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Risking Their Health

August 16, 2005 | Men are much less likely than women to seek regular medical care. How doctors and lawmakers are trying to change that.

Anthony Whitney admits he used to be the type of guy who visited the doctor “maybe every five years.” “I just never thought about getting check-ups because I didn’t feel bad,” says the 34-year-old. “Most guys, we feel like as long as we don’t have any symptoms, there’s no reason to go to the doctor.”

But the Richmond, Va., computer analyst learned otherwise when he finally saw a doctor because of dizzy spells, frequent headaches and the need to urinate constantly. The physician told Whitney he suffered from hypertension: his blood pressure of 180/110 was way above the normal reading of 120/80 or lower. Worse, years of high blood pressure had caused irreversible damage to his kidneys, which meant he'd need dialysis or a transplant to stay alive. At first, doctors put him on a high dosage of steroids to try to strengthen his kidneys. Then he spent three days a week, four hours a day, hooked up to a dialysis machine that filtered his blood. Finally last December, he received a kidney from his Virginia State University fraternity brother, Scott Johnson, 35.

Whitney knows how lucky he is to have gotten a donor kidney. But he also knows that he may not have needed it if he'd had annual physicals and gotten his blood-pressure checked regularly. “If I caught it [the hypertension] earlier, it’s something that may have been prevented,” he says. “I found out too late.”

National health organizations are now trying to make sure that other men also get that message. The U.S. Department of Health and Human Services has declared Sept. 20 "Take a Loved One to the Doctor" Day and ABC network radio stations across America will air a series of public service announcements encouraging men to get regular physicals. Some of the messages will be aimed at minorities, who are at greater risk for conditions like heart attacks and strokes. Government figures show that disproportionately higher numbers of African-American men over 20 are diabetic and that their life expectancy of 68.6 years is almost seven years less than white males. (White women are projected to live a massive 12.4 years longer than black men.) An additional barrier for many African-American men is their distrust of the healthcare system, in part because of revelations about past studies like the Tuskegee experiment of 1932-1972, in which black men died from untreated syphilis.

Meanwhile, legislators like U.S. Rep. Randy (Duke) Cunningham of California, a prostate cancer survivor, are pushing to open an Office of Men’s Health at the Department of Health and Human Services. “Men think they’re bulletproof,” says Dr. Kenneth Goldberg, a urologist who founded the nation’s first male health center. In fact, men are more likely to die of heart disease, cancer, injuries, stroke, AIDS and suicide than women. And their life expectancy is lower: 73.8 years versus 79.5 years for women.

They are also raised to avoid complaining about pain. “When a boy is 8 years old and skins his knee, the first thing he’s told is, ‘Be brave and don’t cry',” says Dr. Jean Bonhomme, a member of the board of directors for the non-profit Men’s Health Network and president of the National Black Men’s Health Network. “He’s being taught to ignore the signals of his own body.” Women, by contrast, get into the health care system when they're young. “Women are certainly groomed for it early on,” says Dr. Gary J. Martin, vice chairman of the department of medicine at Northwestern University. “Pap smears and contraception bring them into a doctor’s office.” A 1998 survey for a Commonwealth Fund report called “Out of Touch” found that nearly a quarter of men had not seen a doctor in the year before the survey, and one-third of the men had no regular doctor (compared to just 19 percent of women).

So what should men do to detect killer diseases early? Health officials suggest the following:

HEART DISEASE: The U.S. Preventive Services Task Force recommends blood pressure checks every two years and cholesterol checks at least every five years, starting at 30 for most men and at 20 for those who smoke, have diabetes or a family history of heart disease, the leading killer of U.S. men. Blood-sugar tests can also detect diabetes, which is also linked with heart disease. (Go to the National Heart Lung and Blood Institute’s Web site, www.nhlbi.nih.gov for the Framingham risk calculator, which estimates your total risk for cardiac problems.)

Men should also avoid smoking, which injures blood-vessel walls and speeds up the hardening of the arteries, eat less and exercise to prevent weight gain. “Focus on those core things,” says Northwestern University cardiologist Donald Lloyd-Jones. “Take a third less on your plate, don’t have seconds. Get up from your chair, walk 20 or 30 minutes a day. If you’re already doing that, kick it up a notch higher.”

PROSTATE CANCER: Doctors recommend that when men reach the age of 50 (40 if they’re higher-risk African-Americans), they get a prostate-specific antigen test and digital rectal exam. Men should check for other prostate problems too, such as an enlargement of the normally walnut-sized gland, which can cause swelling and trouble with urination.

TESTICULAR CANCER: Doctors say men between 18 and 40 should check for lumps in their testicles “If you feel a lump, go to the doctor,” says Dr. Steven Lamm of New York University. Testicular cancer is the most common form of cancer in men 20 to 35.

COLON CANCER: Men should beware of unexplained rectal bleeding, a common symptom. At 50 (and even earlier with a family history of the disease), doctors recommend starting regular colonoscopies.

SEXUAL HEALTH: At any age, those who are sexually active and not in a monogamous relationship should wear a condom and get tested for sexually transmitted diseases like HIV and chlamydia. It’s also important to check for infections like HPV, the Human Papillomavirus, which can increase a female partner’s risk for cervical cancer. Men should also tell their doctor about changes in their erections, which may be caused by problems such as diabetes and high blood pressure.

Whether its a Mercedes or a man, NYU's Lamm says, “There’s no machine that doesn’t need maintenance.” That's a view Whitney certainly shares. He is now visiting his doctor frequently, running two miles three or four times a week, using a Nautilus machine, eating more fruits and vegetables--and trying to go easy on his beloved fried fish. “I feel great now,” says Whitney, who recently got married. “I haven’t felt like this in years." His goal now: to get other men to feel equally good.