Since June is Men’s Health Month, we’d like to take this opportunity to take a closer look at men’s health, particularly during this time when COVID-19 has taken center stage of most health conversations. Eric Schaefer, M.D., medical oncologist and hematologist at Highlands Oncology Group in Northwest Arkansas, warns that it is “critically important for men (and women) to pay extra attention to their health during this COVID pandemic. The added stressors of working from home, job loss or even the added presence of children at home full time, paired with decreased social interaction (because of social distancing) have led many men to increase food and alcohol consumption.”
Schaefer also points out that there has been a surge in new cancer diagnoses, and most likely in other diseases as well, because people ignored symptoms and waited to see a doctor due to fear of contracting this virus from a doctor’s office. It’s important people not skip medical visits; see a professional if you have medical concerns.
Below, we’ve listed the top 10 causes of death for men in Arkansas, according to data from the Arkansas Department of Health. Healthy weight and regular exercise are the key measures to preventing almost every disease. Overeating, not exercising, smoking, drug- and alcohol-use are common denominators of most of the following causes of death.
1. Heart Disease
Heart disease is the leading cause of death for both men and women across the country. Sadly, Arkansas has one of the highest mortality rates in the United States. With more than 8,000 deaths per year, the state is ranked third-highest in the nation. According to Reza Hakkak, Ph.D, professor and Chair of Department of Dietetics and Nutrition and Associate Dean for Research at the University of Arkansas for Medical Sciences (UAMS) College of Health Professions, most deaths from heart disease (as well as stroke and diabetes) can be attributed to being overweight or obese. “Arkansas has one of the highest obesity rates and is now 3rd in the U.S. in the percentage of adults considered obese in 2019,” Hakkak says. “There are several reports that say there is a link between obesity and chronic diseases development, such as heart disease, stroke, type-2 diabetes and certain types of cancer that are some of the leading causes of preventable, premature death.”
• According to Centers for Disease Control and Prevention (CDC) data from 2017, there were 8,270 deaths in Arkansas related to heart disease.
• Arkansas is ranked as the third-highest in heart disease compared to other states.
• Most heart disease is linked to unhealthy weight.
• Men are prone to heart disease at a younger age than women. On average, men with heart disease suffer their first heart attack at age 65, while women average a first heart attack at 72.
According to the CDC, Arkansas is ranked the sixth-highest state in cancer-related deaths. Local doctors agree that there are multiple reasons the state ranks so high. Schaefer says one reason is a delayed diagnosis leading to later stage cancer before treatment. “Patients who ignore symptoms typically have missed routine screenings,” he explains. Age-appropriate recommended screens for men include colonoscopies and prostate exams.
Dr. Balan Nair, Chief Medical Director and Medical Oncologist for CARTI says, “Arkansas has one of the highest rates of smoking in the nation. This is the primary driver for a number of cancers including lung, head and neck, esophageal, bladder and kidney. Additionally, there is a correlation between developing cancer and obesity or excessive use of alcohol, which are both issues that plague our state.”
“Lung cancer is the top cause of cancer death for men in Arkansas, and the number of Arkansans we lose every year to lung cancer is greater than those who die of colorectal and prostate combined,” says Dr. Matthew Steliga, Chief of the Division of Thoracic Surgery and associate professor of surgery in the UAMS College of Medicine. The good news is that with early detection through CT scans, cure rates are very good. Schaefer recommends that people who have smoked more than one pack per day for more than 30 years get a lung cancer screening CT scan. “The biggest factor that prevents people from getting these basic cancer screens is the perceived costs of these tests,” Schaefer notes. “One of the most remarkably effective, but underpublicized screening programs is the NWA Lung Cancer Screening Program.” This free screen is available at Highlands Oncology in Northwest Arkansas.
• In 2017, there were 6,517 deaths in Arkansas related to cancer.
• Arkansas is ranked the sixth-highest in cancer-related deaths.
• Lung cancer is the top cause of cancer death for men and women. Smoking cessation is the best thing to do to decrease cancer risk.
• Men should get age-appropriate colonoscopies and prostate exams.
3. Chronic Lower Respiratory Disease
With 2,517 deaths in 2017, Arkansas has more deaths from chronic lower respiratory disease (CLRD) than any other state in the nation, according to the CDC. Dr. Nikhil Meena, an interventional pulmonologist at UAMS, says the reason the numbers are this high are from smoking, diet, health literacy, access to health care and poverty. “Smoking cessation and nutritious diet along with an increased health literacy and belief in science would change the outcomes markedly,” she says. “Poverty and access to health care are bigger and harder to alter.” CLRD includes chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, as well as asthma, pulmonary hypertension and occupational lung diseases. While mortality rates for the top two leading causes of death — heart disease and cancer — are decreasing, deaths from CLRD continue to rise.
• There were 2,517 deaths in Arkansas related to chronic lower respiratory disease in 2017.
• Arkansas is ranked No. 1 in chronic lower respiratory disease compared to other states.
• Smoking is a major cause of CLRD.
Although stroke is the fourth-highest cause of death in the state, gender-specific statistics show that men die more from accidents than from stroke, making accidents No. 4 among men. Dr. Ron Robertson, medical director of trauma and chair of the Department of Surgery at UAMS College of Medicine, says “In some cases, men are more likely to be in environments that increase their injury risks: construction, industry, farming, trucking, etc. In other cases, [the higher death rate] is felt to be related to risk-taking behaviors such as speeding, motorcycle riding, alcohol consumption, competitive sports, etc., which men are more predisposed to.” Similar to disease, injury is believed to be preventable in most cases. “Injury prevention related to gun violence is a current calling for trauma centers around the country. The public health approach emphasizes prevention that focuses on innovations that can address gun safety, mental health and meaningful policy change.”
• Unintentional injuries are the leading cause of death for males between the ages of 1 and 44.
• Arkansas is ranked 29th in the nation for accidents that lead to death.
• Alcohol greatly increases the chances of accidents of all kinds.
Arkansas is ranked 7th in deaths from stroke compared to the rest of the country. Unfortunately, this is the fifth-highest killer of men, but the good news is that many fewer Americans die of stroke now than in the past. Hakkak points out that, like heart disease and diabetes, there is a correlation between stroke, poor diet and lack of exercise. “Sedentary people burn fewer calories than people who are active,” he says. “In Arkansas, we consume a diet that mostly has very high saturated fat, low fiber and low calcium. Of course, we are not eating enough vegetables even though we are one of the most important states in agriculture.”
• Two main causes of stroke are blocked artery or burst blood vessel.
• In 2017, there were 1,612 deaths due to stroke.
• Arkansas is ranked No. 7 in stroke deaths.
• Poor eating and lack of exercise contribute to risk of stroke.
Arkansas ranks as the third-highest for diabetes-related deaths. There are two types of diabetes. In type-1 diabetes, the body does not produce insulin. In type-2 diabetes — the most common form of diabetes — the body is able to create insulin, but doesn’t use it properly. The exact cause of type-1 diabetes is unknown, but being overweight is strongly linked to the development of type-2 diabetes. Hakkak believes we can prevent diabetes and other deadly diet-related diseases by undertaking a healthy diet and increasing physical activity. This includes eating whole grains, fruits, vegetables, lean protein and drinking water. For physical activity, the CDC recommends adults do at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity — or a combination of both, along with two days of strength training per week.
• Arkansas ranks as the third-highest for diabetes-related deaths.
• Diabetes killed 1,180 people in Arkansas in 2017
• Type-1 and type-2 diabetes are both thought to have genetic and environmental components that lead to their development.
• Eating healthy and following CDC physical activity guidelines can help prevent diabetes.
Sadly, suicide is a problem nationwide, and Arkansas is no exception. According to Dr. Erick Messias, associate dean for Faculty Affairs and professor of psychiatry for the College of Medicine at University of Arkansas for Medical Sciences, increased suicide risk has been associated with a few factors that are common in Arkansas, including access to firearms and more rural areas. “The lethality of suicide attempts with firearms is very high, and men are more likely to use that as a means compared to women, who tend to use more and overdose,” Messias says. “Increase in suicide is also associated with alcohol and drug use — I am particularly worried about meth and opioid use in our state.” Messias believes preventative measures should include restrictions to impulsive gun purchasing, increased mental health care, more access to substance-use treatment and rehabilitation facilities and partnerships with faith groups that provide support.
Dr. Susan L. Shackelford, clinical psychologist at Psychology and Counseling Associates in Fayetteville, says depression is one of the most common diagnosed mental health disorders in the United States. “Men and women exhibit depression in different ways,” she notes. “Men tend to become more irritable, angry, and exhibit physical symptoms such as aches and pains as well as sexual dysfunction.” Men are less likely to seek help because there is a stigma, but depression, anxiety and other mental health issues are not signs of weakness. They can be caused by medical illnesses, genetic factors and environmental stress.
“I would expect given the current COVID-19 pandemic, excessive job loss and economic strain, we will see many more cases of depression in men as well as deaths by suicide. Unfortunately men are more likely than women to commit suicide,” Shackelford says.
There is help, and treatment is more accessible now through telemedicine. If you or someone you know needs help, call 911 or the 24-hour National Suicide Prevention Lifeline 1 (800) 273-TALK.
• Suicide is the 10th leading cause of death overall in the nation, but it’s the seventh leading cause of death among men in Arkansas. Men are more likely than women to die by suicide.
• Arkansas was the ninth-highest in the country for suicide.
• In 2017, there were 631 deaths by suicide in the state.
• Alcohol and drug use are related to an increase in suicide.
8. Alzheimer’s Disease
According to Dr. Jeanne Wei of UAMS Donald W. Reynolds Institute on Aging, because of our strong historical focus on loving and caring for our older community members, awareness of Alzheimer’s disease as a cause of death is more common in our state than in most other states. Similar to other diseases, Alzheimer’s is also linked to cardiovascular disease, hypertension, high cholesterol and smoking. “The reason why Alzheimer’s disease affects men more than women is because blood pressure tends to rise higher in middle-aged men, while blood pressure tends to rise later in women (usually after menopause),” Wei explains. “It is now more appreciated that elevated blood pressure in middle age is a major risk factor and predictor of cognitive impairment and Alzheimer’s dementia in older age (after age 60).” Some measures to prevent Alzheimer’s include: stop smoking, avoid fried foods, reduce sugar intake, take blood pressure and cholesterol medication as directed, exercise frequently and see a doctor regularly.
• Arkansas is ranked 10th in the nation for Alzheimer’s disease.
• Blood pressure is a major factor leading to Alzheimer’s.
• The Alzheimer’s Association 2020 report estimates there are currently more than 5 million Americans over the age of 65 living with Alzheimer’s — a number expected to nearly triple by 2050.
According to Dr. Nasir Khan, assistant professor and transplant nephrologist in the UAMS College of Medicine, death from kidney disease globally as well as across the U.S. in adult population across all age groups and genders is one of our biggest challenges in modern health care — increasing by as much as 50 to 60 percent over the past 15 years or so. In particular, among African-American men in Arkansas, death from kidney disease is one of the highest in the nation, unfortunately. African-Americans have a genetic predisposition that makes the effects of other diseases — especially high blood pressure and diabetes — on the kidneys even more severe.
“In my opinion, to prevent or minimize the death from kidney disease, there has to be a coordinated, three-prong approach,” Kahn says. These are prevention, treatment and transplantation. The first step is prevention by minimizing risk factors such as obesity and high blood pressure and going for regular primary care visits that could lead to early detection, especially among African-Americans. The second step is to seek early treatment as it is of utmost importance to slow down or halt the disease. Finally, once the kidney failure has set in, early kidney transplantation has repeatedly been shown to be the most cost-effective treatment that also prevents early death, compared to dialysis.
• Arkansas is ranked third-highest in the nation for death from kidney disease.
• In 2017, there were 725 deaths in the state from this disease.
• African-Americans have a higher genetic predisposition.
• High blood pressure and diabetes are major contributing factors.
According to Dr. Robert H. Hopkins, professor of Internal Medicine and Pediatrics and director of the Division of General Internal Medicine at UAMS College of Medicine, Arkansas has a smoking rate that is roughly 20 percent higher than the rate in the entire country (most begin in childhood), and our teen smoking rate is about 40 percent higher than the national rate. “Arkansas has wonderful outdoor opportunities, yet we have one of the highest rates of obesity in the nation,” he says. “This contributes to many adverse health outcomes, including pneumonia.”
Influenza vaccination rates in Arkansas children are a bit above the national average, however, rates for adolescents and adults lag significantly behind the national rate. Unfortunately, pneumococcal vaccination rates for children and adults are all well below national rates, particularly for those who are at highest risk — persons with chronic medical conditions and persons 65 years of age and older. Hopkins recommends Arkansans start or maintain regular aerobic exercise and team up with health care professionals to improve their overall health and to help them quit if they are vaping or smoking. Children should be immunized completely in accordance with CDC/AAP/ACIP guidance to minimize their risks for vaccine-preventable diseases like influenza and pneumonia. All adults should receive an annual flu vaccine and many adults (including all aged 65 and older) should receive pneumococcal immunization.
• Arkansas is ranked 5th in the nation for influenza/pneumonia deaths.
• In 2017, there were 8,270 deaths in Arkansas related influenza/pneumonia.
• Smoking is a major risk factor, and the Arkansas smoking rate is roughly 20 percent higher than the national rate.