Why are men more reluctant to go to the doctor than women, and should they be encouraged to see a GP more often?
ONE-THIRD of men suffering from chest pain would attempt to walk it off rather than seek help. That stark statistic reinforces the notion that men are blasé about their health. On average, just 30 per cent of those in a doctor's waiting room are men.
And that's not because men are healthier than women. So why do men seem to take less care with their health and why are they less likely to visit a doctor?
Part of the reason has been attributed to a "big boys don't cry" culture, while it has also been felt that traditional male attributes of aggression, suppressing emotion and viewing sickness as a sign of weakness may also be factors. Men are often defined by their work and some fear that illness could have a detrimental impact on their careers.
Dr Mel Bates, chairman of the communications and publications committee of the Irish College of General Practitioners (ICGP), says the fact that a sizeable number of men ignore chest pains or heart problems is an indication of a deep problem.
"It is strong evidence that something is going on out there among the men not to actually attend," he says. "They evaluate their health like they would their fitness or their physical strength - they take pride in it and then, when it doesn't go well, they're a little bit embarrassed or ashamed or feel they are bothering the doctor. Also, the big boys don't cry and all that upbringing would tend to make the man feel 'maybe I should just put up with this'."
But Prof Tom O'Dowd, who teaches general practice at Trinity College, says it would be a mistake to say that men are not interested in their health.
"It's a kind of a myth that has grown up," he says. "Men are interested in their health."
There are a number of underlying reasons why men fail to visit their doctors as often as women, such as isolation and, in particular, the lack of the networks to inform them about health issues that women seem to have.
"I think the problem is it's not permissible for men's conversation to be dotted with where you can access a particular health service or a particular diet or where you can access particular advice about cardiovascular disease," says O'Dowd.
"I think what's missing is the ready conversation. Women have ready conversation about their health whereas men don't. People learn a lot informally about health and health is not as much a part of informal conversation as it is for women."
Clare Moynihan, senior research fellow and research associate with the Institute of Cancer Research in Britain, agrees that lack of information for men is a key issue.
"We have found that men will go when they know what's serious and a lot of the time the medical profession and society itself have left men out of the equation - they don't get the information that women do and that's a very important point," she says.
The informal and formal networks among women have led to campaigns for better services as evidenced by the setting up of programmes such as breast check. To date, men have largely been inactive on their particular health issues.
"With breast cancer, there has been a huge women's lobbying business going on," explains Moynihan.
"Masses of women activate themselves and become almost political about it. Men are now starting to do the same with prostate cancer."
There are also historical reasons why women tend to visit their doctor's more and at a younger age and are much more in tune with health matters.
"Women will tend to interact more with the GP. They will come in for pill checks, come in for smears, come in during pregnancy, they may have periods coming too frequently or not frequently enough.
"They may have a variety of conditions and so, generally speaking, they tend to be the carers for children and indeed the elderly," says Mel Bates.
With that in mind, the medical profession also has some work to do to make doctors' surgeries more male-friendly. A surgery full of women and children with notices and posters about breast checks and smear tests can be off-putting for some men.
"I think some guys arrive into a doctor's surgery with the same feeling that instead of going to the barbers, they have arrived into a hair salon and they feel very uncomfortable sitting around there," says Bates, adding that many surgeries have improved and now have equal volumes of information for both sexes.
Both Moynihan and O'Dowd argue that encouraging men to become more health conscious can be a double-edged sword.
"It's a fine balance between turning invulnerable, full of life, young men into people who worry about themselves constantly," says O'Dowd.
"My own experience in clinical practice is once men become worried about themselves, it is very difficult to get them out of that frame of mind because they seem to pursue perceived ill health with the same verve and enthusiasm as they pursue enjoying the good life."
Men: the vital statistics
On average, Irish men can expect to live to 73 years (women to 78.6 years).
The Irish death rate from coronary heart disease in people under 65 years is the highest in Europe and the main cause of death in men under 65 is heart disease.
Heart disease is largely preventable if lifestyle changes are made, but men are poor on certain lifestyle factors: they eat less fruit and vegetables than women, have a higher intake of fat, and more men are overweight and obese.
Men die from testicular and prostate cancers when both are treatable if identified earlier.
Some 75 per cent of all suicides are men, in particular young men.
Deaths from road accidents are three times higher in men, especially young men.
Men appear in greater numbers in mental hospitals and in prisons.
Men are less likely to visit a doctor when they are ill and less likely to report symptoms of disease or illness.
Source: Health Service Executive North West Area