Try to be healthy, but don’t forgo your masculinity: Deconstructing men's health discourse in the media

Abstract

The emergence of discourse around men's health has been evident now for at least 10 years across academic, policy and media texts. However, recent research has begun to question some of the assumptions presented concerning masculinity and men's health, particularly within popular media representations. The present paper builds on previous research by interrogating the construction of men's health presented in a recent special feature of a UK national newspaper (The Observer, November 27, 2005). The dataset was subjected to intensive scrutiny using techniques from discourse analysis. Several inter-related discursive patterns were identified which drew upon essentialist notions of masculinity, unquestioned differences between men and women, and constructions of men as naïve, passive and in need of dedicated help. The implications of such representations for health promotion are discussed.

Introduction

The emergence of discourse around Men's Health has been evident now for at least 10 years across academic, policy and media texts (see Courtenay, 2000; White, 2004). The increased attention afforded men's health can be traced to a number of interlinked factors, such as published statistics highlighting sharp sex differences in major illnesses, vociferous expressions of concern from health professionals, and media constructions of a ‘crisis’ in masculinity generally (see Horrocks, 1994). However, recent research has begun to question some of the assumptions presented concerning masculinity and men's health, particularly popular media representations (Clarke, 1999; Coyle & Sykes, 1998; Gannon, Glover, & Abel, 2004; Lyons & Willott, 1999). A focus on media materials is important because of their power in defining and reinforcing specific meanings around health (Bury, 1997; Seale, 2002). The present paper builds on previous research by interrogating the construction of men's health presented in a recent supplement of a leading UK Sunday newspaper: The Observer (November, 2005). This feature forms part of a wider corpus of men's health material collected from UK newspapers (Jan 2005–06) and is selected for analysis here because of contains a series of articles covering a range of relevant issues. Intensive scrutiny of this feature draws on techniques from discourse analysis (Potter & Wetherell, 1987) and aims to identify dominant representations of men's health and their implications for health promotion.

The term ‘Men's Health’ is now very much in vogue across academic, policy and media texts. It is typically associated with the following set of claims:

• there is now a men's health ‘crisis’ since men are particularly vulnerable to a range of health problems;

• men do little or nothing to protect their health;

• ‘masculinity’ is to blame for men's poor health; and

• dedicated research, policy and service provision is required to address the problem of men's health.

These interlocking claims are now discussed. Over the past ten years or so, the state of men's health has emerged as a key concern in the UK and beyond. The UK Government Department of Health has expressed concern about statistics showing men to be at risk from several major diseases because of poor diet, high alcohol consumption, smoking etc. (Office for National Statistics, Social Trends 30, 2000; Office for National Statistics, Social Trends 34, 2004). This picture is repeated in Europe (White & Cash, 2004), Australia (White, 2002) and North America (Courtenay, 2000). For many disease-related phenomena, men are worse off than women (e.g. heart disease, mental illness, life expectancy), although there is considerable variation between men. For example, men from working class backgrounds are over-represented in figures for chronic sickness (Baker, 2001; Office for National Statistics, 2002).

The general vulnerability of men to disease is wryly conveyed by Dr Ian Banks (President, Men's Health Forum):

If you compare all the major killers, such as heart disease and lung cancer, men easily come out best, from the undertaker's point of view (http://www.menshealthforum.co.uk, accessed 13/01/05).

In the academic literature, recent reviews on men's health (e.g. Courtenay, 2000; White, 2004) emphasise men's greater vulnerability to major health problems (physical injury, most cancers, obesity, suicide, etc.). However, it is clear that men's health research is in its infancy. As White (2004) acknowledges, traditional medical research was almost exclusively oriented towards white middle-class men, with findings generalised to women and other groups of men. Moreover, gender was not considered in any analyses, so that men qua men remained invisible. With a few exceptions, this situation has not changed significantly—there is still a dearth of health-related research in which gender is explicitly considered. While many studies do include sex as a variable, few explore how culturally dominant notions of masculinity and femininity might influence health practices. For example, a questionnaire-based study by Wardle et al., 2004) found that women were more likely than men to report healthy eating, diet restriction and to place more importance on healthy eating—but there was little attempt to explore why this might be the case.

Another problem with research which is ostensibly concerned with men's health is the tendency to resort to stereotypical observations when gender is considered, notably that ‘hegemonic masculinities’ (Connell, 1995) play a negative role in men's health. Briefly, hegemonic masculinities work to oppress women and other men through a range of ideals and practices such as competition, aggressiveness and heterosexuality. While many men will not actually attain or maintain culturally valued modes of masculinity, they nonetheless benefit through complicity with dominant ideals. Such privilege is not readily available to ‘marginalised’ masculinities, however, which are evidenced in groups of men who occupy relatively disadvantaged positions by virtue of categories such as class and race. In addition, ‘subordinated’ masculinities are those which are actively subjugated, such as the stereotypically ‘effeminate’ practices of gay men. So, hegemonic masculinities comprise sets of identities and practices which exist in relations of power to each other. Despite this complexity and diversity, hegemonic masculinity is often reduced to a singular construct—the stereotypical macho man for example—which is deployed in relation to the ‘crisis’ in masculinity and men's health. This tendency is lamented by Connell in his recent review of the concept of hegemonic masculinity (Connell & Messerschmidt, 2005).

With respect to men's health, the assumption that ‘masculinity is bad for your health’ is clearly challenged by masculinised practices which can be viewed as health-promoting, such as sport. Although there are risks of injury, cardiovascular activities incorporated in sport and exercise are associated with health protection and even enhanced self-esteem (Crone-Grant, Smith, & Gough, 2005). However, men often talk about sport and exercise in terms of masculine attributes such as competitiveness, toughness and homosociality rather than health benefits (Messner, 1992). So, the links between masculinities and health need to be investigated further, and should consider the burgeoning literature on masculinities which has been produced within the social sciences since the 1980s (Connell, 1995; Connell & Messerschmidt, 2005; Edley & Wetherell, 1995; Seidler, 1989). This literature has produced complex understandings of how masculinities are socially constructed within diverse contexts.

Although there is some recognition of variability in health outcomes between men according to social categories like class, age, disability and ethnicity, the complexities pertaining to masculinities have yet to be incorporated into health policy (Robertson & Williamson, 2005), professional practice (Seymour-Smith, Wetherell, & Phoenix, 2002) or mass media representations (Coyle & Sykes, 1998). The media in particular have tended to reproduce stereotypes relating to gender and health (Lyons & Willott, 1999), and given the huge ongoing interest in men's health shown by the media, and the power wielded by media in promoting images of health generally (Bunton, 1997; Seale, 2002), dedicated analyses of media materials become important.

An interesting paper by Singleton (2003) presents a critical analysis of North American self-help books on men's health. The main argument is that such texts perpetuate a neo-conservative ideology which constructs individual men as responsible for attaining good health and well-being. Further, Singleton argues that this individualist rhetoric favours middle-class men and neglects the influence of social factors such as class and race on health status. Another study by Toerien and Durrheim (2001) reports on a discourse analysis of the magazine Men's Health (South African edition). Their focus was not so much on men's health as on conflicting constructions of masculinity (‘macho’ and ‘new’) and on how a compromise identity position of ‘real masculinity’ was promoted. This analysis highlights the continued appeal of hegemonic forms of masculinity for men, and, I would add, implies a resistance to actively adopting new masculinities and new health-protective lifestyles. Similar findings come from studies of specific conditions, such as infertility (Gannon et al., 2004) and prostate cancer (Clarke, 1999).

In the UK there have been some critical analyses of newspaper texts featuring men's health. For example, Coyle and Sykes (1998) focus on male mental health as presented within a ‘guide to men's health’ provided by the British broadsheet newspaper The Independent. They found that a ‘crisis’ in men's health was unequivocally conveyed, with men presented as ‘victims’ of competing forms of masculinity (‘traditional’ and ‘new’). They also found that hegemonic forms of masculinity, although implicated in negative health practices such as risk-taking, were at the same time promoted in favour of alternative, ‘feminised’ modern masculinities. This simultaneous valorisation and critique of hegemonic masculinities leaves ‘unhealthy’ masculinities unchallenged and arguably absolves men from actively protecting their health. Another discourse analytic study by Lyons and Willott (1999) also considered representations of men's health by a UK Sunday newspaper, this time the Mail on Sunday, a more ‘middlebrow’ publication. In contrast to The Independent feature, the explicit target of The Mail on Sunday piece was women: ‘a woman's guide to men's health’. Clearly, as the authors go on to argue, men are presented as passive and helpless when it comes to health matters, and in need of women's protection. Although they acknowledge complexity and contradictions in the way men and women are construed, they argue that predominant discourse patterns located in the texts work to uphold conventional gender relations which position women as nurturers and men as naïve infants.

Building on such work, the aim of the research reported in this paper is to further interrogate contemporary newspaper portrayals of men's health. What follows then is a discursive analysis of a special feature on Men's Health which appeared in The Observer (November 27th, 2005), a leading UK Sunday newspaper whose readership can be characterised as middle-class, professional and left-of-centre. Latest readership survey figures (Oct 2004–Sept 2005) cite 1,297,000 Observer readers, with more than half male (700,000), and about equal numbers of younger (<44) as older (>44) readers. The Men's Health feature explicitly addresses men rather than women, and presents several articles on a wide range of health issues. Such dedicated media features offer researchers an excellent opportunity to scrutinise prevailing assumptions about men's health, and with only a brief glance at this particular feature one is struck by the sheer richness of the material. Specifically, the main objective of the analysis is to deconstruct men's health discourse within the special feature and to argue for a more sophisticated conceptualisation of masculinity and men's health.