Dear Heathy Men: You’ve mentioned several times in this column that men don’t go to the doctor as often as women and that they live shorter, sicker lives than women. I’m sure that’s true. But what I really want to know is why. Why don’t men take better care of themselves?
A: A number of factors keep men (and boys) from being as actively engaged in their own health care as they need to be. Here are some of the biggest ones:
— Socialization. When we’re little, boys are bombarded with the idea that “big boys don’t cry.” When we’re in high school, we’re told we need to “take one for the team.” And when we hit adulthood, it’s “man up.” Overall, the message is clear: Asking for and/or accepting help is a sign of weakness. Not surprisingly, men and boys ignore their symptoms and stay as far away from medical providers as they can.
— Media messages. In a comprehensive study of print advertising for health products and healthy lifestyles, Dr. Salvatore J. Giorgianni, Jr. found that ads were half as likely to be directed at men than at women. “This sends a clear message to boys and young men that (a) only women and girls have health-related needs, and (b) taking care of one’s physical or mental health is women’s responsibility,” says Giorgianni, co-founder and vice president of Healthy Men, Inc. (healthymen.org).
— The health care system is unwelcoming. A 2019 Cleveland Clinic survey found that going to the doctor is "so unappealing" that 7 in 10 men would rather do household chores, like cleaning the bathroom or mowing the lawn, than go to the doctor, and 77% would rather go shopping with their wife or significant other than to the doctor. As a result, about two-thirds of men prefer to self-diagnose and the same percentage will wait as long as possible before finally agreeing to see a provider. By then, it’s often too late.
Some of the blame for men’s experience of being unwelcome and uncomfortable in health care settings rests with providers. A majority of men in the 2019 survey said they would be more likely to have regular checkups if medical offices had more flexible hours. But even when they do make an office visit, according to researcher Will Courtenay's "Dying to Be Men: Psychosocial, Environmental, and Biobehavioral Decisions in Promoting the Health of Men and Boys, “men receive significantly less physician time in medical encounters than women … and are provided with fewer and briefer explanations." And while men are more likely than women to engage in high-risk behaviors and less likely to adopt health-promoting behaviors, physicians give them less advice about how to reduce their risk factors.
That said, men need to take some responsibility. In the 2019 Cleveland Clinic survey, about 20% of men admitted that they haven’t been completely honest with their doctor. Major reasons include feeling embarrassed, judged or uncomfortable; hoping that whatever problem they were having would go away on its own; not wanting to be told to make lifestyle changes; or simply not wanting to know.
Clearly, there’s a lot of work that society as a whole has to do to improve male health outcomes. To deal with the health care system part of the problem, Healthy Men, Inc. recently developed a Certified Men’s Health Educator program that has been very successful in teaching providers, educators and others who work with boys and men how to communicate in a male-friendly way that will motivate them to take on a more active role in their own health care.
