Why do men die earlier than women? It turns out that when it comes to talking to their doctors about their health, male patients like to do the Marlboro Man.

Two related studies by Rutgers University School of Arts and Sciences researchers point out that the inherent beliefs of men on masculinity may compel them to be less honest to their doctors, thereby ignoring symptoms and recommendations or delaying treatment until it is too late.

In the study reported in Preventive Medicine, Diana Sanchez, an associate professor of psychology in the School of Arts and Sciences, and doctoral student Mary Himmelstein conducted two similar experiments among 500 men including 250 male undergraduates of a public university who were interviewed in clinical exam rooms by pre-medical students wearing white lab coats. All of the male participants filled out an online questionnaire assessing their perception on masculinity and differences of attributes among men and women.

The results suggested an inverse relationship between beliefs in masculinity and honesty — that is, they are more likely to hide symptoms the higher they score in toughness. This is understandable since most men grow up being told they have to be brave and self-reliant.

Interestingly, though, while men prefer male doctors, they tend to be more honest among female doctors probably because they can show their vulnerability without losing their machismo.

But do women also exhibit the same characteristics? The researchers then conducted a similar experiment among 193 university students including 105 women and 298 regular people, of which half were females.

While the outcome, now published in Journal of Health Psychology, remains the same among men, women who share the same beliefs also tend to lie to their doctors about their health.

"Men can expect to die five years earlier than women, and physiological differences don't explain that difference," said Diana Sanchez. Thus, most probably, the "I am macho" idea, which can be present in more men and women, provides the answer.

Nevertheless, the researchers stress that this belief is more dangerous among men.

"Men have a cultural script that tells them they should be brave, self-reliant and tough. Women don't have that script, so there isn't any cultural message telling them that, to be real women, they should not make too much of illnesses and symptoms," said Himmelstein.