A comparative analysis of men's reluctance to seek health care : performing masculinity and deflecting blame : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University

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Massey University
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Men have higher rates of premature mortality than women and may arguably have higher of rates of morbidity. An explanation frequently offered to account for these gendered health differences is that men are reluctant to seek health care. This research, within a social constructionist framework, explores the discursive construction of men's reluctance to seek help by investigating through a comparative analysis the ways in which two small groups of men from different socio-economic locations make sense of the reluctance to seek help notion, as well as the implications of this discursive and social positioning for the enactment of their lives. Individual unstructured interviews with nine, mid-aged New Zealand men were analysed using Foucauldian Discourse Analysis. Two dominant discourses were identified in the men's accounts. A discourse of masculinity, which constructs reluctance to seek health care as a form of idealised masculinity, was draw upon by both working-class and professional men. In a contradictory account, working class men also drew on an impediment discourse, which constructs reluctance to seek help as a product of restrictive contextual factors that limit the health practices that men can undertake. Utilisation of the masculinity discourse enabled both groups of men to present themselves as masculine men and perform gender as socially prescribed. The impediment discourse also allowed working-class men to present themselves as victims of circumstance and deflect blame for their unwillingness to seek help from themselves to socio-structural restraints. Presenting themselves as masculine men and victims of circumstance was problematic for the men, as each of these positions was fraught with ambivalence. Their accounts reflect a series of unresolved tensions and dilemmas as they worked through the conflicts between the preservation of their social identity, acknowledging the need to seek help, and deflecting blame. They render overt the interplay between gender, power, and social class. These men's accounts are consistent with previous research that indicates that men are reluctant to seek help, but ascribe this to social expectations and socio-structural constraints. rather than individual choice. Reluctance to seek health care is thus reframed as a social issue.
Men, Medical care, Attitudes, Utilization