The Influence of Masculine Norms and Mental Health on Health Literacy Among Men: Evidence From the Ten to Men Study

Abstract

Background: Adherence to masculine norms, such as self-reliance, has been thought to predict lower health literacy. Additionally, males with poor mental health may have low health literacy. Using two waves of the Ten to Men cohort, the current study examined whether masculinity and depressive symptomology explained three aspects of health literacy among men. Methods: Three subscales of the Health Literacy Questionnaire were used as the outcomes: Ability to find good health information; Ability to actively engage with healthcare providers, and Feeling understood and supported by healthcare providers. Exposures were masculine norms, measured by the Conformity to Masculine Norms Inventory (CMNI-22), and depressive symptoms, measured by the Patient Health Questionnaire (PHQ). We controlled for confounders of the relationship between exposure and outcome. Ordinary least squares regression was used to assess the CMNI and depressive symptoms (measured in Wave 1) on health literacy (measured in Wave 2). Results: Across all three health literacy scales, increased global conformity to masculine norms was associated with a decrease in health literacy. Moderate-to-severe depressive symptoms were likewise associated with a decrease in health literacy on all three scales, with the effects particularly strong for “Ability to engage with healthcare providers” (coef. −1.54, 95% CI [−1.84, −1.24], p value < .001). Conclusions: The results of this article highlight that both conformity to masculine norms and depressive symptoms may be predictors of health literacy among men. The results of this study suggest the need for health literacy media campaigns that address the complexities of gendered help-seeking behaviors. Trial registration: Not applicable.

Conformity to masculine norms and its effects on men’s well-being

“…This means that for this particular age group and culture, the gender expectation to deal on their own with all problems carries the highest risks to general well-being. This 'cluster' of correlations is in line with some previous studies that have shown poorer mental well-being among men who are highly self-reliant (Milner, et al, 2018, Milner, Shields & King, 2019Rice, Fallon & Bambling, 2011).…”

COVID-19 e os impactos na saúde mental: uma amostra do Rio Grande do Sul, Brasil

“…Although these professionals are more exposed to the disease than most of the population, factors that can help us understand this decline are greater access of these professionals to health services and broader knowledge about COVID-19 prevention and treatment. The literature has indicated that health literacy, that is, greater knowledge about diseases, their risk factors, self-care and trained health professionals and services for treatment, contribute to better mental health rates 32,33 . However, in any case, it is worth emphasizing that health professionals were mostly under social distancing measures, which could decrease the likelihood to be infected, and, therefore, alleviate anxiety related to the disease and the risk of mental disorder.…”

“…It is also essential to develop interventions in primary care focused on prevention, such as health literacy campaigns and actions 32,33 . In this sense, it is understood that easily understood information related to prevention, contagion, and mental health care becomes essential for the population.…”

‘Dudes Are Meant to be Tough as Nails’: The Complex Nexus Between Masculinities, Culture and Health Literacy From the Perspective of Young Aboriginal and Torres Strait Islander Males – Implications for Policy and Practice

“…Recent studies reveal that numerous social determinants of health exert strong influence on health literacy. Culture, gender and age have been identified as particularly powerful variables (Baum, 2019; Beauchamp et al, 2011; Bröder et al, 2017; Crengle et al, 2018; Lie et al, 2014; Milner et al, 2019; Peerson & Saunders, 2011). The nexus between these determinants, and their collective relationship with health literacy, remains largely unexplored.…”