Beyond masculinity : a qualitative study of men’s help seeking and health service use in South Australia.

Abstract

Men's help seeking practices and patterns of health service use are significant public health issues in the Western world. However, until recently, there has been little empirical research, particularly qualitative studies, examining how and why men seek help and use health services. In Australia and internationally, this has limited the evidence-base available to inform men’s health policy development and service delivery. In this thesis I investigate lay men's views of their help seeking practices and health service use. I achieve this through an analysis of qualitative interviews conducted with 36 Anglo-Australian men living in North-West Adelaide, South Australia. My analysis adopts a strengths-based approach, consistent with a new public health perspective. This recognises the multiple dimensions of men's lives and explores the intersection between gender and other social aspects of identity that relate to ageing, family, work, previous illness experiences and doctor-patient relationships. My primary empirical findings are presented as three peer-reviewed journal articles. In the first paper I examine the intersection between ageing and masculinity. I show that independence can be perceived as both a health enhancing and health damaging trait. I argue that traditional masculine traits, such as independence, will not always impact negatively on men’s help-seeking practices. Rather, such traits offer opportunities to engage men in health services at particular junctures across their life-course. In the second paper, I explain how men actively self-monitor their health. My analysis highlights how help-seeking among men is negotiated in the context of social and environmental circumstances that extend beyond, but may relate to, gender. Such factors include prior illness experiences, the ability to maintain regular duties (such as employment), the perceived seriousness of health concerns, and the availability of time. Consideration of these factors can guide the development and implementation of health promotion programs and primary health care services aimed at engaging men. In the third paper, I explore what the health service interaction looks like when men decide to visit their General Practitioner. I identify five core qualities men value when communicating with general practitioners in primary care settings: the adoption of a frank approach; demonstrable competence; a thoughtful use of humour; empathy; and the prompt resolution of health issues. Health professionals who adopt a patient-centred approach by incorporating the above qualities into their daily practice are regarded by men as providing an environment conducive for men to speak openly about their health. I conclude my thesis by suggesting that a strengths-based approach provides an alternative way to view and respond to Anglo-Australian men’s help-seeking practices in Australia. I use this approach to explore the implications for men’s health policy development and implementation at a national level, and to suggest strategies that can be used by policymakers to improve men’s engagement in the Australian public health system.