“The body doesn’t come with an instruction manual,” Sabbs says.
If a boy doesn’t have a healthy male role model, he probably will act out on instinct and make bad choices when angry, depressed or lonely, Sabbs says.
Hearing advice from Mom isn’t the same thing, he says: “Men don’t realize the pull and power they have. Some things Momma just can’t translate that Dad can.”
Households where fathers don’t discuss health matters with their sons are more common than you think, says Ryan Berglund, a urologist in the Glickman Urological & Kidney Institute at the Cleveland Clinic.
When he asks men for their health history, he often hears something like this: “My dad died at 75. He had a prostate problem. I think that’s what he died of but I’m not sure.”
Men often are vague about family health history, Berglund says. This is crucial information for doctors, however.
“Shared genetics is an important data point,” he says. Having a father who had prostate cancer doubles a man’s risk of getting it. Knowing this, a physician might begin prostate cancer screening for such a patient at an earlier age.
Troubled by this gap in men’s knowledge, Berglund and his colleagues launched a survey in 2017 to find out how many fathers talk to their sons about health. “It can have a substantial impact on outcomes,” he says. Heart disease, stroke, diabetes, some cancers, mental illness and high blood pressure all can run in families.
While 70 percent of the 500 men contacted said a father or father figure had discussed health at times while growing up, the conversations typically excluded anything about sex, diet, urological health or annual health exams. Roughly half did not know their family health history before going for their first physical as an adult.
Darryl Davidson, director of the Milwaukee Fatherhood Initiative and coordinator for several men’s programs for the city, leads courses guiding fathers on how to care for their children’s health and their own. One class was a how-to on taking children to the doctor, for instance. How often should they go? What to ask the doctor during the appointment? Information about vaccination schedules, dental care and the like.
Isn’t this common sense?
“Not even close,” he responds. The men in his free monthly classes did not have fathers who modeled these responsibilities. They don’t know what different medical specialists do or how to keep their children safe, he says.
“It can be hard to find the right words to talk about health if your own father didn’t talk to you about it,” Berglund says. But he reminds fathers that it is less about their discomfort and more about doing the right thing for their sons. Testicular cancer can strike teens at age 15. Fathers should be instructing sons how to do a monthly testicular self-exam while in the shower, Berglund says as an example.
Beyond advising kids to wear a bike helmet or lay off the cheeseburgers, “Dads need to be the ones to tell their sons that it’s ok to feel pain or that they don’t need to be bleeding to ask for help,” Brott says. Boys don’t get this message from the culture when sportscasters praise athletes who play through injuries and ignore pain, he says.
Brott suggests that fathers plan pointed conversations about more difficult subjects when watching a movie together. Ask your children whether the character using drugs made good choices. The same approach could be applied when discussing consensual sex, depression or violence.
Mitch Luxenburg, a father of four in Cleveland, understands more than most about being open with his children about health concerns. Now 48, he was diagnosed with prostate cancer at 36 and lost his wife to breast cancer not long before that.
“It’s not where we sit down and have lectures,” he says, but he redirects them if they aren’t eating healthfully or focusing on their mental health.
Luxenburg stresses to his children the need to establish an ongoing relationship with a physician to reap prevention and early detection benefits. In addition, he has told them to seek second medical opinions. Luxenburg’s signs of cancer were missed by the first doctor he saw. Knowing his dad had prostate cancer, though, he was “on the lookout for this issue” and consulted a second physician who confirmed his hunch and started successful treatment promptly.
Latrice Rollins, assistant professor of community health and preventive medicine at Morehouse School of Medicine, studies fatherhood and the particular health issues of African American men. Black men have a greater incidence and higher mortality rate than white men for conditions including stroke, many cancers, heart disease, AIDs, diabetes and homicide.
Fathers are “an underutilized resource” in stopping the cycle of racial health disparities, she says. Educating sons about their heightened health risks as African American men could go a long way toward prevention and early treatment.
One obstacle is that men are notoriously reluctant to ask for directions — or any other help. “Men don’t tend to reach out or seek resources that can benefit them,” Rollins says, despite a wealth of free health information available online or through community health organizations.
But today’s fathers are doing better, the Cleveland Clinic survey found. Millennial fathers were more likely to have conversations with their sons about health than dads of previous generations, the data showed.
“Our fathers didn’t talk about feelings, emotions or health,” says Luxenburg, a Gen Xer. “We have to make sure we don’t repeat their mistakes.”