The EMHF's Director Erick Savoye reports on the success of a health survey designed with men in mind and argues that those who dismiss such gender concerns as overly simplistic are themselves guilty of oversimplifying the expression of masculinity.
'As director of EMHF, I often present about men’s health to groups of patient advocates and policy makers. For most it is a real discovery. For many, men’s health did not mean much more than erectile dysfunction or prostate cancer. They never realised masculine attitudes to health could have such an adverse effect on the outcomes of most conditions. The improvement of most health determinants, including lifestyle and health education, takes a new dimension when considering the health behaviours of most male population groups. In fact, shouldn’t being a man constitute a key health determinant in itself?
The validity of this approach is often instinctively obvious. For most, it is easy to recall examples of that in our own life, or around ourselves. But for others, a first impression is that it is too simplistic and that this thinking sits comfortably among a stream of other popular perceptions characterised by a lack of scientific grounding.
Indeed, they may well be right about the simplicity of the arguments. Summarising the presentation of key ideas cannot do justice to the rich body of evidence-based research carried out over the last decades. Essentially since the beginning of the 80’s, academics from all over the world and principally in the States, the UK and Australia, have demonstrated the relevance and applicability of masculinity theories to health matters.
The concept of masculinity is broad and based on the social construction of the male gender which distinguishes it from purely biological considerations. Whitehead and Barrett [2001] define masculinity as ‘those behaviours, languages and practices, existing in specific cultural and organisation locations, which are commonly associated with males and thus culturally defined as not feminine’.
Peer pressure tends to exacerbate the expression of key attributes of masculinity such as risk taking behaviour, strength and endurance, and reluctance to seek help from others. Boys don’t cry. Men tend to conceal health issues and remain notoriously distant from health services. And to answer those who seek complexity as a means of validation, each man expresses his own ideal of masculinity depending on factors such as his age, ethnicity, social class and sexuality [Courtnenay, 2000]. For those interested in learning more about the theory, I can recommend some really good books, or some courses dedicated to masculinity and health behaviours, such as the module run by Prof. Alan White, Professor of Men’s Health, at Leeds Metropolitan University.
Benefits of using such theories were recently put to the test by EMHF.
Our European HIV quality of life survey considered gender as a fresh and useful angle of analysis. Assessing the project from a primarily male perspective, knowledge from masculinity theories was applied to the preparation of the project and to the interpretation of its results. It enabled the detailed examination of areas of prime importance to male quality of life, and illustrated the potential for highlighting issues which would not have surfaced otherwise. We were able to appreciate how important it was for men to be able to maintain a position within social networks that is representative of their masculinity ideals. The relationship of men to diagnosis, treatment and health literacy provided some additional insights, along with their propensity to deal with changes in life.
Beyond issues pertaining to the complexity of the analysis, it even seemed conceivable that this approach could be replicated and adapted to other disease areas such as cancer, or that a male specific quality of life model be derived.
Masculinity theories can bring much scientific underpinning and credibility to the work of men’s health organisations. However, it remains that the effective communication of the value of such benefits requires a major awareness-raising and educational effort beyond the gates of the academic world. It must effectively reach a wider circle of stakeholders to inform the development of their actions and be translated into health and social policy. More effort should perhaps be dedicated to sharing the scientific argument at an appropriate level and form. When do we start?'
