I feel obliged to respond in what I hope is a constructive way, to
Jeff's comments

Professor John J Macdonald
Foundation Chair in Primary Health Care
Co-Director Men's Health Information and Resource Centre
P11 Hawkesbury Campus
Locked Bag 1797 Penrith South DC NSW 1797
Tel (61) 2 45701123
Fax (61) 2 45701552

-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Jeff Denis
Sent: Saturday, June 16, 2007 3:40 PM
To: [log in to unmask]
Subject: Re: [SDOH] Norway: National strategy to reduce social
inequalities in health: an Australian response: men's health week

Interesting article, John. But, at the risk of sounding PC, and with
limited knowledge of the specific case of Australia, here are some
counter-arguments: THE SDSH APPROACH ALLOWS US TO STOP THINKING IN TERMS
OF "ARGUMENTS")

1. Historically, women were under-represented in health research. That's
why the more recent focus on women's health.

NOBODY WOULD ARGUE THAT WOMEN'S HEALTH IS NOT IMPORTANT OR NOT WORTHY OF
ATTENTION. WE SPEND MILLIONS OF DOLLARS IN AUSTRALIA ON A NATIONAL
WOMEN'S HEALTH LONGITUDINAL STUDY - PROVIDES A RATIONAL BASE FOR HEALTH
POLICY. GREAT.THERE IS NO EQUIVALENT IN MEN'S HEALTH. APPROACHES TEND TO
BE BASED ON NON-EVIDENCE BASED OPINIONS, SUCH AS THOSE OF "HEGEMONIC
MASCULINTY" AS IN 'WE DON'T NEED TO STUDY THIS, WE HAVE OUR EXPLANATIONS
(see below)

2. Cultural constructions of "masculinity" are important for health
(linked to various forms of risk taking and violence). Moreover, they
are not "endogenous"
to individual men. The term endogeneity implies masculinity is innate.
In fact, it is learned through socialization and reinforced by the
expectations and sanctions of others (especially, but not exclusively,
men). Of course, these cultural constructions vary with the historical
context and the political and economic structures of societies (and
individual men's location in them) and it's important to investigate
precisely how. But that doesn't mean that "what it means to be a man"
and the power dynamics between men and women are irrelevant for health
or immune to change.

THIS IS INTERESTING AND HAS RELEVANCE: THIS DISCOURSE, HOWEVER, HAS
DOMINATED SUCH MEN'S HEALTH POLICIES AS DO EXIST IN MOST COUNTRIES. IT
IS, HOWEVER, NOT EVIDENCE BASED IN ANY REAL SENSE. IT IS OPINION AND AS
WORTHY OF CONSIDERATION TO BUILD A WHOLE PICTURE AS MARXIST VIEWS,
FEMINIST VIEWS, POST MODERNIST VIEWS ETC

3. I agree that other SDOH factors like unemployment, stress, lack of
access to public transit, etc. have a huge impact on health. But why
should we expect these factors to affect men's health any differently
than they affect women's health? In other words, isn't poverty bad for
male and female hearts and male and female minds, whereas "hegemonic
masculinity" is bad for men because it motivates them to take unhealthy
risks MEN TAKE UNHEALTHY RISKS HERE IN AUSTRALIA TO PUT OUT FIRES, THANK
GOD. TESTOSTERONE IS NOT A SIN. (hence, lower life expectancy) WOW.
JEFF, YOU HAVE THE TOTAL EXPLANATION OF THIS DIFFERENTIAL! SDSH ADDS TO
OUR UNDERSTANDING OF THE COMPLEXITIES INVOLVED and bad for women because
it subjects them to greater violence and control (hence, more rapes,
murders by spouses, and chronic ailments)? If there is something
different about how poverty affects men, then isn't that because it is
bound up with cultural constructions of masculinity (e.g., the man has
to "bring home the bacon")? MANY MEN DO BRING HOME THE BACON AND IT'S
NOT ALL BAD

WHAT I AM SUGGESTING IS THAT THE SOCIAL DETERMINANTS OF HEALTH APPROACH
ALLOWS US TO LOOK BEYOND OPINION AND ALLOWS US TO BUILD RATIONAL HEALTH
POLICIES AND CONDUCT USEFUL RESEARCH. OF COURSE WE SHOULD PROTECT
EVERYONE AGAINST VIOLENCE BUT LET'S AVOID SIMPLISTIC EXPLANATIONS OF
THIS PHENOMENON - OUR CURRENT DISCUSSIONS HERE OF VIOLENCE IN THE
ABORIGINAL COMMUNITY DESPERATELY CALL FOR A SOCIAL DETERMINANTS
PERSPECTIVE. WHAT WE WILL GET ARE PARTIAL EXPLANATIONS LEANING ON THE
"HEGEMONIC MASCULINTY" FRAMEWORK. ALL I ASK IS THAT THE DISCOURSE WIDENS

JOHN




--
Jeff Denis
PhD Candidate
Department of Sociology
Harvard University

"The principle of organizing our society for the benefit of all the
people and not for a privileged few - that is still here and that is a
principle to which we adhere." - Tommy C. Douglas



Quoting John Macdonald <[log in to unmask]>:

> I love it and will read it all and use it when speaking to Australian 
> parliamentarians this coming week. The website keeps me going. Thank 
> you, Dennis.
>
> But I notice that no one takes me up on my challenge when I say - in 
> this international men's health week - that simplistic western notions

> of gender and totally understandable concern for gender inequalities 
> in health in some countries and situations prevent us from using the 
> social determinants of health framework to look at inequalities in 
> health some men experience. Pity that political correctness seems to 
> prevent us looking at men's health other than to say they must change 
> their behaviour. Go tell that to men in families in western Sydney, 
> white as well as Indigenous, who are affected by job insecurity, poor 
> transport, poor access to affordable good food etc. Here in Australia 
> the dominant gender discourse is about hegemonic masculinty. If anyone
is intersted in a social determinants approach to men's health:
> "Shifting paradigms: a social-determinants approach to solving 
> problems in men's health policy and practice"
> John J Macdonald MJA 2006; 185 (8): 456-458 
> https://www.mja.com.au/public/issues/185_08_161006/mac10104_fm.html
>
> John Macdonald
>
>
>
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