pregnant is when she's on her cycle. So all other times it's okay to have unprotected sex. That's another topic for another time but at the same time these young people don't have a clue as to what's going on and these young people turn into old people who still don't have a clue as to what's going on. Our number is 1 -800 -360

-1799 -1 -800 -360 -1799. Liz in Charleston, South Carolina. Listening to WSCI. Good evening Liz. Thanks for holding. Good evening. I'm a nurse. I work in critical care and I just have well actually I have two comments because I'm also the mother of teenage boys. As far as earlier you were talking about why men are less likely to seek medical attention I think it has a lot to do with their virility or their perceptions of their virility that you know the survival of the fittest and they're less if they're sickly they're less likely to have the stature and the attention of females. So and that's that's been in my practice as well as the fact that the drugs that we have and that we use that people are they're unsure of it especially beta blockers and the ability to achieve and maintain erections they don't realize that we have more variety of drugs to

treat some of the conditions and on the latest little bit with teenage boys I am not originally from the South I'm in the South now. Parents opt out of having the sex education classes taught to their children it's it's almost like they believe that if they're educated that they no longer have the ability to remain abstinent or practice what they believe is morally correct behavior and it's it's truly amazing as having teenage boys how many kids boys and girls don't know that you can buy condoms over the counter you can go to the health department and you can pick them up because the parents do not allow them to have the sex education and I think that's wrong that's why we have all these wonderful things happening you know I think pregnancy and all the STDs that are now

prevalent are part of that is because they're not educating their children. Do you think now you're from the from the north is that right actually I'm from California now on the west coast is health education mandatory. Well I couldn't answer that because my when I went to school and I'm 38 years old it was mandatory everybody had health education it wasn't an option it was taught and it was taught across several age groups not only in junior high school but in high school and here it's not mandatory that they can they can sign you out and say you don't need to be educated you know the parents will say oh I'm I'm not allowing my children to learn about sex education and it's amazing it's amazing the sexual practices of the teenagers now that didn't happen when I was a kid they have parties called lipstick parties and you know it's really quite profound and and oral sex

is not considered sex and it's it's amazing it is it sure is Liz thank you so much for your phone call and for your what do you think about her comments Dr. I think she's hit a very important point because a lot of men do see going to a doctor as some sort of personal failure or defeat I think that one of the attitudes we've we've cultured into our men is is an attitude of self -reliance that if you have a problem you got to solve it yourself and some men don't accept the idea that you know going to a doctor is is okay they think that they somehow failed in doing that and I think that again that that issue about the beta blockers and the effects on sexuality that's an aspect of distrust of the health care system what will they do to me if I go there mm -hmm Dr. Sullivan well I certainly agree there and I would add that I think it is mistaken impression on the part of parents that if they keep sex education away from their children that they will indeed

remain absent I think too many things happen because young people really are ignorant of what really human biology is all about they do learn from their classmates and from other people so I think it is much wiser much better for them to learn about human biology in a course in health education in high school and certainly the parents are responsible for giving their children guidelines on what is acceptable behavior on their part but I think the idea that you're protecting children by keeping this information away from them is really erroneous I believe that children will be much better able to handle sexuality and issues such as abstinence if indeed they understand how the human body works and what indeed from their parents

what is acceptable behavior so it really is a mistaken impression that keeping children from learning about human biology and sexuality really will protect them from sexual activity that's clearly not the case our numbers 1 -800 -360 -1799 -1 -800 -360 -1799 Lewis and Whiteville North Carolina good evening Lewis thanks for holding good go ahead please sir I will earlier today tonight there was an indication that the child need to or the adult need to lay the adult need to when he's had pain go see something and have something done I'll see some seek medical help I think that that's a little late no I'm an I'm an African -American can't take cancer survivor and I have yet to have pain I

was fortunate enough to know the symptoms I knew I had an irregularity that was a urological problem I think we should teach our young people men and women and definitely African -American men to know symptoms which I think is more important than waiting until pain okay dr. McGowan I agree no you're seeing the right thing we're not seeing suggestion at all but pain for some of these entities is the symptom that goes with the disease process itself and you're absolutely correct there are instances when pain presents then it may already correlate with an advance stated the disease process so we're not suggesting that's really I'm not suggesting I don't think the other panelists are either suggesting that you come when you start

having pain we should come all the time anyhow and let us check you because there are certain routine tests that we do on every male patient that comes in once twice yearly to get these things looked at so you're absolutely right we don't want you to wait till it hurts to come we certainly want you to come before them but for some of our colleagues some of our men out there in the real world today they're already hurting so we're trying to reach everyone and and not leave anyone out so you're absolutely right sir I do agree with you don't wait till pain but you need to be coming you know all the time but there are some folks who've already passed that comment yes I fully agree with that and also an emphasize we're not saying that one should always have pain in order to seek medical care no there are a number of things that'll be different if there's weight loss if there's change in bowel habits or if there are other things that are different they really require medical attention so so clearly the caller is you know has a good

point so clearly I don't think any of us were suggesting that anyone should wait to have pain to see a doctor but what we're saying is that often when there is pain it is ignored or suppressed or denied and that really leads to complications that really would not occur if people were to come in with those with those symptoms all right Lewis thanks so much for your call and for your comment Dr. Bonom you wanted to add something I think the caller said something very important because he said he knew this he knew some symptoms he had information about prostate cancer he called it prostate cancer a lot of people call it prostrate cancer and prostrate means laying flat on your face the thing is that the one of the important things is that there's a lot of misinformation about men's health to give you an idea how profound that is we've had men's health screenings for prostate cancer and we've had some women from the community has to be tested there's some people who actually don't know which gender the prostate gland belongs to so the point is that

more information about health health problems is essential and this gentleman was an illustration of how beneficial it could be he knew the symptoms so he knew to do something before it hurt now if if women are in the community and they don't know what that the prostate belongs to the prostate gland belongs to a male isn't there shouldn't there be more educational information available to people to let them know either that's exactly what I'm saying the whole community male and female needs to have a greater awareness of men's health challenges how do you do that how do you make give them that awareness if they're not because a lot of times you're talking to adults who have not been to school I mean are to have not received that information in school well what we're doing now is part of it and I think also no matter what a person's level of education is you can still make it teach them by analogy I can tell in a literate person a cancer is like weeds trying to take over a garden you know you can make an analogy no matter what a person's educational level is to make them understand it's just a question of speaking their language and the thing is true for

other people and other specialists other I don't know a lot about computers or technology whatever you know I take out gallbladder for a living you know so even those folks who are experts in their own field we have to find ways to help them understand God I was going to say you asked the question coming what are we going to do well we're trying to do all we can you know all of us all the doctors I've never met a doctor since I've been in this whole process think the Lord that has not seen the emphasis of importance on trying to educate folks in general in particular the parts of the community but you know we go to the health fears we we don't at that time I go to church and speak to who we have been trying to arrange for different groups for men to come and just listen to try to make it a non threatening environment to make it more of an educational environment just to try to help get the word out get more of the truth out because there's just so much nonsense there it's making the water really really dirty so all we're trying all I'm trying to do is trying to make it clear make it make it so that everyone can have access to property

health care I think that is a human right and that regardless of what whether person has insurance or not I don't know of any physician who was in it for the right reason who will turn any person away who is asking for help we're going to take a break in just a moment shantai want you to stay with us um we are we'd also like to remind you that PowerPoint is heard live on the serious satellite network on the NPR talk channel 107 we're going to take a break right here if you want more information on PowerPoint you can visit us on the web at www .powerpointradio .com that's www .powerpointradio .com we're back in a moment welcome back to PowerPoint coming up next

PowerPoint part two on men's health the psychology behind why men won't go to the doctor and we'll take a look at mental health that's next on PowerPoint our number is 1 -800 -360 -1799 -1 -800 -360 -1799 Shanta in Houston, Texas listening to KTSU good evening Shanta thanks for holding hi go ahead I wanted to come in about why AIDS and HIV is predominantly found in African -American neighborhood and I think one of the big reasons is not because we're not going and having tests done it's just that some people believe that if they take the test one time and they come out negative then that's it that they're fine they don't realize that they have to keep going back okay um if you think sometimes they make is it what about false negatives dr. Bunnell when the test is administered properly false negatives are rare there is a window period associated

with the test where if it's where if it's not enough time is a lapse like three to six months you may get a false negative I don't think that's the real problem I do think that some people do make that interpretation my test is negative so I can go out and have a party and that's not what the test means the test means you don't have it yet oh okay so there might be a delay dr. Sullivan in the test coming back I don't mean in the test coming back I mean that if the test comes back negative it's true that they it if it's been done properly with the proper lead time it's true that they don't have it but some people think I don't have it means I'll never get it so then they go out and then go and indulge in risk behavior it's not that the test is inaccurate is that their perception is that it's a clean bill of health not for now but for the future regardless of what I do oh okay dr. Sullivan well I agree with that because what the test really is measuring is antibodies against the AIDS virus and it takes those antibodies a few weeks to develop so you could have been exposed to the virus perhaps a week or two or three before and the test may not

yet yet be positive so that's one phenomenon but the issue as I already mentioned really is engaging in high risk behavior that is unprotected sexual activity or taking IV drugs et cetera so clearly those are things that really should not be done because indeed that gives the virus a chance to spread now are any of you we when our last call or Lewis was on he was talking about prostate cancer and then oh no the it was the the RN who said that men are concerned about beta blockers and the possibility of impotence but are any of you struck by the fact that there is a solution there are solutions to male impotence but there's no cure for AIDS heart disease continues to be a problem stroke cancer they're all formidable battles and but impotence boom got it taken care of dr. McGowan

you're absolutely right once again I take I need to bring you to work with me you know you you're just bang on tonight maybe to come with me okay okay you know you're absolutely right you know my I use my father who's been deceased for several years now as a prime example he refused to take my first medicine for that very for that very side effect and I tried and tried and tried to to help him understand that it you know things are different now yes that's that's an old medicine we have some new things that are out there now that will allow you to maintain your pressure in a normal range and yet still maintain your level of virility and and he still would do it and you know so I use I think of him often when I try to speak when I speak with other men in other forms and other settings and trying to reach men as we are tonight and think about what would I do with my own father you know how was it that I as a even at that time a medical student and a resident unsuccessful in convincing my own

father who might know my whole life to to change his attitude and behavior and this is is the gives you an idea of the kind of battle we're up against but yet and still I am convinced that what we are doing tonight is a step in the right direction and we have to stay the close and not carry that one day someone is going to listen and the white bulb is going to go off coming and people are going to start doing a little bit better and we have to keep struggling because you know I lost my father which didn't necessarily have to be but the same time maybe in his death and through that process I've learned something that could help another son's father make it and live a little longer a little higher quality of life Dr. Bono I think you've hit upon something really important but it's also something that I think is caused for hope your father did not want to take the medication because it would interfere with his sexual performance men are performance oriented that can be

used to to to to basically build about a bridge between men in the healthcare system look at how pro athletes will take steroids you can't get a guy to take in medicine but pro athlete will take steroids for better performance drugs like Viagra Levitra Cialis they bring men to the doctor because men want to perform they want to be stronger they want to be more virile they want to work better they want more concentration they want to be faster they want to do the things that make them feel like men better and if healthcare is marketed to men as a means by which a man can regain the performance that he's lost or maybe attain his maximum performance or maybe maintain it longer holding off the ravages of aging or whatever or whatever disease he may have then I think healthcare will be more appealing to men the fact that men don't go to doctors for the same reason that women do doesn't mean that there aren't aren't things in healthcare that can be appealing to men if we find the right buttons I think we can get men to come and I think they're working the issue on male performance is a very promising avenue certainly work for what I've tried to do hmm so you see there

is hope for getting them there's up there's a there's a light at the end of this tunnel yeah because the drugs when a man comes in for erectile dysfunction and wants a prescription for Viagra it gives the doctor a chance to screen him for health conditions that may have much bigger ramifications much bigger consequences than just his erectile dysfunction he might be a diabetic he might have be his arteries might be clogging up with high cholesterol there could be a whole bunch of underlying problems as a matter of fact a lot of the men who have strokes and heart attacks had erectile dysfunction sometime in the years proceeding it so some people even even consider it a warning sign if a man's having ED check him out thoroughly because there may be something else going on so as we celebrate another year of the father what should men know about their health dr. Sullivan well I would say first of all men should understand that they are very valued members of their family and their community and that they are more than sexual

beings because indeed as has been commented too many men really feel that if indeed they have erectile problems that life is at an end that's that's clearly not at all the case they are valued as companions as leaders in the community and have a lot more to contribute than simply sexual activity so that's one of the things that we have to educate men about that that the realty is really only one part of masculinity being the head of a family being a wage earner being a leader in the community all of these are valued things now what that means is certainly their health overall is important they have to be concerned about it they have to do those things including visiting the doctor to see that they maintain their health but indeed we need to educate men that there's a lot more that they have to contribute to their families and to their communities that means

that they should protect their health dr. McGowan last word yes I want every man who's looking to this and it's really every person who's in this conversation tonight to make a a personal promise to help one person seek medical help that otherwise we're not going to have done so and all that you ask in return is that person just help one person dr. McGowan that's got to be it you're listening to PowerPoint this is PowerPoint a production of WCLK FM a broadcast service of Clark Atlanta University production and broadcast of PowerPoint is made possible in part by

a grant from the corporation for public broadcasting and by the National Legacy Foundation this is PowerPoint an information age clearinghouse for news issues and ideas that impact the African -American community the nation and the world have you heard this excuse from the male in your life it's just a little pain I'm all right it's called male denial factor hello I'm Carmen Burns and this is PowerPoint over one third of American men have not had a checkup in the past year nine million men haven't seen a doctor in five years the consequences serious medical ailments even death also will have an in -depth look at the mental state of men's health it's a health and wellness father's day edition of PowerPoint but first the news this is the news on PowerPoint I'm fond of Smith NPR's Mary Louise Kelly examined an interim report from the so -called nine eleven commission last week she says it finds no credible

link between Saddam Hussein and Al Qaeda contradicting the Bush administration claims to the contrary the commission report has found no credible evidence that Iraq and al Qaeda cooperated on attacks against the U .S. now that is a very controversial statement because senior Bush administration officials have long asserted that there were established ties between Saddam's regime and al Qaeda that was in fact one of the original reasons given for going to war in Iraq this interim report from the nine eleven commission says that there were contacts that bin Laden did explore possible cooperation with Iraq there was even a meeting in 1994 but this panel has concluded that the contacts don't appear to have resulted in a collaborative relationship NPR's Larry Abrinson attended a hearing of the so -called nine eleven commission he says the original plot was much bigger in the initial stages of planning originally the master mind of the plot Colleague Sheikh Mohammed says in interrogations that he had planned to hijack

ten planes and was going to attack targets on different coasts of the U .S. was going to attack the CIA headquarters nuclear power plants skyscrapers on the west coast and he planned to take that tenth plane landed somewhere make a statement announcing U .S. policies he was going to execute all of the mail passengers and then release the women and children on the plane the expected arrest in the Sahara desert of a man believed to be one of North Africa's most wanted terror suspects is snacked over rebel groups demand for more money and an official close to the case a marie -safi and Algerian militant linked by western officials to al Qaeda is thought to be in the hands of a chatty and rebel group that captured him in March diplomat said earlier that the rebels had contacted Algeria France Germany the west African nation of Niger and the United States about handing over supine and followers captured with him the official of a country involved in the case who spoke on condition of anonymity said the rebels were holding out for the highest bidder

attacks on Iraqi pipelines have halted oil exports in PR's Emily Harris says most of the country's exports come from the southern parts of the country clearly this shows that Iraq's oil industry is still vulnerable it's a different difficult area to protect there's miles of pipeline all over the country Iraq has made an investment into two surveillance aircraft that they hope will help them protect the pipelines and they're going to increase that fleet in the next couple of months but still it is quite a vast area to patrol in PR White House correspondent Don Gagne says the president is not ready to hand over former Iraqi strongman Saddam Hussein to the new Iraqi government until Washington is sure Hussein can be held securely the president is insistent that Saddam Hussein be tried by Iraqis he makes that point clear but what he is less clear on is how the handover of Saddam will take place once the interim government

takes over after June 30 so the concern for the White House is that security remains such that there's no danger of Saddam Hussein escaping or in any way managing to avoid a trial. Grinada's parlor mit held a special session last week to honor Ronald Reagan for ordering the 1983 U .S. invasion that followed a bloody coup on the Caribbean island. Roy minister Keith Mitchell was among the legislators modding the former president who died June 5th at age 93 lawmakers approved a motion saying Reagan played a significant role in restoring peace and democracy. The UN peacekeeping force in Haiti may soon be getting troops for more countries according to the deputy U .S. ambassador the UN force started arriving on June 1st to replace a 3600 strong U .S.-led multinational force sent to Haiti after a three -week rebellion led the country's elected president John Bertrand Eristee to flee in February. U .S. deputy ambassador Stuart Holliday said the United States was very encouraged by the smooth transition

from American to Brazilian command and new offers of troops from the UN force. That is the news on U .S. And welcome back to PowerPoint I'm Carmen Burns and a very happy Father's Day to our listening audience. Recent studies have shown that before age 65 men suffer heart attacks two and a half times more often than women. By age 65 one and three men suffers from high blood pressure, a primary risk for heart attack. Yet men are less

likely than women to have their blood pressure checked. According to a recent survey by men's health magazine and CNN, every year men make 150 million fewer trips to doctors than women. The disparity occurs in every age group, not just the years some women have prenatal checkups. So why don't men go to the doctor and what are the mental effects involved? An American Medical Association study in 1990 found that men don't go to the doctor because of fear, denial, embarrassment, and threatened masculinity. But you have to consider economics, environment, and other disparities. What about men who are re -entering society from correctional facilities? There are a lot of things to consider and our panel tonight will add some insight. Joining us from Atlanta, Dr. Alan Carter, psychologist and expert in the depression. Also joining us, Dr. Henry Treadwell, who is the director of community voices located

at Morehouse School of Medicine. Community voices is healthcare for the underserved and it's a multi -year initiative of the WK Kellogg Foundation targeted at ensuring the survival of safety net providers and strengthening community support services. As always you can join in our PowerPoint hotline numbers, 1 -800 -360 -1799, 1 -800 -360 -1799. Good evening and thank you so much for being with us. Dr. Carter, let's start with you. The mental state of men in this country, particularly minority and low income, is crisis an adequate word to describe it? Well it's important how you define crisis but obviously there is a certain disparity. It was interesting. Earlier today Bill Clinton was on the 60 -minute interview and they were asking what was one of his regrets about his administration and what he said two things and one of the two things he said

was that he did not get healthcare coverage passed or his eight years when he was an officer. He was quoting and citing many people, poor people especially in which means also black people. I think it's 45, I can't get out of Bill now, but so many, now there's a huge number of people who just don't have any type of healthcare coverage at all. If you take that in consideration that the large number of people who have no healthcare coverage at all and particularly in the minority community, you could use the word crisis and some people will be legitimate in using that word crisis. I think it's legitimate, but obviously it is a situation which demands dire attention. Now what about the whole mental illness part of it because there's we talked about health and physical but what about mental health and in trying to maintain that and even just acknowledging that there may be a

problem as far as mental health is concerned in the black community. Well again I don't tell you show you what I've been doing or they are watching this morning. The morning Mike Wallace was on TV, I don't know if you saw it or some of this was probably saw it, but he was talking about, he had this denial about going to that he had any kind of symptoms of depression. Now this is Mike Wallace, a man who is very sophisticated obviously and has access to a lot of resources and he's also white. In our community there's a history of mental health in a particular for black males of being something that we usually do not see as an adequate way of dealing with our particular problems. We see more of a white type of way of intervention and so it is not something that has a lot of history for us as black people and black males in particular. So it is not something traditionally or historically that we have used.

However that I think that's beginning to change somewhat but they still is a significant stigma associated with what your particular man and black being in particular is a normal health treatment. Our number is 1 -800 -360 -1799 -180 -360 -1799. Dr. Treadwell will be joining us shortly. Now Dr. Carter as far as mental health and depression, what are some of the symptoms that people should be aware of as far as being depressed? Well first let me say a comment that depression we have not seen what we're talking about. Everybody gets sad. I mean you have a bad day at the office or you're girlfriend or boyfriend quit you or something like that. We feel sad and that's appropriate. So what we're talking about here is what we mean by clinical depression as opposed to normal sadness or normal depression sometimes. Now when we talk about clinical depression we are talking about many different forms of depression. So it's not

like one thing called depression but what we can say is that usually what happens when a person gets into a state of clinical depression there are some symptoms that you can look and see. Plansions you know usually there's a lot of decreased energy. The person has lost enthusiasm. Those things that once were very pleasurable for the person might have been playing golf or whatever it was. They just don't have the energy to zest for life. They lose interest. They have maybe a decrease in appetite. Sometimes you ever have sleep disturbances. They feel like this life is hopeless. There's nothing much that they can do and they may have a tremendous feeling of guilt. Those are some of the things that you begin when you begin to see those things and it begins to last over a stint period of time. By stint period of time I mean a few weeks to a month or so then you begin to want to you know this person really

having some trouble here. This mold and just sadness associated with some particular loss or whatever. That's what you begin to consider then. Well how does sadness over maybe a loss turn into depression and how do you know when to when what the difference is? Well like I said you know let's just say suppose your mother died. Somebody who you very much care for okay. If they would die or something like that would have something very serious what happened to them. Of course it's the normal grieving process that one would go through. It would last for just a certain amount of time. We use your the grieving process has been the standard so that they are not functioning in an effective way that having difficulty concentrating. It cannot get out of bed. Let me tell you I had a patient one time who said to me just give you an idea of what this thing called clinical depressions like as opposed to your abnormal depression. So

I had a patient described it very aptly. She told me one time she said it's like having a wet blanket on you all the time okay. And it's like you carrying around a wet blanket you just can't do it. You want to get out of bed but you just can't do it. And it's not because you're lazy okay. A lot of people may say oh you're just lazy you know it's not that they want to do it but it's just isn't there for them to do it. 1 -800 -360 -1799 is our number 1 -800 -3 -360 -1799 well so what is the stigma attached with especially with black man and dealing with mental health is it just saying that there's no way I'm crazy. Yeah well that's part of it you know I mean we have this thing called you know I don't want to be able to crazy but what me and the whole thing is you know we've got to be a woman you know we don't want to be you know a punk or something okay so it's

part of our sense of our masculine identity that we are able to be in power and control the whole training of the masculine self -concept has to deal with that I cannot show vulnerability I cannot show weakness I can handle this I would be able to I as a man I can do this and do that and so there's this tremendous thing that we have as as man that we are supposed to handle things we are supposed to be on top of things we are supposed to be in charge this issue of power for us is really sometimes I think extremely extremely negative and self -defeating for us so oftentimes for men and men to admit that they have emotional or psychological problems it would be like you know a threat to their man for that well it's power something that's kind of overrated as far as I mean men should be able to to work in conjunction with everyone else as opposed

to working over everyone else or running through them hello I'm just saying that they should be able to oh Dr. Treadwell is with with us now I was just saying Dr. Carter there shouldn't there be some sort of restructuring of that whole power thing yeah it's going to kill us yeah I hope so because it really is self -defeated okay it's not what true power is it's a mistake okay I agree whole arm of what you imply Dr. Treadwell thanks so much for being with us now let's just we're talking about men's mental health and their relationship as far as being able to go to the doctor or their home makeup as far as mentally whether it's seeking help for mental issues whether it's depression or whether there may be some psychosis involved or anything like that but just the whole stigma do you think that there is any role that the oppressive history of African

Americans in particularly a black man that that plays into the attitude towards seeking help for any mental issues I think that's an absolutely a major part of some of the issues that we face there is a lack of trust in the system and okay Dr. Treadwell we have I'm sorry go ahead you have to repeat that for me please because we kind of went away for a second okay they do not get what they need from the system so I do think the oppressive history is a major part of the problem and if we look at just how the services would be paid for historically there have been programs for women and children at least with Medicaid but from then there's just no help if they happen to be a poor person they certainly have no help I make that point simply to say that for some reason men of color have been excluded from some of the consideration for helping them to get care

particularly if finances are an issue but overall I believe that trust in the system is a major problem now when you say they don't get what they need what do you mean men are typically deflected we have found through some of our work with men's projects across the nation that when men seek care quite often there are subtle things that occur they're told well you need to go somewhere else to sign up and so even at the front office some are not accepted for care and again I'm speaking mainly of the working poor but you know we we have a problem with people identifying mental health as an issue one of the reasons that I put a number of my remarks in the context of the working poor and poor men is if you look unfortunately at that population of men of color that are in in our nation's prisons

so many have mental health issues that could be treated outside but they evidently have no access to anywhere to get that care but they can get it in prison but if they're released they don't have anywhere to go we're talking with Dr. Anri Shredwell who is the director of community voices located at Morehouse School of Medicine also Dr. Alan Carter who is a psychologist and expert in the field of mental health especially in depression our number is 1 -800 -360 -1799 -1 -800 -360 -17 -9 -9 is that even or well sorry we lost him 1 -800 -360 -1799 is our number now Dr. Shredwell you were talking about prison care and that is it fair to say that sometimes prison has become an alternative for those who actually have mental health problems it's not only fair to say it it's really just the right answer that is what is happening in this nation for men poor men

particularly if they need care and have no money it's the best place to be with the exception of some services such as oral health care many men in the prisons they're only options ought to have teeth extracted and it's an interesting fact that even there when they have options for care African -American men don't seek oral health care even when available and so even if it's not simply an extraction so there are I think some basic issues around the health care system and the trust that men have in the system sometimes even when care is available Dr. Carter why is it that even I mean your teeth if health care is if oral health care is available why would someone not seek that or at least before it becomes an issue well I think you may want to ask Dr. Shredwell that because he was well

one I really can't answer the question directly I've simply been doing a lot of research and speaking with people from the federal level through state levels and they are not able to explain it and I say that it's really very difficult because we even find that Latino men will seek care at higher levels than will African -American men well how is the health care in prison as far as being available at all it's typically from our experience it's good care is so is it just a question that men don't seek it out or is it voluntary or what happens some of it's voluntary and they just for some reason don't go I I have the feeling and of course I don't know this but

I still believe that there is this issue of trust there certainly is the issue among some of the machismo strong men don't need health care but if you when I've gone and visited people in prisons and just in regular hospital settings they want care but they don't feel that they get the respect or exactly what they want from the system and whether they don't get that care or they simply don't have the opportunity to dialogue in the way that they would like with the provider I don't know what the issue is I think we need to learn a lot more about why our men are not seeking care regardless of their financial level one interesting thing that we have learned recently though I'm not sure it's confirmed is that a lot of men prefer care from a woman and a woman physician or woman provider if that's true then

do we need to think about that is an issue and why would that be our number is 1 -800 -360 -1799 -1800 -360 -1799 -Susan in South Carolina listening to WSCI good evening Susan thanks for holding thank you I think that there are many areas of concern as it relates to health care and the treatment for African -American males especially and as a health care professional who has 20 years of experience I think I have a pretty good hand on this and the number one issue is trust when we mention trust we have to reflect back to our own history and I think if we look back in history we'll look back at the Tuskegee experiment as for me here in the South that has been something that has never really left the African -American males because the older generation continued to talk about it and then in later

years a movie was made about it and I think that's another fact too black men are not trusting of white doctors and there are very few black doctors in the areas sometimes where you have lower socioeconomic people secondly it's been my experience to treatment for African -American males that might be treat treat might be have a problem excuse me for depression is usually a little bit biased because we are looked upon as the lazy race so if they need treatment for depression maybe they're trying to get disability and so we don't want to give them any medication because I didn't put them in the system so there's a lot of problems there and we need to speak out on the disease itself it's not just a female thing I've seen men that definitely could benefit for treatment of depression and they were totally ignored just fell through the cracks so to speak all right Susan thanks so much for your comment Dr. Carter well you know she's talking about

the issue of trust which Dr. Trevwell brought up earlier you know that's me if you have a system like for instance oftentimes of black men and black people but black men in particular what misdiagnosed if you were psychotic I showed any signs of psychotic symptoms okay you automatic okay we're having a little bit of a technique okay Dr. Carter you're back up oh we're having a little genie in our phones oh yes so you need to repeat those gems please especially that diamond all right go ahead we'll be tested okay no I was saying that you know historically what we do know is that oftentimes what happens not just historic is still going on today to some extent but what happened was if a black client came in particularly if he was black male if he exhibited psychotic symptoms such as hallucinations or whatever he automatically usually got diagnosed as schizophrenic and

he could have been you know depressed or whatever but because that was a tendency particularly with white physicians and white psychiatrists and psychologists to automatically assume with these black and he's psychotic he's you know he's schizophrenic and then once they got you know relegated into that position then that meant you know for men and people it meant well okay this is a hopeless case no sense of working with him just you know just feed him some bunch of meds okay and so he got relegated into a system that really you know kept him in a place called non -recovery oftentimes this occurred historically and even though there has been some changes in the A system as well as in the state mental health system there's been some change in that that still is some of the prevalent thinking that exists in both the training of of psychiatrists and psychologists okay is such

a need a dire need for training to be to be included as to cultural differences cultural factors that occur in diagnostic evaluations as well as treatment plans is such a dire need for that to be included I know when I was president of licensing board here the psychology licensing board in the state of Georgia one of my agenda was to get passed that all psychologists will have to have a certain degree of cultural competence uh it was very difficult in my fact that one of two two states in the union is Massachusetts and Illinois that required in the licensing process that and also in the in the renewal credential renewing process okay dr. Carter we're gonna have to take a break right here uh please phone in with your question or your comment 1 -800 -360

-1799 you're listening to PowerPoint PowerPoint is funded in part by PowerPoint's affiliate station consortium KTSU FM in Houston W -R -V -S -F -M in Elisabeth City North Carolina Baltimore's W -E -A -F -M and W -N -C -U -F -M in Durham North Carolina PowerPoint's affiliate station consortium committed to the continuation of quality public radio programming and welcome back to PowerPoint and Carmen

Burns we're talking about the state of men's mental health joining us dr. Henri tread well who is the director of community voices at more house school of medicine community voices health care for the underserved is a multi -year initiative of the WK Kellogg Foundation targeted at ensuring the survival of safety net providers and strengthening community support services also joining us dr. Alan Carter psychologist and expert in the field of mental health and dr. Carter has been on PowerPoint several times and he's also a specialist in dealing with depression 1 -800 -360 -1799 is our number Karen in Houston listening to KTSU good evening Karen thanks for holding good evening thank you I was giving you a call in regards to the me and the arts are some that experience experts I'm sorry depression and I was just like to give and Karen turn your radio down for me please

okay okay all right go ahead okay I'm sorry for example I'm dating someone in our field that with our financial being that was struggling financially that I'm he tends to say that I'm the blame for this I'm the blame of that he reminds me of someone that has a drug addiction I'm not seeing that my hearing say does but I want to do that helps me to believe that it appears to be some depression there okay so you want to know how you can tell yeah if someone has has has depression or any sort of a mental health issue yeah okay dr. Carter let me ask you what's your name again Karen Karen yeah let me just ask you a couple of

questions okay when you say you think that maybe a drug addiction problem are you do you know what not he is using drugs no he's well what makes you think that that's a drug well I didn't say that it was a drug addiction it's just that being that I've been associated with different organizations that have talks and everything important with teenagers that was some of the things that I was interested in becoming a part of so that I could deal with my family socially just to get some teen health okay well what's some of the symptoms or what's the what's some of the behaviors that he's doing that's causing you concern um this is the blame he goes with he starts out with centers I blame you and it's hard for him to express how he feels um and another thing is that his

frustration appears to be like pressure um I believe it could have to be on the financial struggle that you think he do you think are you talking about possibly financial problems then they may be he may be exhibiting some frustration because of that yeah okay now we can't really diagnose him on the air at all but um Dr. Carter can you go over again some of the symptoms of depression yeah let me just say first to to her that you know it may be you know what one of those situational things which like you said they it's related to maybe financial it may not who knows but I hear that your concern is is that you know you might be getting brain attack and that he's unfairly treating you is what I also hear you saying well not that depression and I can't say because I don't have enough information to say that I can say that if you want to get some help and if he's willing to get some help then you know and your relationship office is important to you then if you if you can steer into that

you know which sometimes very hard but you can do so now in response to the question about what are some of the symptoms of depression where there are several symptoms as I mentioned earlier that there are different forms of depression but you know generally you can think of such symptoms as that they have decreased energy the concentration is you know is decreased you are saying that you seeing him maybe becoming emotionally more variable he going up and down and stuff that can sometimes be a a symptom of mood disorder but like I said can't say enough about him yet because we don't know enough there's decreased sleep sometimes there's you know feelings of helplessness all kinds of symptoms like this can be depression I would caution you to you know in making any kind of conclusion about your your friend or your husband's condition but I do hear that you are concerned about your relationship and about him and you may want to seek some kind of you know counseling regarding that our numbers 1 -800 -360

-1799 Evans and North Carolina listening to WNCU good evening and thanks for holding hi go ahead yes my first question had to do with getting the doctors to perhaps comment on the role of a person spouse or a man spouse or significant other and getting him to go in for therapy of some sort regarding depression and as an adjunct to that the relationship of the new medications for depression and many men having a reluctance to take those medications as I had a problem doing secondly I wanted to comment on doctor I think Tridwell's view of prison health care I'm an author and who who spent or who had spent

more than 20 years in prison and there's a great distrust for prison healthcare because it's generally not very good or at least that was the situation with my imprisonment in Virginia and thirdly if you don't mind switching the subject a bit before you sign off I'm concerned about the spread of hepatitis C in the black community I was in the barbershop the day and was afraid to actually have the age up to put against my skin because a fear of the hygiene and the barbershop being part of a spread of hepatitis C which many people don't talk about that's great in the black community all right Evans thanks so much for your call and for your comments let's talk about the medication doctor Tridwell is

there men are reluctant to take some of this medicine is it have anything to do with male virility I'm not so sure about that in terms of medication for mental health issues certainly in areas of hypertension etc there are concerns about virility and that's a problem I think that Dr. Carter would know better than I but I also believe that access to some of the drugs that do not have such a severe effect on the total system is limited in the African -American community and and at least from what I'm told they get the older medicines that have other side effects that results in the person not being able to function well so they don't take them Dr. Carter well I'm not a physician I'm a psychologist PhD but you know there are some medicines that are you know specifically designed for certain type of mood disorders like major depression or lithium or I mean excuse or bipolar disorder whatever and they

any medication and sure Dr. Tridwell was there can you know help side effects and there are some some men have reported some side effects as you are referring to comment about some virility questions about with some of the anti -depressant medications but I think a physician can respond to that question okay okay now what about the prison health care that he referred to Dr. Tridwell when I say that the health care system in the prisons is I won't say it's good I may have said good but compared to what they are able to get on the outside particularly poor men at least they can get some medications now whether they're the right medications are good ones there is someone there now with regard to hepatitis C that is an enormous challenge and most I know of no prison systems that are are testing for the presence of hepatitis C because they say it's too costly I believe Pennsylvania did and stopped because of the cost

some states have treatment for prisoners around hepatitis C while they are in prison but when released there really is no program for them to go into so there are the rest to the health of the entire community not just from hepatitis C but other things but certainly people are just deciding not to screen for it because they say they can't afford to do but and I don't think that's the right answer because it's really disproportionately affecting some community now hepatitis C affects the liver and it is it can be fatal yes okay so that's what I guess we kind of need to clarify that for people who aren't familiar how is hepatitis C contracted it's generally related to sharing of drug products I mean needles or injections at least that's the way it's typically described that

that's the way it's caused or from other fluid interchanges and so it starts in the use of drugs that involve needles or something like that at least that's one way of starting it but of course when people come out of prison that's not necessarily the way it's transmitted into the community because once you have it you can transfer it to others our number is 1 -800 -360 -1799 -1 -800 -360 -1799 Hans and Houston listening to KTSU good evening Hans thanks for holding hello Hans okay let's go to James in Houston listening to KTSU good evening James thanks for holding yes good evening to you and you guess look I suffer with depression and I'm listening to the doctor I've agreed with some of them and some of the banks they say look I take

so cold I take so long I also have a feeling cold for sleep at REM ERO now my depression come from three things first of all I went to prison for nothing secondly I had a serious injury back in you three back surgery I've read up on just happy injured and also cause depression another thing being a black meal in this society trying to please the white community as well as the black community I'm talking about my black sister I wonder how many black meals do not suffer with depression with what he has to go through okay all right James thanks for your calling

for your comment Dr. Carter well is interesting I was hearing James and he was on those various different forms of medication so there are some forms of depression which tend to be more biochemically based that certainly respond to biochemical intervention okay uses certain kinds of medications or whatever and those are your major depressions and all the forms of major mood disorders there are some other forms of depression which do not have as we can see as much you know biochemical linkages of base okay it what seems to be common to them though all is that the person has some experience some proceed are real sense of loss they have something and it's been taken away from them and they judge it that this just hurts them is unfair or something like that in the way that they are thinking about it now this is where psychotherapy can happen that can be a good intervention in conjunction sometimes with with some

biochemical type of depression based depression now he was mentioned about you know what's happening to us is black men what's huge I mean we've been you know this 400 years that we've been you know under oppression and it's it's too out I guess it's too out credit that you know we haven't gone as crazy as you know one with a spec so this speaks to a tremendous amount of strength but I think what it also says is that we know sometimes we do deny that we have been hurt so much I think this is what James was talking about but we got to see that you know if depression is linked to a sense of loss okay if there's some kind of linkage there then maybe we can look at that differently okay maybe we don't have to be as powerless and helpless as depression will want us to be you know we we can get involved in activities one the major things you can do for a person to depressed is get them to do something give them some sense that they can do something that they can change that world so

whatever that we can do get involved in political movements get involved in their church activities or whatever you know and once a person can feel that I can make a difference it tends to revitalize them so yes you know there are many of us as black men who we have a system set up that is designed to make us not only oppressed but depressed but we don't have to self do this much let's go to Hans in Houston listening to KTSU welcome back Hans thanks for holding oh thanks for taking my call I'm just wondering I had the personal emergency that I'd take care of and I've missed that unfortunately a good part of the discussion one time weren't they using electric shock therapy for depression that might be nandofolian now you know or Anna Karistik whatever the word is anachronistic okay you know help me out I don't need to use the being guilty of low career

excessive use of words but yeah another thing is this whole medical dealings didn't somebody do a study that showed where probably the patient the black patient will have more confidence talking to a black physician that the physician the black physician probably can get a more accurate history from a black patient now there was a study I think that was released and early cause some problems and some circles because right then the accreditation agency that rates all these residency programs came hard came down hard I think on how it's the ER program and their pediatric program and their family medicine program we thought of as sort of a backlash but maybe we can't get into that politics thanks for entertaining all right Hans thanks for your call Dr. Carter well you know electric shock therapy that was the

biggie well yeah I remember when I was in when I was doing my internship at UC hospital that's all you know first my first time seeing a ECT it just grossed me out okay at one time they were just shocking people almost anything okay it was like you know a journal panacea if it wasn't that it was lobotomy wasn't it huh it wasn't at all didn't people get lobotomies well yeah at one time they were doing that also okay but don't confuse the ECT electrical shock with lobotomy oh I won't okay that there'd be a difference yeah all right big difference although you know we were talking about dealing with the brain maybe Dr. Tripwell wanted to also come in this but yes that was it one time tremendous push to use it and they were using almost indiscriminately you know particularly on black people okay those young like I said you know it was like they had very few options then there was a big you know push that came in with the cycle pharmacological you know

inventions that came in and the drug companies came out with all these new pills and stuff so it began to decrease for a while and then it has now suppose they come back on the rise again okay not to the static that was being used back in the 40s and 50s and so forth but yes that is a major intervention okay that it's often used and I think it's going to be used at the last of what I feel okay Dr. Tripwell we'll talk with you about this in just more of it in just a moment as far as how black patients relate better to or do they relate better to black doctors we'll continue at just a moment a reminder to join PowerPoint next week for a special report on returning Iraq to self -rule and to rebuild its institutions right here on this radio station and welcome back to PowerPoint I'm Carmen Burns

we're talking about the state of mental health Dr. Tripwell what about black patients being able to relate better to black doctors that survey that Hans mentioned are you familiar with that I am and familiar with other work there is a real problem because there are not enough black physicians out there for people to have access to and particularly the African -American man is some would say a disappearing breed in medical schools but also in other training programs and so people we really need to look at who is being trained who's in the pipeline and what's happening to people because they simply aren't there but the data I think do support that people would like to have the choice of speaking to someone from their own group who may understand their perspectives and where they're coming from 1 -800 -360 -1799 is our number Greg and Houston listening to KTSU good evening Greg thanks for having

it good go ahead sir okay that's great yeah I was I was just listening to the program that I make those comments and try to get some feedback okay number one I was incarcerated in 86 and I experienced a lot of my brothers I would say were taking hallucinated medication and I guess they called it therazine at the time I don't know if therazine yes some type of therazine or some type of mental medication that was only name we knew with therazine but however you know a lot of brothers took the medication some needed it and some took it just to be in a what you call a mental a medical ward you know they could better treatment better housing or whatever but I found that a lot of these brothers really become even if they were thinking they have to take it and

let it issue that that perspective and then in recently I've come acquainted with some people who have group homes I guess foster parents and it seems that every child is in the foster care homes are under some type of medication and you know and it's really sad that that's the you know that's what we've arrived at you know doping the truth and matter of fact I just I know you've got time they're strength but anyway I even my son was having some disciplinary problems of school and they suggested that maybe he needed to be on some medication some rhythm and up some type right and and you know what to make a brief and I couldn't understand how you know he's fine now he's making good grades and he just was

adapting to the school you know but it's just a way that they quickly immediately they wanted to medicate him if he was having any problems but however just to make this last I'm on a quota if I know that's not a religious perspective but I'm a quota scripture from Genesis it says God told Abraham to know of a surety your seat should be a stranger in a land that is not there as they should serve them they should be afflicted for for 400 years that affliction is really part of the prophecy are the most in history but I think it's more prophecy okay it's it's the equivalent to our condition in America black people okay Greg I've got to let you go with that because we're these deals okay thanks so much okay thank you very very much um let's go to Brandon and W in listening to WSC I'm Columbia good evening Brandon turn your radio down for me please okay I think go ahead okay um

this will be just kind of a short question I was um wanting to I guess get more information on what the lady was speaking about earlier as far as the hepatitis C mm -hmm okay the methods of it being transmitted through like syringes and needles as far as drug use within the prison and then um out of the prison she says and then of course it's introduced into the community um through other methods I just wonder what what or some of those other methods might be Dr. Treadwell in exchange of bodily fluids um in any way it certainly doesn't have you can come in contact with the blood if someone is bleeding and somehow you come in contact with that blood and it somehow gets into your skin because you have some breaks in your skin then you can have transmission and so we need to be very careful about whether or not people are being screened and how we need to be protected I think Dr.

Carter said something earlier about people needing to get involved in looking at what is happening to people and what is happening to the community and taking charge of some of this I'm not sure it has to be the way it is but we've got to get in charge of it Brandon is that help yeah yeah that helps um because I was just wondering um not only breaking the skin but maybe also through other forms of fluids say some I was a real nasty cold or something like that I'm going to be sitting there early I was switching from my earpiece actually taking out to the phone because the volume is changing okay Dr. Treadwell what about I mean cold is it that common can it be spread that way I'm not sure that we know all of the ways of how any particular disease is spread but um there were have been reports of people uh I think I need to just stop it finally okay we might need to have an expert really talk more about it sure I understand well last words on all of this um what do you think what is

the what can we do to kind of stem the tide or change the flow as far as how men are treated in the prison system or just in general as far as their mental health is concerned Dr. Treadwell I think the training programs are essential I Dr. Carter mentioned that there needs to be some process for certifying that people are really culturally competent but in addition to cultural competence I think we need to have larger numbers of African -Americans are people of color in the field because just having someone sitting on these panels where they discuss the cases if there's a person of color you might have a very different outcome in terms of referral for care then you do if there's nobody there and those people who are there don't have any cultural perspective sensitivity Dr. Carter well I just want to say that we need to just stay awake shows like yours that you know that braid to people's attention you know just what's going on in the world and just what's going on with us as African Americans we need more

information about that and not just information but we we can't just stay depressed ourselves about we can get involved involved in knowing that we can do something we can change something we can have an effect in the world to make a difference you know not to come to this day call there's nothing that we can't do okay thank you so much Dr. Carter for being with us and Dr. Treadwell we hopefully will make a difference in all of that and I do apologize to all of the callers that we could not get to this evening the executive producer for PowerPoint is Reggie Hicks the producers are Rose Holmes and Lee McDaniel our production manager is Glenn Simmons call screener is Joy Johnson PowerPoints news director is fond to Smith I'm Carmen Burns and you're listening to PowerPoint . Powerpoint is funded in part by the Corporation for Public

Broadcasting and the National Legacy Foundation. This is Powerpoint, a production of WCLK FM, a broadcast service of Clark Atlanta University.