Garth Rattray | Deadly male iatrophobia

I recently participated in Dr Jaki Campbell’s radio programme, ‘Powering Your Health’. It airs on Power 106 FM from 8 to 9 p.m. on Wednesdays. The topic was men’s health. Like other physicians, Dr Campbell is very concerned that most men do not pay enough attention to their health, and some appear to fear doctors.

When taking a ‘family history’, it is always obvious to physicians that females generally outlive males. The statistics bear this out. Although worldwide figures indicate that males slightly outnumber females at birth, the gap declines with age and by 65 years old, the women significantly outnumber the men. Jamaica is unusual in that, of our 2.97 million population, overall, females outnumber males by 23,080. The older the population, the more females outnumber males.

Females live longer than males for several reasons. The female hormone, oestrogen, protects women by reducing their risk of cardiovascular disease. However, at menopause, the oestrogen level falls off; but by then, they have a jump start on longevity. Since cardiovascular disease is the main cause of premature mortality, women tend to outlive men.

Women carry their fat in the right places. The predominantly female hip and thigh (pear-shaped) fat distribution produces less cardiovascular risk than the predominantly male, truncal (apple-shaped) fat distribution. This fat distribution occurs around the abdomen and inside the abdominal cavity. Those areas are notorious for increasing the risk of metabolic disorders and cardiovascular disease.

Men engage in more risk-taking activities than women. They are more involved in the military, security jobs, risky lifestyles, risky or extreme sports/games, violent criminality, and fights. They are more likely to use recreational substances (tobacco and alcohol) more often, and in higher portions, than women. Men use more dangerous illicit drugs than women, and they succeed at suicide more often than women.

DANGEROUS FLAW

Masculinity tends to come with another dangerous flaw. The physical power and confidence provided by the male hormone, testosterone, also imbues males with a feeling of invincibility. Most men rarely visit physicians because they fear surrendering themselves to examinations, investigations, and possibly hearing unpleasant news. But being fit and strong does not necessarily mean that you are healthy. The only way to truly assess the state of your health is to have physical checks done on a regular basis.

Herein lies the problem. Apart from urologists, doctors will tell you that most of their patients are female. I find that male patients eclipse female patients at both ends of the age spectrum. I see many very young male children, and I see many very elderly male patients. However, young men, middle-age men, and the men in the youngest-old (65 to 74 years-old) category are conspicuously scarce when it comes to visiting doctor’s offices.

Unfortunately, the same flawed thinking that encourages male risk-takers to believe that they can perform all sorts of dangerous antics and daredevil driving on our roads without disastrous outcomes, or easily engage in physical confrontation and([perhaps) violence and triumph, is the same flawed reasoning that leads some males to erroneously believe that, since they feel fine, everything must be okay. The problem is that many diseases are silent until they cause damage or spread somewhere. By that time, it may be too late to stop further damage or to get rid of the problem.

BELIEVE THEY ARE TOUGH

Men are usually acculturated into believing that they are tough, and that only sissies run to see doctors. Therefore, I find that most men go to the doctor because of a significant pain. Men turn up if and when pain (usually back pain) has become intolerable or chronic. Men also seek out doctors for medical insurance purposes, United States permanent resident visa problems, work medicals, trauma, and infections of all sorts. When I find men who were unaware of their hypertension, diabetes, or another serious conditions, I tell them to thank God that something brought them in and saved their lives.

Some of the highest resting blood pressures that I have ever seen were in young to middle-age, hard-working, strong, slim, ‘fit’ men who need a physical in order to retain their job or to become employed. Sometimes the physicals reveal shockingly high blood glucose levels in very active labourer types, who did not have any inkling that they were in serious trouble.

When young men die, it is usually because of trauma. But when middle-age and older men die prematurely, it is usually because of a possibly preventable cardiovascular incident, or an unexpected and possibly curable or preventable cancer. Therefore, adult men should take care of themselves by getting checked annually, or more frequently if deemed necessary. At the very least, simple blood pressure, glucose checks and basic investigations should be done annually. Jamaican men are very prone to prostate cancer. Early screening (35–40) reduces the risk of fatality. Men age 45 and above should do screening for colon cancer. Men with a family history of early colon cancer should be screened earlier.

Gentlemen, remember that feeling well does not mean that everything is okay. Don’t wait until you feel sick before getting checked. I believe that an additional reason why women outlive men is because women visit doctors far more often than men. Ladies, insist that your man gets himself checked out regularly. You may save his life.

Garth A. Rattray is a medical doctor with a family practice. Send feedback to columns@gleanerjm.com and garthrattray@gmail.com.