“I don’t make it a priority,” the Kansas City-based consultant and artist says. “I just keep putting it off.”
Waldorf isn’t alone. A recent Cleveland Clinic survey showed that 55 percent of men don’t see a doctor regularly and for men of color, the number jumps to 63 percent. Yet men pay a high price for ignoring their health. In the U.S., they live, on average, five years less than women. In addition:
- Men are 50 percent more likely to die of cardiovascular disease than women.
- One in two men will develop some form of cancer in their lifetime, compared to one in three women. (Prostate, lung, colorectal, bladder and melanoma top the list for men.
- Men are now four times more likely to die by suicide than women.
Like many men, Waldorf’s initial resistance was tied to youthful bravado. He was a healthy college student, then young professional, so why waste time having a doctor tell him what he already knew? Then, after Waldorf came out, he wanted a doctor comfortable treating a gay man. “That just added another layer,” he said.
Since then, he’s been put off by a host of reasons other men cite as well, including the high cost of seeing a specialist, the long wait time for appointments and a pervasive case of “it-it’s-not-broke-don’t-fix-it.”
“You get to a place where ignorance is bliss,” he said. “If I go, they may give me bad news.”
Another common reason men hold back is the headache associated with navigating a complex system. Ron Seeger, a retired museum director, has had long stretches without a primary care physician, mostly after doctors have moved. In addition, he once fell through the cracks with a specialist only to learn, months later, he needed significant treatment for an issue.
“It’s so frustrating,” he said.
For women, reproductive health is often a driver to seek routine medical care and establish some sort of physician-patient relationship. Many men, however, aren’t even aware of the list of routine check ups they should be getting. Director of Behavioral Health, Dr. Manuel Solano, of the Samuel U. Rodgers Community Health Center, says that list can vary, depending on medical history, but, in general, men should make these tests part of their routine.
Annually, they should have:
- A physical
- Blood pressure screening
- Cholesterol check
- Skin cancer check
Then, as men age, they should add these tests into their routine – unless symptoms or a family history dictate earlier screenings.
- Diabetes screening (Age 45)
- Colorectal screening (Age 50)
- Prostate exam (Age 50)
- Abdominal aortic/aneurysm screening (Age 65)
Dr. Solano said most public education campaigns aim straight for a message centered around educating men about the need for check ups. And while that’s critical, he sees other, bigger issues at play as well.
At Sam Rodgers, Dr. Solano sees patients from a wide array of cultures, countries and backgrounds. Factors like masculinity and culture play a significant role in whether a patient sees a physician regularly, he said. Many men are raised to believe that acknowledging pain is a weakness. Black and Hispanic people in general – men and women – are less likely to seek preventative care because they’ve had negative experiences in a health care system heavily biased toward white people. And, in many other countries, check ups just aren’t a part of any health care regimen.
Still, in spite of all those drivers, the most reliable predictor of a preventative health care routine is education, said Solano. People who are less educated are more likely to have generational poverty and less likely to have insurance benefits, reliable transportation, time for a doctor’s visit – and the resources needed to navigate a complex system.
Education, he said, creates access. And while culture used to be one of the highest barriers to a preventative routine, today it’s limited access due to cost or life circumstances.
“We blame the user,” Dr. Solano said, “because we don’t want to take a look at the systems that are creating barriers.”
Taking the First Step
Dr. Solano, and other medical care professionals, say the first step for men wanting to buck the odds and be proactive about health is to establish care, find a doctor up front when you’re feeling fine. The hardest part is getting into the system but once you’re in, the system will, in fact, work to keep you healthy.
For example, Dr. Solano said Sam Rodgerswill remind men that it’s time for their annual screenings. They’ll send a notice about flu shots and other vaccines.
“It doesn’t have to be a physician even,” he said. “It can be a nurse practitioner or a physician’s assistant – anyone working in primary care.”
For men who face significant economic and resource constraints, a federally qualified health center is the best option. They may have more flexible schedules, offering evening or weekend hours, for example. Plus, they’re equipped to anticipate barriers to care and help the patient address them, from transportation issues to an inability to afford medication.
“We look at the whole person,” he said.
How to Help Him Access Care
If a man in your life is avoiding health care, there are lots of ways to help him take that first step. Try these:
Ask for a referral. We trust our friends and family to offer restaurant recommendations. Why not a doctor? Plus, you can get information up front that might be helpful. For example, what’s the office like? What’s the physician’s approach to care?
Encourage him to figure out what he wants. It’s OK if he’d prefer a physician that meets certain sex, race and language requirements. The important point is that he feels comfortable with the physician.
Make the first call. It’s better if, eventually, he owns the process and makes his own appointments. That said, if he needs a nudge for the first one, help him out.
Offer to join him. A trusted companion can not only calm his nerves, they can ask follow up questions. You can offer to join at whatever level he’s comfortable with – as far as the waiting room or into the exam.
Point out the obvious. (Gently.) One of the most common reasons men don’t go to the doctor – especially after having avoided care – is they fear bad news. However, not going for preventative care isn’t going to make any lurking issues better. An early diagnosis will, however.
“The most important part,” Dr. Solano said, “is getting into the system. Do that, and the rest will help you.”
