By Jamie Cohen | June 7, 2011 | abcnews.go.com
Men Avoid Preventive Health Care in Sickness and in Health
Maybe it’s just a guy thing. Men duck doctors when sick and avoid checkups when well.
“Study after study has shown that men are more reluctant to face up to worrisome symptoms or go to the doctor for checkups,” says Dr. Timothy Johnson, ABCNEWS’ medical editor. “And that is probably one big reason why men’s life expectancy, which in the early 1900s was virtually the same for both sexes, now lags behind women’s by approximately six years.”
Policymakers also will have a role to play. One obstacle that may require their intervention is men’s general lack of access to health care. More than one-third of men aged 18-44 do not have a regular doctor, and one-third have not seen a doctor in the past year. In addition, men are less likely than women to have health insurance, primarily because they are less likely to be enrolled in Medicaid. One-quarter of men aged 15-49—including 37% of men in their early 20s—have no health coverage of any kind; these rates are substantially higher among poor and minority men. Even those who are insured may not have access to the services they need, because counseling and skills-building services require substantial amounts of time to provide and are unlikely to be covered by either private or public insurance. – The Guttmacher Report on Public Policy
Men are also less likely to see themselves as susceptible to disease or injury when, in fact, they are more susceptible, says Dr. Will Courtenay, director of Men’s Health Consulting in Berkeley, Calif., a lecturer at Harvard Medical School and editor of the International Journal of Men’s Health.
A woman’s lifetime risk for cancer is one in three, for example, while a man’s is one in two. “Compared to women, men have higher death rates for all top 10 leading causes of death,” says Courtenay.
Excuses, Excuses, Excuses
So what is it about a visit with a “white coat” that has men dragging their heels?
Perhaps just what patient David Hutson described to ABCNEWS’ Good Morning America as a typical visit: “Doctor’s offices are so cold, you have to get naked, and then stare at diagrams that make you feel like an idiot.”
“Many say they’re ‘too busy,’ ‘they feel good,’ and that’s there’s ‘nothing wrong with them,’ ” says Dr. Neil Coleman, a family physician with HealthWise Medical Associates in Vernon, Conn.
Others see it as a waste of time and money, a problem magnified by the fact that “men are less likely than women to have health insurance,” says Courtenay.
“To make sure I’m not dying, I give blood several times a year. They check my blood pressure and pulse. Who needs the doctor?” Brian Flynn tells Good Morning America.
Agrees Hutson: “The best thing a doctor can tell you is ‘You are fine.’ So, for all the effort, the best result is ‘You’re OK’, which you probably figured anyway. Why do I need a doctor?”
And finally, there are those like Eduardo Monjardim Pussar, 38, of New York, who opt for the “What I don’t know can’t hurt me” approach.
“I don’t want to find out I’m going to have to deal with something that would disrupt my life,” he says. “Once I get into a routine and like it, I don’t want to make any lifestyle changes.”
And what can happen should a man finally go to the doctor? Healthcare professionals “spend less time with men than women and thus provide less time for men’s questions.” –Dying to Be Men, published in 2011 by Will Courtenay
The ‘Boy Code’
Experts on the male psyche suggest the reason men put off seeing the doctor is more than time or money, and perhaps a deep-rooted, inherent sense of what it means to be a boy.
It seems that from the moment a newborn male is swaddled in a blue blanket, he begins to learn the “boy code,” a term coined by Dr. William Pollack, director of the Center for Men and Young Men at McLean Hospital in Belmont, Mass., and assistant clinical professor in the department of psychiatry.
The boy code teaches young males to be rough and tough. “Research also shows boys are discouraged from seeking help and are often punished when they do,” agrees Courtenay. Boys come to believe they should slough off pain and just play through it, an ideal that is hammered in by coaches, fathers and sports heroes.
The Uncomfortable Visits
The men who do put aside their pride and fear to visit the doctor (often to silence relentless pleas from friends and family) report feeling “put down and ashamed,” says Pollack.
And it’s not just the backless gown.
Experts say many men view sickness as a vulnerability, the polar opposite of masculinity. “A physical problem changes a male’s sense of self,” says Pollack. Acknowledging a need to be protected alters a man’s perception that he is the protector.
Women, in contrast, are much more likely to see the doctor because this decision does not affect who they are. Being cared for is viewed as “feminine,” so it feels more acceptable. Furthermore, a woman’s yearly gynecologic visit may have trained her to understand the importance of preventive health care.
Pollack suggests that physicians be sensitive to a male’s need to feel strong and in control. The way a man feels after a visit with the doctor will often determine whether he will follow the advice his doctor gives. In the end, a doctor’s attitude and approach is “a matter of life or death,” says Pollack.
But experts say one approach to the problem is to appeal to the male’s sense of honor and duty by helping family members concerned about him. A wife may try telling her husband, for instance, that she and the kids “love and need him around,” making him feel he’s seeing a doctor in order to fulfill a familial responsibility.
Avoiding the doctor means that many men miss out on catching problems that could be prevented with early intervention. So experts say don’t wait until it’s too late.
“Seeing your doctor regularly and screening for common diseases can give you the peace of mind that you’re healthy, or worst-case scenario, that you will have the best odds of beating whatever you do have,” says Johnson.
For more information on men’s health, see Dr. Timothy Johnson’s OnCall Guide to Men’s Health, which provides men of all ages with guidelines for staying healthy and dealing effectively with medical concerns as they arise.
Male Matters’ author is a member of NCFM.org