The association between masculinity rank and mortality patterns: a prospective study based on the Swedish 1969 conscript cohort

Månsdotter, Anna; Lundin, Andreas; Falkstedt, Daniel; Hemmingsson, Tomas

doi:10.1136/jech.2008.082628

Cited by 28 publications

(21 citation statements)

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“…Further, entrenched masculinity ideals could lead to psychological vulnerability, and risky lifestyles for compensating a threatened position, among men who fail to achieve them. In a recent study of Swedish men born in 1950, we found support for this hypothesis since scoring low on masculinity was notably associated with increased risk of suicide and overall mortality [11] . The finding suits also the proposal that the most detrimental position for both women and men is to neither achieve masculinity nor femininity [10] .…”

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confidence: 49%

“…Connell [5] has proposed a division into 'hegemonic masculinity' which refers to the highest valued masculinity at any given place and time, 'complicit masculinity' which refers to not achieving but supporting in principle the hegemonic ideals, and 'subordinated masculinity' which refers to neither achieving nor supporting these ideals. There are several potential hypotheses regarding the relationship between type of masculinity (femininity) and lifetime health [11] . The hegemonic ideals of strength, ambition, and self-reliance among men may, for example, inspire to physical activity and education, but connect also to considering safety and health investments as irrelevant.…”

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confidence: 99%

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Further Thoughts on Gender and Lifetime Health

Månsdotter

2010

Gerontology

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confidence: 49%

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confidence: 99%

Further Thoughts on Gender and Lifetime Health

Månsdotter

2010

Gerontology

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“…Accordingly, identification of gender-specific obstructions can be used to more precisely target and resolve the cognitions that impede use of life-improving, life-saving procedures. In addressing how males and females approach CRCS differently, the basic findings of poorer male health (than females), reflected in higher mortality rates [22,23] and the identification of male gender as a significant mortality risk are linked to the less frequent use of health services [24-27]. Even when males progress to health care contacts, they unfortunately spend less time during doctor visits than women, receiving less advice about risk factor reduction [24,27-30].…”

Section: Introductionmentioning

confidence: 99%

Gender differences in attitudes impeding colorectal cancer screening

et al. 2013

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BackgroundColorectal cancer screening (CRCS) is the only type of cancer screening where both genders reduce risks by similar proportions with identical procedures. It is an important context for examining gender differences in disease-prevention, as CRCS significantly reduces mortality via early detection and prevention. In efforts to increase screening adherence, there is increasing acknowledgment that obstructive attitudes prevent CRCS uptake. Precise identification of the gender differences in obstructive attitudes is necessary to improve uptake promotion. This study randomly sampled unscreened, screening - eligible individuals in Ontario, employing semi-structured interviews to elicit key differences in attitudinal obstructions towards colorectal cancer screening with the aim of deriving informative differences useful in planning promotions of screening uptake.MethodsN = 81 participants (49 females, 32 males), 50 years and above, with no prior CRCS, were contacted via random-digit telephone dialing, and consented via phone-mail contact. Altogether, N = 4,459 calls were made to yield N = 85 participants (1.9% response rate) of which N = 4 participants did not complete interviews. All subjects were eligible for free-of-charge CRCS in Ontario, and each was classified, via standard interview by CRCS screening decision-stage. Telephone-based, semi-structured interviews (SSIs) were employed to investigate gender differences in CRCS attitudes, using questions focused on 5 attitudinal domains: 1) Screening experience at the time of interview; 2) Barriers to adherence; 3) Predictors of Adherence; 4) Pain-anxiety experiences related to CRCS; 5) Gender-specific experiences re: CRCS, addressing all three modalities accessible through Ontario’s program: a) fecal occult blood testing; b) flexible sigmoidoscopy; c) colonoscopy.ResultsInterview transcript analyses indicated divergent themes related to CRCS for each gender: 1) bodily intrusion, 2) perforation anxiety, and 3) embarrassment for females and; 1) avoidant procrastination with underlying fatalism, 2) unnecessary health care and 3) uncomfortable vulnerability for males. Respondents adopted similar attitudes towards fecal occult blood testing, flexible sigmoidoscopy and colonoscopy, and were comparable in decision stage across tests. Gender differences were neither closely tied to screening stage nor modality. Women had more consistent physician relationships, were more screening-knowledgeable and better able to articulate views on screening. Men reported less consistent physician relationships, were less knowledgeable and kept decision-making processes vague and emotionally distanced (i.e. at ‘arm’s length’).ConclusionsMarked differences were observed in obstructive CRCS attitudes per gender. Females articulated reservations about CRCS-associated distress and males suppressed negative views while ambiguously procrastinating about the task of completing screening. Future interventions could seek to reduce CRCS-related stress (females) and address the need to overcome...

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“…We focused on two specific psychosocial factors relevant to African-American men's preventive health services delays: masculinity and medical mistrust. Previous research links masculinity to men's mortality, health behavior, and healthcare use [26][27][28][29] and medical mistrust to African-Americans' use of preventive health services. 30,31 Researchers speculate that men delay using preventive health services because of traditional social constructions of masculinity, which prescribe extreme self-reliance, stoicism, and healthcare avoidance for men.…”

Section: Introductionmentioning

confidence: 99%

Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

et al. 2010

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BACKGROUND:The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE: To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS: A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003)(2004)(2005)(2006)(2007)(2008)(2009). MEASUREMENTS: Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were selfreported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS: After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23). CONCLUSIONS: Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men's potential to frame preventive services utilization as a demonstration, as opposed to, denial of masculinity and implementing policies to reduce biases in healthcare delivery that increase mistrust, may be viable strategies to eliminate disparities in African-American male healthcare utilization.KEY WORDS: masculinity; medical mistrust; preventive health services delays; African-American men.

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The association between masculinity rank and mortality patterns: a prospective study based on the Swedish 1969 conscript cohort

Abstract: Earlier research has proposed that masculinity may hold both positive and negative aspects regarding lifetime health. The major conclusion here is that being ranked less masculine is associated with higher mortality.

Cited by 28 publications

References 19 publications

Further Thoughts on Gender and Lifetime Health

Further Thoughts on Gender and Lifetime Health

Gender differences in attitudes impeding colorectal cancer screening

Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

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