Home Health & Wellness How Gender Norms Influence Health Behaviours and Access to Care for Men and Women

How Gender Norms Influence Health Behaviours and Access to Care for Men and Women

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Gender categories, feminism and masculinity, are strongly associated with the health status of men and women and their influence on help-seeking and the delivery of healthcare. Men and women approach health issues differently. This is identified in mortality and morbidity patterns, as life expectancy is the standard indicator of a difference in men’s and women’s health in virtually all countries. Although there are significant differences in men’s and women’s morbidity and mortality, there is a dispute over where the differences are sourced and the overall impact on health. COPD is the descriptive name for several conditions, including chronic bronchitis and emphysema, affecting nearly 3 million people in the UK. COPD obstructs the airways and causes difficulty breathing. Emphysema is the destruction of the alveoli (air sacs) in the lungs, reducing the ability of the lungs to absorb oxygen. Chronic bronchitis is the buildup of mucus that causes inflammation of the bronchial tubes, leading to long-term coughing.

The World Health Organization (WHO) defines COPD as a life-threatening lung disease that resulted in 6% of all deaths globally in 2012. Research shows that there is currently no medication to improve mortality rates in COPD patients. But there are medications to improve the quality of life. The WHO suggests that COPD is underdiagnosed, even though there are common symptoms such as breathlessness, abnormal sputum (a mixture of saliva and mucus within the airway) and chronic coughing, all of which can impact an individual’s life dramatically. 

Many fail to report symptoms to their doctor due to the assumption that these are connected to ageing. This results in a late diagnosis, increasing the risk of primary lung cancer. Lung Health Study Research found COPD co-exists with lung cancer, affecting an estimated 40–70% of all lung cancer patients, and is the most common cause of death by airflow obstruction. Lung cancer is the most common form of cancer in the world and is the leading cause of cancer-related deaths worldwide. 

Fortunately, COPD is preventable since the primary cause is tobacco smoking, including passive exposure. Smoking prevalence varies by gender, and in the 1970s, men in the UK reached their highest levels of smoking prevalence. Smoking was perceived as a masculine characteristic, and society disapproved of women smoking.  Even though, in 1920, the number of women smoking increased, it was still deemed inappropriate behaviour by a carer.

COPD is still more common in men due to the increased use of tobacco, with men being estimated to be five times more likely to smoke than women. Cigarette smoking triggers lung inflammation, which is strongly linked to significant components of COPD. Action on Smoking and Health suggests that 22% of men in the UK are smokers, and the highest prevalence is in the 25–34 age group. Men generally commence smoking at a younger age, smoking more cigarettes on average per day than women. In the early part of the 19th century, imagery and promotion for tobacco were masculine-based. The tobacco industry understood how to target its audience and culture.  Art, film and literature also contributed to the masculine image of smoking by using actors. This emphasised the masculine qualities of risk-taking and rebellion against society. The Maine Department of Health and Human Services suggests smoking has been portrayed as a masculine ideal that is linked to succession and wealth within society. But in reality, smoking causes premature death and can lead to COPD. 

Masculinity is broken down into four categories: hegemonic masculinity, complicit masculinity, subordinated masculinity, and marginalised masculinity.  Masculinity is dictated to men to remain strong, confident and able to deny pain. However, health issues such as COPD gradually deteriorate over time and cause pain. COPD affects men and women equally. However, high-risk activity and decreased engagement with healthcare are ideals of masculinity. The cultural ideals of masculinity refer to men’s health beliefs and behaviours of denying weakness or vulnerability, appearing solid and robust, resulting in the dismissal of medical assistance when men are ill or leaving their health concerns for an extended period. Within today’s society, there is a change in men’s practises of not being the only “breadwinner” and instead sharing the traditional role of women (childcare and housework). However, there is still a social expectation of masculinity within men. Gender practice has created the ideals of what is expected of men due to historical events such as World War I and World War II. 

As one writer put it: “masculine gender socialisation is hazardous for men’s health, posing a double whammy of poorer health behaviours and lower use of health care”. The social construction of masculine acts influences their health and limits men’s lives. The National Health Service Choices announced that life expectancy in the UK is 79 for men and 82.7 for women. Suggesting there are potential factors, such as masculinity, impacting men’s health dramatically, as explored with COPD. 

Gender role is defined by particular attitudes, behaviours, and self-presentation methods which are biologically ascribed to either males or females. Gender roles are created within the family unit in early childhood and then developed by the family and environment. The theoretical model of perceived gender roles is based on the Grounded Theory analysis, which categorises masculine and feminine attributes that are connected to health behaviour. 

Masculinity and femininity define what gender expects. For instance, if a man shows traits associated with women, such as compassion and emotions, they are perceived as being weak within society.  In today’s society, there is still a myth of men needing to be heroes; living without considering risks, and not taking care of their health is connected to the image of a “real man”. The Integrative Model of Masculinity displays the influences that affect an individual’s masculinity and suggests both negative and positive impacts of masculinity. 

Masculinity dominates and is reflected in the unhealthy and antisocial patterns within men’s health. It is also impacted by the social determinants of health.  Masculinity affects other social determinants of health by decreasing health interventions. It interacts with their socioeconomic status, the community, and their education, as masculinity qualities can be socially constructed within a social context. “Pollack’s Boy’s Code is an example of how education can implant masculine qualities early, encouraging boys not to cry and deny pain. With this embedded in their childhood, they are less likely to seek medical assistance.

There are many studies documenting the low attendance of men seeking medical help, identifying several barriers linked to masculinity by implying that men seeking health are weak. Men who endorse hegemonic masculine ideologies are less likely to engage in health positive behaviours.  Men can fear being perceived as feminine, encouraging them to identify themselves within the normal ideals of men, which can lead to their refusing treatments. Women are more likely to attend medical appointments and ask for health advice. This illustrates how masculinity and gender differences affect choices and health. More attention is needed on the role masculinity plays in the behaviour and health of men, impacting men’s life expectancy. 

Natalie Quinn-Walker is a lecturer in public health and deputy course lead at Birmingham City South Campus – Seacole.


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