Why men don’t like thinking about healthcare

When it comes to guys’ health, mum’s the word.

Last September — prostate cancer awareness month — The Miami Herald mentioned the disease twice. One mention concerned a terrorist released from a Scottish prison because he supposedly was dying of the disease. The other was a short wire story about scientists disputing claims that pomegranate juice helps prostate patients.

Last October — breast cancer awareness month — The Herald ran 74 stories mentioning breast cancer, many of them about local women who have battled the disease or about groups raising money to combat it. One October day the newspaper tinted the whole front page in pink to raise awareness of the disease.

Which disease is more widespread? The National Cancer Institute estimates 209,000 new cases of breast cancer in 2010, causing 40,230 deaths (all but 390 female). That compares with 217,730 new prostate cancer cases and 32,050 deaths in 2010, estimates the NCI. So the diseases are roughly equal.

Where am I going with this? Certainly not a rant about women dominating the media. The Herald’s two healthcare writers — one of which is me — are both male. Neither of us advocated a single prostate story during September.

Truth is most guys don’t like to think about our own health, particularly prostate cancer, which brings up possible side effects of impotence and incontinence.

Much better to support women. Remember all those football players wearing bits of pink last year? Did those big guys do the same for prostates? Heck, I didn’t even know the color for prostate cancer awareness when I started writing this. (Do you?) … It’s light blue.

Surveys have repeatedly shown that women are more concerned about their health. A national survey by a federal agency shows that barely half of men — 57 percent — see doctors for routine care or checkups, compared to 74 percent of women.

“Women tend to be more health conscious,” says Daryl Veach, who studies such things for Blue Cross Blue Shield of Florida. That means they visit doctors more frequently and get more tests — and that’s why insurers tend to charge women more for individual policies.

According to a recent analysis of federal data by Health Affairs, the average American woman costs one third more in healthcare than the average man, though that’s bumped up by maternity care. A federal report found that “holding other factors constant, a 22-year-old woman can be charged one and a half times the premium of a 22-year-old man.”

A standard $500 deductible policy in Miami-Dade costs $291 a month for a nonsmoking 30-year-old male, compared to $345 for a nonsmoking 30-year-old female, even with no maternity benefit.

Those numbers are for the young. As guys get older, their avoidance of healthcare catches up with them and — morality tale! — men’s care costs more than women’s. That same Blue Cross $500 deductible policy for a 55-year-old male runs $626 a month, compared to $603 for a 55-year-old female.

One company that appreciates this is Ryder, the Miami-based logistics specialists. Its workforce is predominantly male, and Pamela Rothstein, the company’s benefits director, noticed that a lot of guys were not getting screenings that might detect diseases early. Ryder’s solution: Dropping co-pays for most screenings.

Now, I have postponed this story for a long time. Two reasons: First — no surprise — I don’t really like to think about guys’ health. Secondly, I originally planned doing this as a news story, which would have started out with a “typical” guy saying he didn’t like to think too much about his healthcare.

I called up a bunch of guys recommended by colleagues. They either didn’t want to be talk publicly about healthcare or said they were very concerned about healthcare, generally because they had serious healthcare problems, although they acknowledged that most guys didn’t want to think about their health. If I kept searching, I could have eventually found an example, but it felt like formulaic journalism stating the obvious.

Besides, I didn’t have to look any farther than myself to find a typical guy.

A while back, the big toe on my right foot throbbed with pain. I was limping. I think I stubbed it in the dark. I could have raced off to the doctor. Get an X-ray? A trip to an orthopedist? Usually my wife nags me about things like this, but she was out of town, and so I just let it slide. A few days later, the toe was fine.

I was practicing, after my fashion, what Coral Gables philosopher Dave Barry described recently as “the Protocols of Guy Medicine, under which you assume that, unless you have a bone protruding at least three inches out of your body, you will, given time and plenty of fluids in the form of beer, spontaneously get better.”

A couple of months ago, just as I was thinking of writing this story, my annual physical revealed that my PSA level — the prostate blood test — was 2.9, not a high number, but one point above where it had been a year before, a change that caused my primary doctor to send me to a urologist for further examination. It turned out to be nothing serious — a truncated way of saying I spent several weeks pondering looming side effects — but during that period of uncertainty, I dropped Guys’ Health from my idea list. No way was I going to turn my medical problem into a confessional.

That’s typical, says Skip Lockwood, president of Zero — the Project to End Prostate Cancer. Lockwood freely acknowledges that the men’s disease gets far less publicity than breast cancer, and men are largely to blame for that.

One reason is that while many women are happy to talk to the press about their cancer experiences, most men are not. When journalists call Lockwood asking for cancer survivors, he contacts a patient on his list. “He finds out he’s going to be asked about incontinence or impotence and he has no interest whatsoever in talking.”

That reluctance extends to political leadership, says Lockwood, who lobbies Congress for increased funds for prostate research. While someone like Rep. Debbie Wasserman Schultz talks eagerly about her experiences with breast cancer, “there is known to us a secret prostate cancer group that meets in the Senate. Can you imagine a secret women’s support group? No way. There a few male members out in the open, but a fair number are not at all.”

Such secrecy makes it difficult to get prostate coverage in the media, but Lockwood acknowledges women have “done a brilliant job” promoting breast cancer. The result is that, in The Miami Herald and many other places, prostate cancer takes a back seat.