A male dilemma
Do you suppress the impact of injuries, illnesses? Yup...you’re a man
Heard about Movember?
Exactly. It’s a movement for a men’s health awareness in the month of November, but not many people are aware of it.
In October, dozens of agencies, organizations and businesses around Marietta went pink to mark women’s health month and breast cancer awareness. The number of events on the calendar of the Movember website in all of Ohio? Zero.
Men’s Health Month in June – Father’s Day falls in June, hence the designation – got some attention, including a lengthy news release from U.S. Rep. Bill Johnson urging men to look after themselves. International Men’s Day on Nov. 18 lit up a bit on social media..
According to the National Institutes of Health data, men tend to be far less conscientious than women about their health, especially on the prevention side. Of the nearly one billion physician office visits across the nation in 2017, female patients will account for more than two-thirds. Even when adjusted for visits involving pregnancy, women between the ages of 18 and 64 go to the doctor at a rate of 342 per 100,000 population annually, and men in the same age range account for only 205 per 100,000.
In the end – really, the end – the life expectancy for men is close to six years less than that of women in the U.S.
The data shows that there really is more difference between men and women than just the packaging. Men engage in riskier physical behavior from an early age, suppress the effects of injuries and the symptoms of illnesses, and despite a trend toward gender equality in the
workplace still are much more likely than women to have jobs that beat them up physically.
Women band together over health issues, network with one another and conduct public awareness campaigns. Men come together for the most part to form teams for activities that will give them fractured bones, overstressed joints and concussions.
Suicide data from the World Health Organization shows that men in America kill themselves at a rate more than three times more frequent than that of women: for 2015, 22.1 men per 100,000 population died of self-inflicted injuries; for women, the number is 6.5.
Anyone who has filled out a life insurance application knows that men are more expensive to insure than women at all ages because men are short on prevention, long on catastrophe and don’t live to the same age, which means fewer years of premiums to collect before the final payout.
Dr. Leah Hopkins, an internal medicine and primary care practitioner for the Memorial Health System in Marietta, notes another piece of data buried in the CDC numbers: Men who are married get back, in a general, statistical sense, that five or six years of life.
Short of a life-threatening event, she said, men tend not to show up at a doctor’s office until they reach their mid-40s. Unless they’re married.
“The No. 1 reason I’m given by men why they come in is that a female made them do it,” she said.
Men tend to be dismissive about preventive care, she said.
“You feel good, you don’t have time for it, why bother? But women are the caretakers, nurturing, they plan ahead. It’s kind of the way we are wired,” she said.
Hopkins noted that in America, despite the public dialogue on the cost of health care, the fundamentals of good health are taken for granted, and relatively cheap.
“The truth is, the basics of health aren’t that expensive. We have access to clean water, access to decent nutrition, shelter, all kinds of things. When you look at what you need for stability for people to thrive, we have a lot of that,” she said. “There’s a perception that spending money on doctors is a waste of time — why do that if you feel fine?”
Dr. Doug Brooks has taken a specific interest in the health of men. Before returning this summer to his hometown of Parkersburg to practice as a primary care physician with Camden Clark Medical Center, he operated a clinic in Charlotte, N.C. specifically to care for men.
The clinic was staffed entirely with men, featured sports broadcasts and generally was designed to provide a welcoming atmosphere for male patients, he said.
“I’ve always had that interest in men’s health,” he said.
Although men tend to be stoic and macho about their health, he said, the typical clinical settings have not been deliberately conducive to bringing them out of that shell.
“What I’ve seen in the past was that children go to pediatricians, women have gynecologists but men really have not had anybody that interested in their health,” he said. “When they can find somebody who can talk them through things, they realize it’s vital to go to a doctor, somebody who is going to take an interest and try to make a difference in their future.”
Brooks said men suffer disproportionately from three general health issues: early heart disease, prostate cancer and colorectal cancer, and family medical histories can help foretell problems with all three.
“Some men have uncles, parents, grandparents, cousins who have had heart attacks in their 40s and 50s. If they have that kind of (inherited) cholesterol, it’s something you can’t really change with diet and exercise,” he said.
It’s a treatable condition, he said, but the first step is identifying it, which is a matter of a specific test used on a blood sample.
Blood tests for many years have included a standard screening for the antigen indicator — PSA –for prostate cancer, but Brooks said the medical community has taken a second look at that.
“It’s changing a bit,” he said. “It used to be that everyone received the PSA check and an annual prostate exam, but now it’s more in the middle,” he said. “You should talk to your doctor, because the risks don’t always outweigh the benefits.”
There are lot of false positives in the PSA tests, he said, and the risks include infections from biopsies and the mental distress of a possible cancer diagnosis.
“If a man has a family history, I’ll push for it, but if not I’ll warn him about the false positives because it might open a Pandora’s box. The most aggressive prostate cancers happen in your 40s and 50s, so if you get past that you probably don’t need testing unless you have symptoms,” he said.
Men’s reluctance to go to the doctor goes beyond the nature of the clinical setting and the sympathy of the physician.
“Even outside of a medical setting, women are just better in tune with their bodies and their emotions, they talk about their problems a lot more than men do,” Brooks said. “I think we can start to change that narrative if we can convince men to be more open, especially if it’s presented as something to be done for families, not themselves. That’s the definition of strength.”
Cost is another factor.
As if to confirm the concept of men’s reluctance to talk about health, several declined to talk to the Times in a random tour of local parking lots, and two who agreed to didn’t want their names used.
The two men in the Giant Eagle parking lot took a break from talking about the merits and shortcomings of their hunting dogs to discuss health care.
“Too expensive, that’s it,” the main in a plaid jacket said. “Just common sense.”
“Outrageous,” the other said. “My wife pays $600 a month for insurance, and that’s just her share for the company plan. I’ll go if I start feeling rough, but that’s all.”
“Me and my brother have both had heart attacks,” the man in plaid said. “I don’t know how you’re going to live in this world. My back hurts. It’s an arm and a leg just for the pills they give you.”
“Guys don’t go to the doctor because of the cost. That’s all there is to it.”
Brooks agreed that cost can be prohibitive.
“I’ve been doing this 17 years and I’ve never seen insurance so high,” he said. “A lot of people are making their deductibles high because they want low premium, catastrophic coverage. Until you hit the deductible, you’re on your own … The whole insurance market has to improve, and it’s very complex, and I don’t have the answers, but until people can afford insurance that gives them good preventative care, it’s going to be prohibitive.”
Getting people to embrace good diet and exercise is an uphill struggle but the medical benefits can be enormous.
“I like traditional medicine, but I think we’ve gotten away from putting in the hard work of diet and exercise,” Brooks said. He recommends the Mediterranean diet or the paleo diet, and said weight lifting has made a comeback as a good cardio exercise. Stretching and yoga is good for the body and the mind, he said.
With the changing economic and social conditions in Appalachia, many men see a dimmer future and as a result have neglected their health.
Mental and physical health go together, Brooks said, and each is important to the other.
“Do depressed people do unhealthy things, or do unhealthy things make you depressed?” he said. One way to find out is to start doing healthy things, one at a time, and watch the effect.
“Exercise increases the neurochemicals in your brain like dopamine and serotonin, and that makes you feel better,” he said. “There is absolutely science behind that.”
At a glance
Men and health:
¯ Life expectancy at birth in the U.S. compared to women: Six years less.
¯ Physicians office visits in the U.S. for women age 18-64, per 100,000 population (adjusted for visits related to pregnancy): 342.
¯ For men: 205.
Source: National Institutes of Health.