“Big boys don’t cry,” is a phrase many men hear while growing up – but the mindset behind it may be taking a toll on their health. Men are only half as likely as women to schedule routine checkups, and nearly 7 million American men haven’t seen a doctor in more than a decade.
The result? Male life expectancy trails women by about five years.
The reluctance to seek care is often rooted in cultural expectations. From a young age, boys are told to be strong, independent and self-reliant. Many grow into men who equate vulnerability with weakness. While ignoring aches and pains might feel like toughness, it can mean missing the early signs of treatable conditions. That avoidance behavior shows up across all generations – but a recent Cleveland Clinic survey reveals just how differently each age group acts in regard to health.
The survey, which polled men classified as Gen Z (born 1997–2005), millennials (1981–1996), Gen X (1965–1980), and boomers (born before 1965), found that while 95 percent of men said living a healthy lifestyle was important, their behaviors didn’t always match their intentions.
“The survey is enlightening because it shows the generational gap with regards to healthcare,” explained Dr. Anthony Taylor, a primary care physician with Cleveland Clinic Indian River Hospital. “Something as simple as getting a yearly physical showed substantial differences. Sixty-one percent of Gen X and boomers get their yearly exams, compared to only 32 percent of millennials.”
Younger men, especially those in Gen Z, are less likely to have a primary care physician at all. Nearly 2 in 5 report not having a regular doctor, and many aren’t sure if they’ve ever had their blood pressure, cholesterol or BMI checked. Instead, they often turn to the Internet for answers.
“Younger people in general take their health for granted and feel invisible, whereas the older we get, the more concerned we become about our health,” said Dr. Taylor. “The youngest ones tend to rely on Dr. Google – Internet advice for their health that can be dangerous. Dr. Google can’t check your vital signs, blood pressure or screen you for diseases like diabetes.”
Millennials, often called the “sandwich generation,” face different challenges. They are juggling careers, families and aging parents, which sometimes leaves their own health low on the priority list. While they’re more likely than older men to talk about mental health, they are the least likely to schedule physicals. Gen X and Baby Boomer men, meanwhile, are more diligent about checkups, but many skip important screenings like colonoscopies or prostate exams – even when they’re at the age where those tests could be lifesaving.
Doctors are adamant that annual checkups and age-appropriate screenings are crucial for catching problems before they become serious.
“Yearly physicals can flush out underlying issues and catch any abnormalities early,” Dr. Taylor continued. “There are certain times in a man’s life when he should be getting routine screenings as well to ensure that he is maintaining good health.”
Vail Health Foundation outlines what men should be doing by decade, with each test playing a vital role. In their 20s and 30s, men should be establishing baseline health markers – blood pressure, cholesterol and routine labs – while also being screened for sexually transmitted diseases. Testicular self-exams can catch early signs of testicular cancer, which is more common in younger men. An electrocardiogram, recommended starting at age 30, can pick up heart rhythm abnormalities before they cause symptoms.
By their 40s, men need to add screenings like prostate-specific antigen tests for prostate cancer and hemoccult tests to detect hidden blood in the stool, an early warning sign of colorectal cancer. Some may also need testosterone screening or chest X-rays, depending on their health history.
After 50, men should consider bone density testing for osteoporosis, especially if they’ve had fractures or low testosterone. At this stage, catching cancer early – through colonoscopies, PSA tests, and other screenings – can mean the difference between life and death.
Yet, the survey revealed that one-third of Gen X and boomer men who are eligible for colorectal screening have never had it, or don’t remember if they did. Likewise, about a quarter of men over 50 have skipped or forgotten prostate cancer testing. Even though 74 percent of men admit they fear cancer, actual screening numbers remain low.
Physical health is only part of the picture. Mental health remains a major hurdle for men. Nearly 65 percent say they never seek help for mental health issues, even though conditions like depression, anxiety and PTSD are common. Left untreated, these ailments can fuel substance abuse, increase the risk of suicide, and worsen physical illnesses such as heart disease and diabetes.
Dr. Taylor sees hope in younger generations, though. “The survey shows that younger men are more willing to address mental health issues,” he noted. “Fifty-nine percent of millennials and Gen Z men reported seeking help, compared to just 53 percent of Gen X and boomers. That may be because society is more open to conversations about mental health today than in the past.”
Another key factor in overall health is exercise. While most men recognize that fitness impacts their energy levels, mood and even sexual performance, about 30 percent admit they don’t exercise regularly. Lack of activity often leads to fatigue, stress, weight gain and low self-esteem.
Sexual health itself can be a hidden barometer of overall health. Complaints like erectile dysfunction or low libido are sometimes brushed off as normal aging, but they can also signal serious conditions such as uncontrolled diabetes, hypertension, heart disease or depression. Men who bring up these issues with their doctors may uncover larger problems earlier than they would otherwise.
“Having a good relationship with a primary care physician is one of the most important things a man can do,” Dr. Taylor said. “You either invest in your health now, or you’ll be investing in your illness later. Being proactive can literally save your life.”
So, gentlemen – forget the old saying that “big boys don’t cry.” Manliness and courage aren’t about ignoring pain or future illness – they are about taking responsibility for your health, facing problems head-on and giving yourself the best chance for a longer, healthier life.
Anthony Taylor, DO, completed his medical training at Lake Erie College of Osteopathic Medicine and his residency at Billings Clinic Internal Medicine in Montana. He now practices at Cleveland Clinic Indian River Hospital’s Rosner Family Health and Wellness Center, 3450 11th Court, Vero Beach. The number there is 772-794-3364.
