If your arm's not broken and your back doesn't hurt, does that mean your health is fine and you don't need to visit the doctor?Your health could be perfect or there could be symptomless problems that, left undetected, might quietly cause you major medical problems in the future.However, according to the Health Survey of Adults in Bermuda 2011 completed by the Department of Health (DOH) and the Bermuda Health Council (BHeC), fewer adults are visiting their doctors for routine check-ups.The Survey found that between 2006 and 2011, there was a dramatic drop in the number of people who said they'd had physical exams in the previous year, from 81 percent in 2006 to 69 percent in 2011.The most significant decrease was in adults with a secondary or lower educational level (16%).Older adults (65+) were the most likely to have had a check-up in the past year (84.8%) compared to other age groups, especially 18 to 34-year-olds (55.2%). Women (74.8%), on the other hand, were more likely than men (61.5%) to have had a check-up in the past year.The danger of not having a regular check-up, of course, is that routine exams may catch minor, medical problems before they become worse or as noticeable as a broken arm!Adults, the survey found, were generally better at caring for their teeth; 70 percent of Bermuda's adult population had visited the dentist the previous year. However, as with physical exams, men were not as vigilant as women; 35.4 percent of men reported that they had never visited a dentist versus just 26.5 percent of women.As the income levels of Bermuda's population increase, the Survey found, people were more likely to visit the dentist twice a year the Department of Health's recommended guidelines. Thirty eight percent of people in households with an income of $108,000 or more saw a dentist twice a year, while 29 percent of those earning between $60,000 and $107,999 and 22.3 percent of those earning $59,999 or less went twice a year.Routine check-ups and dental screenings are necessary from birth, but as we age certain medical exams become necessary such as mammograms (an x-ray of each breast) for women and prostate cancer screening tests for men.The DOH recommends women who are 40 to 50 years old, have a mammogram every one to two years and women over the age of 50, annually.Our Survey, however, found that women who were 40 and over, between 2006 and 2011, had fewer mammograms (from 95% to 86%).Women with secondary education or less (12%), those with a technical and high education (10%), Whites (11%) and Blacks (10%) all reported a decrease in the number of mammograms between 2006 and 2011.For men the DOH advises that screening for prostate cancer with the prostate-specific antigen (PSA) test be discussed with their General Practitioner (GP).Between 2006 and 2011, there was an overall decline of 7 percent (93% to 86%) in the percentage of men who had a PSA test in the previous two years.The majority of demographic groups surveyed reported dramatic decreases in PSA tests except for Black men, for whom the decrease was small (from 91% to 88%).Serious concern was also raised with the Survey's results on testing for HIV. Between 2006 and 2011, the adults who reported being tested for HIV dropped by 5 percent (49% to 44%) since 2006; however, in the same period there was a 17 percent increase in the percentage of residents who reported having more than one sexual partner in the last year (from 6% to 23%).The Survey did find, however, that in 2011, 14 percent more of the adult population reported using condoms the last time they had sexual intercourse than in 2006 (17% to 31%).Men saw the greatest increase (19% to 42%), while women reported the smallest increase (6%) in the use of condoms.Surveys like these help BHeC to monitor Bermuda's health and access to care, so we can strive to improve our Island's health system. For more information visit our website: www.bhec.bm.