New research revealing the link between good, old-fashioned machismo and an unwillingness to go to the doctor provides the best evidence yet that men with strong masculinity beliefs would prefer to avoid preventive health care altogether, if possible. More importantly, the investigation uncovered surprising new information about the way men in certain social groups feel about taking care of themselves.
Columbia University-based Health & Society Scholar (2008-2010), Kristen W. Springer, Ph.D., author of the study, also explained that, “epidemiological and biomedical gender and health research is generally limited to comparing male and female health outcomes and behaviors without really asking, ‘how’ or ‘why?’ One of my key goals with this project and my Robert Wood Johnson Foundation fellowship,” Springer said, “is to meld gender theoretic research with social epidemiological perspectives on health disparities to better understand how gender shapes health outcomes.” In addition to her masculinity work, Springer has brought together a group of researchers to look at broader questions on gender and health.
Analyzing a sample of 1,000 middle-aged men from the Wisconsin Longitudinal Study, along with co-author Dawne Mouzon, M.P.H., a graduate student at Rutgers University, Springer not only found that middle-aged men with strong masculinity ideals were 50 percent less likely to get preventive care (flu shots, annual physicals, prostate exams), she discovered that the group’s behavior completely contradicted existing findings about socioeconomic status (SES) and health care seeking behavior. “The men with the highest occupational status in the study sample were less likely to get preventive services, despite higher SES.” Surprisingly, Springer explained, blue collar, lower SES men with strong masculinity beliefs had better preventive health habits than the higher SES men, even after they were retired.”
Previous research shows that higher SES generally increases access and use of health care services. “But that link did not hold for middle-aged men with high masculinity ideals,” Springer said. “Their use of preventive health care services decreased as their occupational status increased.” SES was defined by occupation and education level, rather than income which is generally shared in marriages. Guided in part by the groundbreaking SES research of Bruce Link, one of the co-directors of the Columbia Health & Policy Scholar program, Springer was able to better understand the impact of educational and professional standing on the study group’s health seeking behavior. “Link and Jo Phelan’s fundamental cause theory, which describes the impact of flexible resources—money, power, social connections and knowledge on health—helped me make important connections,” she said.
Even though the study had limitations (the sample was not ethnically diverse), Springer says, “our findings may help explain the persistent puzzle that men die earlier than women despite having higher SES.” In an effort supported by RWJF, Springer has now partnered with former Health & Society Scholar (2005-2007), Lisa Bates, Sc.D., to develop and lead an international, interdisciplinary working group to look at the links between gender and health. “We’ve already brought together about 40 social epidemiologists, biologists, chemists, political scientists, women’s studies scholars and other experts on gender to encourage cross-disciplinary research on gender theory, gender relations, social epidemiology and health. We intend to bridge these fields in ways that could advance the work of all involved,” Springer said. “Right now, we are proposing a special issue on the topic for the journal, Social Science & Medicine.”
The paper, “Masculinity and Health Care Seeking among Midlife Men: Variation by Adult Socioeconomic Status,” was presented at the American Sociological Association’s 2009 annual meeting. The Robert Wood Johnson Foundation Health & Society Scholars program is a national program that funds multidisciplinary collaborations in the field of population health.