Kaiser Permanente researcher initiated one of the largest and longest-running men’s health studies
By Sue Rochman
Research scientist Stephen Van Den Eeden, PhD, arrived at the Kaiser Permanente Division of Research (DOR) in 1990 hoping to one day establish a large cohort study that would provide new insights into men’s health, behaviors, and risks for certain diseases. In 2001, as part of a DOR research team, Van Den Eeden received funding to make that happen.
Over the next few years, Van Den Eeden and his colleagues recruited 84,170 male Northern and Southern California Kaiser Permanente members between the ages of 45 and 69 for their newly launched California Men’s Health Study. Nearly two decades later, it remains one of the largest and longest-running cohort studies of men in the world.
Van Den Eeden came to DOR with an interest in men’s health that continues to drive his research today. He is also the lead researcher for the Environmental Exposures Core for the Research Program on Genes, Environment and Health (RPGEH), one of the largest programs in the U.S. to examine the genetic and environmental factors that influence common diseases. As part of the RPGEH, he is investigating the relationship between green space — open space in urban areas such as parks, community gardens, public plazas, and playgrounds — and health care costs.
“With my research,” said Van Den Eeden, “one of my earliest points has always been ‘think about what you can do at Kaiser that you can’t do elsewhere,’ and that has guided me for 30 years.”
How did the California Men’s Health Study get started?
In 1995, the California Cancer Research Program (CCRP) funded the California Teachers Study, a cohort study of more than 133,000 women to investigate women’s health behaviors and risk factors for breast cancer and other diseases. A few years later, CCRP decided a similar study of men was needed and put out a request for applications. This type of study had been a longstanding idea of ours, so we applied, focusing on the diversity of our membership and the unique opportunities it provided. The funding gave us the opportunity to learn more about men’s health behaviors, issues related to men’s health, and risk factors for prostate and other cancers as well as non-cancer conditions.
Are the men who were recruited for this study still being followed?
Yes. Many of the men are still alive. We most closely follow the men who are still Kaiser Permanente members, as can be expected. But those who are no longer our members can still be contacted.
How can researchers use the data you have collected?
It’s a goldmine for investigators. The surveys that the men completed when they enrolled in the study asked questions about their demographics; family, medical, and cancer screening history; sexuality and sexual development; lifestyle behaviors, such as diet, physical activity, and smoking; and their use of prescription drugs, non-prescription drugs, and herbal supplements. We know what health issues the men who are still Kaiser Permanente members have experienced over the past 18 years, so we can look for associations between their behaviors and the diseases they develop.
We also were able to use the California Men’s Health Study as a resource for our genetic health project, the RPGEH. That study was started in 2005 to help us learn more about genetic and environmental factors tied to common diseases and healthy aging. In 2008 and 2009, we asked the men in the California Men’s Health Study for saliva samples so we could add them in a concerted way to the RPGEH study, and more than 15,000 responded.
What do you see as some of the most significant findings from the California Men’s Health Study?
In 2009, we showed that generational status and duration of residence in the U.S. were associated with diabetes prevalence among middle-aged Latino men — a population that has a higher prevalence and younger age of onset of diabetes than whites. This finding provided information, including evidence of a migrant effect, that could drive efforts aimed at reducing diabetes. In 2012, we found racial/ethnic disparities in lower urinary tract symptoms. We are continuing to look for the underlying causes for this disparity. And in 2015 we showed that most men with mild or moderate lower urinary tract symptoms did not have surgery or use medication to treat it. In 2015, we also reported that marijuana use was associated with a lower risk of bladder cancer. Most recently, in 2018, we were the first group to find a genetic risk factor for erectile dysfunction. This was possible because of the men in the California Men’s Health Study who contributed to the RPGEH.
How do you like to spend your free time?
I like to share meals with my friends and family, visit my in-laws in Italy, and travel. The last two are pre-COVID of course. And I spend a little time doing various forms of photography, most recently Polaroids and cyanotypes.