Survival Skills
It is no exaggeration to say that men's health has become a growth industry in this country over the past decade or so. And not just for doctors. Scholars in psychology, sociology, and other disciplines now specialize in male health issues, attend meetings dedicated to the topic, and publish in an array of journals that focus on men and medical matters. There are websites devoted to discussions of the topic. And medical consultants specialize in advising every institution from labor unions to the insurance industry on how to improve the health of American men by improving their behavior. For there is a growing awareness that men don't take very good care of their bodies and minds. Indeed, they are killing themselves by ignoring their medical needs and acting in destructive ways that simply make their health problems much, much worse.
Of course, women can be self-destructive, too, but the strong consensus among healthcare providers is that it's men, far and away, who are taking the most health risks.
There is no doubt that such risks exact a big toll. A study published in a recent issue of the Journal of the American Medical Association demonstrated that while the overall death rate in the United States has declined dramatically over the past 30 years, this trend masks increases in certain specific death rates, such as those from diabetes and an all-too-common lung ailment known as chronic obstructive pulmonary disease. Both of these disorders are strongly linked to unhealthful behaviors--a bad diet leading to obesity in the case of diabetes, and smoking in the case of lung disease. Men smoke too much and eat too carelessly, and that leads to trouble. For example, the death rate among men due to the lung problem is much higher than it is for women.
All this leaves unanswered the question of just why men are so self-destructive. What is the underlying psychological dynamic driving so many men toward poor health? Theories vary from a Freudian "death wish" to genetics and brain chemistry. Most experts today, however, tend to emphasize basic evolutionary biology and modern social norms. "Women were wired early on to care, and to care about their bodies because that is where people come from," says Jerry Kaiser, a California-based healthcare consultant who coaches CEOs on health matters and is writing a book on doctor-patient relationships. "Men, by contrast, are attuned to their musculature, because they're still basically hunters and warriors and that's where food and protection come from. They tend not to pay attention to things that are invisible and internal. If there is no clear external stimulus, there's no response."
Rough and ready. Michael Addis, a psychologist at Clark University, takes a slightly different view, emphasizing the ubiquitous social messages people receive. "Men and women both learn what makes a good man," he says, "and the message is that a good man is always independent. Anything else is weakness." Somewhat whimsically, Addis notes that the timeworn cliché that men, when lost, refuse to ask for directions is really a mundane appearance of this risky male pattern: Asking is weak. More seriously, this message of manly independence includes placing a high value on such traits as ruggedness and such behaviors as fast driving and participation in contact sports. Men view their bodies as machines, not things in need of caring, Addis says.
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