An intersectional mixed methods approach to Native Hawaiian and Pacific Islander men’s health.

Abstract

We used a convergent parallel design to explore Native Hawaiian and Pacific Islander (NHPI) men’s multilevel perspectives of the factors that influence healthy eating, physical activity, and weight, to elicit recommendations for lifestyle interventions and to understand the intersection of masculinity and health from a social constructionist perspective. From June to December 2017, NHPI men 18 years and older were recruited to participate in a survey and in focus groups. The survey included demographic questions and questions about the physical and cultural activities men engage in, perceived social support for lifestyle behaviors, dietary behaviors, masculine characteristics, and values important to NHPI men. The Kessler Psychological Distress Scale was used to assess psychological distress. Focus groups were audio-recorded and transcribed for a thematic analysis. Descriptive statistics were computed for survey data. We conducted 8 focus groups with 89 NHPI men (50% Samoan, 20% Native Hawaiian, and 30% Marshallese). The average age of the participants was 39 years, 43% reported some college or college graduate, 64% were currently married, and 63% were working full time. In all, 90% of men scored 20 or higher on the Kessler 10-item screening scale, indicating mild-to-severe psychological distress. Men described food as a major part of their culture and their identity. Men defined their roles as a provider and protector, with little attention being paid to their own health. Our study found that hegemonic or traditional masculinity and social norms may encourage some men to put their health at risk but may also be used to motivate healthy behaviors.

COVID-19, Equity and Men’s Health

“…33,[64][65][66][67]71,[74][75][76][77][78][79][80][81][82][83][84] This has typically focused on vulnerable, marginalised, and minority groups of boys and men. [66][67]76,[81][82][83][84][85][86][87][88][89] Importantly, this scholarship has frequently used intersectionality as a conceptual framework, whereby the nexus between age, gender, race, sexual orientation, disability, geography and/or socio-economic status has been explored. 64,67,86,90 That is, we now have an emerging evidence-base that can be used by decision-makers to generate new and different health promotion and public health strategies.…”

Equity, gender and health: New directions for global men’s health promotion

“…The dualistic framing of gender equity has also been problematic for acknowledging and addressing the complex health and social inequities faced by marginalised groups of men, particularly those relating to race, age, sexuality, socio‐economic status, geography and disability 4,16 . As a direct result, a more concerted and nuanced focus on health equity in the context of men's health has emerged in public health scholarship over the past decade 17‐22 . In particular, discussion about intersectionality – a need to better understand “the complex web of conditions that help shape the lives and health of men” (Griffith et al 2019) – has increased exponentially, 17‐18,20,22‐24 with a special issue on this topic due to be published in the International Journal of Men's Social and Community Health later this year.…”

“…As a direct result, a more concerted and nuanced focus on health equity in the context of men's health has emerged in public health scholarship over the past decade 17‐22 . In particular, discussion about intersectionality – a need to better understand “the complex web of conditions that help shape the lives and health of men” (Griffith et al 2019) – has increased exponentially, 17‐18,20,22‐24 with a special issue on this topic due to be published in the International Journal of Men's Social and Community Health later this year. Patterns of health outcomes that reflect the intersection of gender and markers of marginalisation (eg, race, ethnicity, lower socio‐economic status, rurality) rarely get mentioned or receive attention in global policy documents 7,11,21,25,26 .…”

The case of Kahewai: Indigenous ways of knowing and Kānaka ‘Ōiwi well-being.

“…Future research directions of Indigenous well-being can incorporate concepts such as balance and being centered in context and place. Sinclair et al (2019) provided an analysis of factors that influence health such as heathy eating, physical activity, and weight and to examine the intersectionality of gender and race for Pacific Islander men. Kahewai’s case was a contribution to the intersectionality of gender and race as his narrative counters the normative narrative of the colonized kāne whose connection with the ‘āina has been severed by colonization leaving him experiencing a lack of lōkahi.…”