Men’s Health: Body, Identity and Social Context

Broom, A. P. Tovey ( eds ) Men’s Health: Body, Identity and Social Context . Chichester : Wiley-Blackwell , 2009 £26.99 (pbk ) ix + 220 pp . ISBN 978-0-7456-3454-8 Monaghan, L. Men and the War on Obesity: A Sociological Study . London : Routledge , 2008 £22.99 (pbk ) xiii + 214 pp . ISBN 978-0-415-40712-0 Galasinski, D. Men’s Discourses of Depression . Basingstoke : Palgrave-Macmillan , 2008 £45 (hbk ) viii + 209 pp . ISBN 978-0-230-50752-4 The field of empirical and theoretical work relating to men and health has expanded significantly over the last 15 years. Understanding this field requires obtaining and integrating information from several disciplines. Yet, with some notable exceptions, it is only in recent years that sociology, and specifically the sociology of health and illness, has turned its attention to exploring the relationships between men and their health through a gendered lens – surprising given the strong historical contribution sociology has in made to advancing debates on gender identity and critical studies of men. It was therefore with great anticipation and excitement that I embarked on the process of reading and reviewing three new contributions to this field. The first work, an edited text by Broom and Tovey, combines chapters that are commentaries, Foucauldian analysis, and qualitative empirical work on subjects as varied as men’s help-seeking practices, prostate cancer, heart disease, mental health, HIV, alcohol, sport and steroids and the health of immigrant and refugee men. While at first glance this appears like a wide and (potentially) unrelated selection it is far from it. The editors have ensured that what runs throughout, and therefore what provides a common thread holding the work together, is a focus on male identities; that is, an emphasis on masculinities and, where appropriate, how these intersect with other aspects of identity. This structure is strongly supported by Courtenay’s opening chapter, ‘theorising masculinity and men’s health’, which provides a substantive overview of men’s health (very useful as an introductory text), and by Petersen’s closing chapter on the ‘future research agenda in men’s health’, which provides particular suggestions of theoretical frameworks for moving men’s health research forward. The stated aim of the book is to ‘provide an international and interdisciplinary perspective on the state of play in men’s health research’ (p.5). To some extent this aim is met. Certainly contributors currently work in five different countries and there is some diversity of disciplinary background. However, the contributions are very much related to men’s health in the Anglo-North America-Australia social context rather than the wider global context. This does not detract from the book in any way, it simply means the initial aim was over-stated. For those specifically engaged in sociological work around gender (and/or masculinities) and health the book provides an excellent collection of recent, high quality, empirical and theoretically informed pieces. As such, it could be extensively used on Gender Studies, Women’s Studies, Health Studies and Sociology of Health courses and modules as a core text to introduce students to the key issues in relation to men, masculinities and health. Other students, and indeed health and social care professionals at pre or post registration level, would also find specific chapters useful in terms of both academic content and as an aid to reflection that may help inform practice. The second book, by Lee Monaghan, would easily make my top three most thought provoking academic works of the last five years. It is a dense book in terms of the depth and complexity of the arguments made and, as such, is not a book for those just starting out in sociology or the sociology of health and illness. Yet the level of complexity is born out of necessity rather than any desire to confuse or confound. Without dismissing the value of nutrition and physical activity for biomedical health, the work highlights the difficulties attached to constructing obesity as a ‘disease’ that war should be waged against by militarised medicine and the concomitant aggressive moralising that forms part of the weaponry in this conflict. In particular, the bombardment of larger people with messages about the unacceptability of their bodies creates both internal personal conflict and material processes of marginalisation and oppression that have consequences for health and well being. In light of this, Monaghan’s aim is to use a critical framework to bring men’s voices in to promote healthy scepticism about ‘the instituted meanings and practices that define (men’s) bodies as objects to be cut down in size’ (p.4) and to start a dialogue amongst interested parties who are open to embracing biological and social components. The men’s voices are structured in chapter two as a typology used throughout the book to inform interpretations about the ‘war on obesity’. In this way the men’s voices are presented as being pre-eminent without falling foul of the incorrigibility principle; that is that lived experience accounts cannot be challenged. The work has additional value above its topic content. The diverse range of empirical material drawn on, how this is supported methodologically (found in chapter one), and how the findings are subsequently presented (chapters two to five) represent excellent examples for sociologists (and other disciplines) struggling with qualitative research conduct and presentation. The book makes a strong academic contribution to sociology particularly as it relates to gender, embodiment and health. For those working in public health policy and practice that are not afraid of wrestling with a text that is likely to challenge and push the boundaries of their thinking it is certainly worth the investment of time and money. The final book, by Galasinski, also provides a fine example of how to conduct and present a qualitative research project, this time one based within a discourse analytic framework. It differs considerably in the style of writing to Monaghan’s (necessarily) dense structure. The style here is very crisp, almost clipped, making the text clear and easy to follow. The aim of the work is to explore what it means for men to have an illness, depression, which fundamentally undermines what it means to be a man. This specifically has two component parts: how do men position themselves in relation to the illness and what is the relationship of the illness experience to ‘masculinity’ (p.2). The structure of the book facilitates this exploration. Chapters two and three juxtapose dominant psychiatric discourses of depression with men’s own constructs which present depression as agentive and in many ways autonomous of the person (man) himself. The second part of the book (chapters four to seven) continues the theme of distancing depression from the self, explores the action (rather than intra-psychic) orientation of men’s accounts of depression, and suggests men’s preference for constructing depression as ‘natural’ rather than an ‘illness’. Part three (chapters eight to ten) focuses on how depression is directly experienced as an assault on masculinity and explores this in connection to work and men’s family relations. The work provides a very useful addition to the currently small body of literature on a critical understanding of men, depression and the role that men’s gender plays in this. In doing so it gives a powerful account of the lived experiences of men with a marginalised masculinity. As with the first book, it could be extensively used on Gender Studies, Women’s Studies, Health Studies and Sociology of Health courses and modules. In addition, it should make core reading on mental health courses or modules - be they for medics, nurses or other allied health and social care professionals - as it elucidates very clearly the personal elements that such professionals ought to consider in their therapeutic contacts with men experiencing depression. In many ways these three works vary in nature, in the topics covered, in the way they are structured, and in the origins of the empirical data used to construct arguments made. However, all three make significant contributions to advancing our understanding of men’s health and illness experiences, they all have a focus on gender, on understanding the role of masculinities and its relation to men and health, and all have content of high quality.