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Although not all health providers see a need for a federal agecy for men's health, many are calling for a bigger effort to change the way men approach wellness.

When Gary Shelton, MSN, RN, visits high schools to talk about safe sex, testicular self-exams and other health practices, he finds a predictable amount of nervous tension among the teenage boys.

"First there's the giggles and throwing around the model I bring, then we get down to business," said Shelton, an oncology nurse specialist at New York-Presbyterian Hospital, Columbia Presbyterian Center's Herbert Irving Comprehensive Cancer Center.

Unfortunately for many men, as they age, their comfort level with health care doesn't seem to improve much. Men are less likely to see a doctor regularly, less likely to take advantage of preventive screenings and less likely to seek care when they're feeling poorly.

Men also die sooner than women, and the life expectancy gap has been widening.

In 1900, women in the United States lived an average of 2.8 years longer than men, according to the National Center for Health Statistics. By 2000, the life expectancy difference had increased to five years. Women live, on average, 79.5 years compared to 74.1 years for men.

Men's health advocates see this widening life expectancy gender gap as a sign of what some call "the silent crisis" in men's health. Men's Health Network, a Washington-based nonprofit advocacy group, points to the greater number of males dying from heart disease, cancer, AIDS, suicide and accidents as even greater proof of the deteriorating health of American men.

In 2001, Rep. Randy "Duke" Cunningham, R-Calif., a prostate cancer survivor, made a move to combat the health crisis. He introduced a bill to establish a national Office of Men's Health within the Department of Health and Human Services.

This new health department, modeled on the Office on Women's Health, would promote men's health screenings and research into male-specific diseases, such as prostate cancer. The 60-year-old congressman attributes his survival to an early diagnosis when he had a prostate screening test during a checkup.

His bill, co-sponsored with Rep. Jim McDermott, D-Wash., is attracting bipartisan support with more than 50 co-sponsors.

"The need for this is absolute and overwhelming," said Ronald Herald, MSN, a member of the advisory board for Men's Health Network, which is lobbying for the bill.

The Men's Health Act of 2001 is in the House subcommittee on health, energy and water. With issues such as homeland security occupying lawmakers, there are no guarantees the bill will make it out of committee this year.

Yet public support for the bill is growing, said Harmony Allen, spokeswoman for Cunningham, and the president could establish an Office of Men's Health by executive order if the bill doesn't succeed. The question is how to balance all the competing health care funding needs for research and education, she said.

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