June is Men’s Health Month, a designation meant to draw attention to preventable health problems among men and boys. One of the keys to preventing health problems such as heart disease and cancer — the top two causes of death among men, according to the Centers for Disease Control and Prevention, or CDC — is getting regular checkups. That’s something men are generally bad at.
According to a survey by the American Academy of Family Physicians, or AAFP, 55 percent of men have not seen their primary care physician for an exam within the past year. The CDC reports that in the first nine months of 2011, 77.9 percent of women aged 19-25 had a usual place for health care compared to 62.5 percent of men in the same age group. The Men’s Health Network cites data showing that men make half as many preventive care doctor’s visits as women.
“Men are just reluctant,” said Dr. Robert A. Lee, a member of the board of directors of the AAFP and a family physician at The Iowa Clinic, P.C. “They don’t want to hear bad news. And guys aren’t really chatty — they don’t like to talk about their problems.”
Dr. Michael Tilly, chief medical officer at Christus Santa Rosa Hospital-New Braunfels, or CSRH-NB, agreed that men don’t want to hear about or talk about medical issues.
“I think men’s egos get in the way,” Tilly said. “Men have a certain air of invincibility, and they don’t want to know if anything’s wrong with them. Most men would rather get up and go to the bathroom three or four times a night than see the urologist.”
Furthermore, Tilly said that while there are plenty of walks and other community fundraisers for conditions like breast cancer, “Men wouldn’t be caught dead in a walk for prostate cancer or erectile dysfunction.”
Beyond that, both doctors said that social conditioning and culture keep men from living their healthiest lifestyles. For example, Tilly said, men get together with their friends to drink beer and eat nachos and the like while they sit in front of a television for several hours to watch a football game. Moreover, Tilly said, Americans are generally trained to eat three meals a day, and skipping a meal on occasion is unthinkable. We are also not trained to consider portion control.
“The culture is killing us,” Tilly said.
Another factor is that men are not as cognizant of the status of their health.
“Their perception of their physicality is not a reality,” Tilly said. “That’s a phenomenon I’ve observed for years.”
According to an AAFP survey, 28 percent of men had been diagnosed with high blood pressure and 10 percent had been diagnosed with diabetes, and according to the CDC, approximately 71 percent of men are overweight. Despite this, 79 percent of men surveyed by the AAFP said they are in good, very good or excellent health.
Failing to take preventive measures has led to an overall decrease in men’s life spans.
According to the Men’s Health Network, in 1920 the life expectancy gender gap was only one year, but by 2010 women were outliving men by about five years. Although more males are born each year, by age 35 women outnumber men, and at age 100, women outnumber men eight to one.
Tilly said men often realize the importance of preventive care after something serious happens or if they come in with an immediate health issue, like a hernia or severe pain or bleeding.
“I’ve had patients come in for a hernia with blood sugar of 800 instead of 110,” he said, adding that sometimes something as major as a heart attack will help a man start taking better care of himself. “It takes almost a catastrophic event to make a man realize something has to change. But you don’t want to get to that point.”
Tilly said that by the time a man is 55 years old, he should have had a prostate exam, a colonoscopy and a blood test to check things like blood sugar and cholesterol levels.
Tilly also said that men can take their health into their own hands by paying attention to what and how much they eat, not smoking and getting exercise.
“A little common sense goes a long way, and there’s a shortage of common sense in dealing with men’s health,” he said. “To me, the most important thing is to stay mobile.”
Tilly said that people in New Braunfels seem to be getting more active, riding bicycles and walking, but that people need to make a concerted effort to stay healthy. He said that if a man’s wife goes walking 2 miles in the evening, the man should go with her, even if he feels tired.
“If you fight through that inertia, you feel 100 percent better in 20 or 30 minutes,” he said.
Spouses and significant others can be more than just exercise partners; the AAFP has said that most men surveyed on the issue said their spouses or significant others would influence their decision to go see a doctor.
Lee said that in Iowa, there is an ad campaign with the slogan, “Be a man; get a checkup.”
“It’s been very effective,” he said, “Patients have come in quoting it.”
Lee said that once a man chooses a doctor, they can work together on preventing and treating health problems.
“My patients have a relationship with me,” he said. “We talk. I’m almost like a buddy they talk to. If they do have a relationship with a physician, they’re more likely to talk to their doctor.”
As Tilly mentioned, Lee said that keeping a medical emergency from happening is better than experiencing one and then deciding to make changes.
“The best thing is prevention,” he said. “It’s better than waiting for the chest pain to happen.”