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He doesn't eat his broccoli. He never used that gym membership you gave him. He hasn't seen a doctor since his accident with the weed whacker a few years back. And as for the annual prostate exam he's supposed to get—well, do you have to ask?
This man sounds all too familiar to millions of women. Men are far less likely than women to adhere to almost every recommended healthy behavior, from checkups to workouts. Women take better care of themselves and, perhaps not coincidentally, tend to live about five years longer than men. "Plus, men get sicker at much younger ages," says Harvey B. Simon, M.D., associate professor of medicine at Harvard Medical School.
Experts have begun to investigate why, in the long run, men—who can generally bench-press more weight and throw footballs farther than women—turn out to be the sicklier sex. Some of it is physiological. For example, while both men and women gain weight over the years, women usually carry the extra baggage on their hips, thighs, and buttocks—which may make trying on bathing suits unpleasant but is not dangerous. Men, on the other hand, typically gain around the belly, increasing their risk of heart attack and stroke.
But this is not the whole story. Behavior—typically "bad" when it comes to males—plays a huge role. "Too many men view manliness as being able to keep up drink for drink, polishing off a big steak, taking risks, and going without sleep," says James Mahalik, Ph.D., professor in the counseling psychology program at Boston College in Chestnut Hill, Massachusetts.
While you can't change your husband's DNA, you can challenge some of his perceptions and help alter a few of those not-so-good habits.
Sit down and have a heart-to-heart with your spouse, and try not to get emotional. Lillian Glass, Ph.D., author of The Complete Idiot's Guide to Understanding Men and Women (Alpha), recommends looking directly into your partner's eyes and telling him how much stress his health (or lack thereof) is causing you. Make sure you have his full attention. "He can't be clearing out the garage while having this discussion," says Glass.
Even if discussing his health gets you worked up, do your best to remain calm. "Crying won't help," Glass says. "Make a logical appeal, and it's far more likely you'll be heard."
Try these conversation starters:
"Men don't want to hear 'you should,' 'you have to,' 'you always,' or 'you never,'" says Florence Isaacs, coauthor of When the Man You Love Is Ill: Doing Your Best for Your Partner Without Losing Yourself (Da Capo Press). "You've got to make him feel like he's the one deciding, not that it's you shoving this down his throat."
Also, don't make it about your needs. "'Do this for me' is a lousy motivator," says Steven Jonas, M.D., professor of preventive medicine at Stony Brook University's School of Medicine on Long Island. "They have got to make changes for themselves."
But be clear that you're willing to facilitate. Tell him you're all for taking nightly walks, preparing healthier foods, and adjusting your schedule if he needs more free time.
While what you say and how you say it is important, so is listening. "My husband, who passed away two years ago, was a cigar smoker," says Isaacs. She had tried and tried to get him to stop, mainly by giving him literature about the dangers of smoking, but he dismissed her. "If I had to do it again, I would have asked him to talk about his feelings," she said. "I'd have said something like, 'Help me understand why you continue to smoke when you know it's not good for you.' Not hostile, not confrontational. Then I would have shut up and listened."
Putting a rational man into a position where he has to explain irrational behaviors might force him to reexamine what he's doing.
What you say—and what you do—counts. If you eat well, exercise regularly, and take good care of your own health, it will have an influence on him, macho man or no. Researchers recently looked at data from 6,072 married individuals to determine the degree to which a person's health habits—smoking, drinking, cholesterol screening—are influenced by their spouse. "We consistently find that when one partner improves his or her behavior, the spouse is much more likely to do so too," says Jody Sindelar, health economist and public health professor at the Yale School of Public Health. "This is found across all the behaviors analyzed—including something as simple as getting a flu shot."
Women account for 59% of all doctor's office visits, which indicates there may be 165 million men in the U.S. who should be stepping into waiting rooms but aren't. Unfortunately, it may be up to you to help plan your husband's next rendezvous with a physician. Dr. Jonas, who is also coauthor of Help Your Man Get Healthy (Harper Perennial), offers these suggestions for motivating him.
Find a doctor who offers evening hours or Saturday appointments. This will help get around the number one excuse offered by men who repeatedly avoid physicians: They're too busy to take off from work.
Remind your husband that not every health problem requires invasive treatment. This speaks to the secret fear that many men, particularly those who haven't been to the doc in a while, have that they'll go in and suddenly be scheduled for a battery of complicated procedures.
Go with him to the appointment: Accompanying your husband to the doctor's office is more than mere hand-holding. You can ask questions, point out symptoms or potential problems and, most important, take notes.
When the Department of Health and Human Services released its new exercise guidelines in October 2008 it made the case for "little changes." For instance, sedentary individuals who start doing just 30 minutes of walking five days a week can cut their risk for premature mortality by a remarkable 50%.
Whether it's his starting an exercise program or giving up fast food, don't expect an overnight change. But your gentle nudges will help, says Steve Blair, adjunct professor at the Arnold School of Public Health at the University of South Carolina, in Columbia. Try such seemingly innocuous "pre-actions" as taking him to the mall and sauntering into the athletic shoe store to "see what they have." Linger in the organic produce section in the supermarket. Drop by to visit that cousin of yours who lost 50 pounds or (to use a negative example) the overweight one who just got diagnosed with type 2 diabetes.
"They may seem like random and unimportant things," Blair says, "but together they will help get your man into the frame of mind where he's ready to take the significant actions that help ensure a long and healthy future together."
Body Mass Index This is a measure of body fat based on height and weight. Visit americanheart.org/bmi.
Cholesterol High cholesterol is a major risk factor for heart disease; monitor your levels at least every five years.
Blood Pressure This should be checked every two years, as high BP is linked to heart and kidney disease, and strokes.
In addition, when a man turns 50 he should have a colorectal cancer screening (even earlier if he has a family history). He may also need to be checked for prostate, lung, oral, skin, or other cancers.
Originally published in the June 2010 issue of Family Circle magazine.
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