"Take a Spoonful of Concrete and Harden the **** up!": How British Men in Hong Kong Talk About Health and Illness

The present study draws on semistructured focus group discussions conducted with British men living in Hong Kong to examine how men’s constructions of masculinity influence health behavior and attitudes. Twenty-eight men aged 21–51 years were divided into groups based on age (≤35 years and ≥36 years); length of residence ranged from 2 to 20 years. Discussions were analyzed using open-ended thematic analysis. Following intensive analysis of the transcripts, four subthemes were identified and analyzed in greater detail: (a) health talk; (b) help-seeking behavior; (c) health risk; and (d) health motivations. Findings suggest a widespread endorsement of a hegemonic view of masculinity among men in the present study. Men expressed reluctance in seeking help for illness, regardless of age, particularly when experiencing symptoms of ill-health that were deemed to be “minor.” However, help seeking was embraced when it was perceived to impact masculinity, for example, when potentially related to sexual performance or function. While men in the present study were sometimes dismissive of health advice provided by family, they were more open and responsive to seeking help upon the advice of male friends. Findings are further discussed with reference to the relationships between masculinities and health; implications for health are discussed.

Situated influences on perceived barriers to health behavior change: cultural identity and context in Kazakhstan

OBJECTIVE

The objective of this study was to identify the perceived barriers to lifestyle changes citizens of Kazakhstan suffering from cardiovascular disease and type II diabetes were experiencing.

DESIGN

14 focus groups were conducted with patients across two regions of Kazakhstan. Topics of discussion included accessing medical care, communicating with health care providers, and following doctor's recommendations. The text of the discussions were analysed for trends and themes across the different groups.

RESULTS

Patients identified a series of external and internal barriers to lifestyle changes, including the environment, a dependency on health care providers, a health care system they feel powerless to change, and a low level of self-efficacy. Most notable, however, was a constructed ethnic identity whose boundaries included unhealthy behaviors, specifically diet and untimely access of health care. This identity both was blamed as a cause for the patient's condition and seen as an unchangeable barrier to health behavior change.

CONCLUSION

Current provider efforts to encourage lifestyle changes to manage disease are not taking into account the broader issue of ethnic identity, namely negotiating a fragile and previously suppressed identity that mostly exists alongside other ethnicities. Therefore, maintaining distinctiveness may be a greater need than modifying health behaviors. Efforts towards healthier lifestyles for the public must include not only messages regarding health but also constructions of a Kazakh identity that allows for such lifestyles to fit within the identity framework.

Gendered accounts of managing diabetes in same-sex relationships: A discursive analysis of partner support

The gendered dimensions of partner support in relationships where one partner has a chronic condition has been a recurring focus within the literature on gender and health. Such literature however typically focuses exclusively on heterosexual couples while same-sex relationships are rendered invisible, leading to the discourse around partner support being heteronormative. This article examines gendered dimensions within accounts of lesbian, gay and bisexual people with diabetes using a discursive psychological approach. The analysis identifies how participants drew upon a range of interpretative repertoires, including: (1) notions that women are more caring than men; (2) that men can take control in an emergency; (3) that gay men are caring; (4) that grown men can take care of themselves; and (5) that gay men are more independent than heterosexual men. It is argued that rather than simply dismissing heteronormative repertoires of gender and health, non-heterosexuals draw upon them in ways that display ideological tensions.

A qualitative meta-synthesis examining the role of women in African American men's prostate cancer screening and treatment decision making

OBJECTIVE

Being an African American man is a risk factor for prostate cancer, and there is little consensus about the use of screening, early detection, and the efficacy of treatment for the disease. In this context, this systematic review examines the roles women, particularly wives, play in African American men's prostate cancer screening and treatment decision making.

METHODS

We searched OVID Medline (R), CINAHL (EBSCO), PsychInfo (EBSCO), PubMED, Cochrane Library, ERIC (Firstsearch), and Web of Science to identify peer-reviewed articles published between 1980 and 2016 that reported qualitative data about prostate cancer screening, diagnosis, or treatment in African American men. We conducted a systematic review of the literature using study appraisal and narrative synthesis.

RESULTS

Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for identifying and screening 1425 abstracts and papers, we identified 10 papers that met our criteria. From our thematic meta-synthesis of the findings from these publications, we found that women played 3 key roles in African American men's decision making regarding prostate cancer screening, diagnosis, or treatment: counselor (ie, offering advice or information), coordinator (ie, promoting healthy behaviors and arranging or facilitating appointments), and confidant (ie, providing emotional support and reassurance).

CONCLUSIONS

Women are often important confidants to whom men express their struggles, fears, and concerns, particularly those related to health, and they help men make appointments and understand medical advice. Better understanding women's supportive roles in promoting positive mental and physical outcomes may be key to developing effective interventions to improve African American men's decision making and satisfaction regarding prostate cancer screening and treatment.

Power through Knowledge: Ignorance and the ‘Real Man’

The aim of this article is to show that tensions between conflicting accounts of masculinity need not only be ‘resolved’ by individual men, but can have a collective ‘resolution’. We argue that the ‘real man’ - by drawing together the ‘macho’ and ‘new man’ discourses - represents one such ‘integrated’ discourse of masculinity available to men. Our argument is based on a discourse analysis of 15 editions of Men’s Health, a South African magazine predominantly aimed at white, middle- to upper-middle class, heterosexual men. We also investigate how such integrated discourses may be collectively produced, arguing that the ‘real man’ is the product of a rhetorical question-answer strategy that moves men from ignorance to knowledge. Focusing on the rhetoric of masculine ignorance, we argue that the knowledge produced in answer to this ignorance serves to ‘resolve’ a current dilemma for men: how to maintain an essential masculinity while distancing oneself from criticisms of men as traditionally macho. We conclude by exploring, from a feminist perspective, the political implications of the ‘real man’ discourse as a collective ‘resolution’.

‘Not living life in too much of an excess’: lay men understanding health and well-being

While research on lay perspectives of health now has a wellestablished history, specific empirical data on male lay perspectives of health and well-being are largely absent. Drawing on focus group data and in-depth interviews with 20 lay men (including sub-samples of gay men and disabled men), and seven health professionals, this article explores how the men conceptualized ‘health’ and the gendered nature of such conceptualizations. Specific emphasis is given to considering notions of ‘control’ and ‘release’, and the associated issues of ‘risk’ and ‘responsibility’, in the participants’ health narratives. A conceptual model for understanding ‘masculinity’ and ‘health’ is presented.

Taking the Biscuit? A Discursive Approach to Managing Diet in Type 2 Diabetes

Adopting and maintaining a healthy diet is pivotal to diabetic regimens. Behavioural research has focused on strategies to modify/maintain healthy behaviours; thus ‘compliance’ and ‘ noncompliance’ are operationalized by researchers. In contrast, discursive psychology focuses on the actions different accounts accomplish—in this case regarding diets. Using thematic discourse analysis, we examine dietary management talk in repeat-interviews with 40 newly diagnosed type 2 diabetes patients. Women in our study tended to construct dietary practices as an individual concern, while men presented food consumption as a family matter. Participants accounted for ‘cheating’ in complex ways that aim to accomplish, for instance, a compliant identity. Discursive psychology may facilitate fluidity in our understandings of dietary management, and challenge fixed notions of ‘compliant’ and ‘non-compliant’ diabetes patients.

‘The Problem with Men’: Working-class Men Making Sense of Men’s Health on Television

Men have higher rates of premature death than women, and may arguably have higher rates of serious illness. One explanation often suggested to account for this is that men are considered to be stoical about illness and reluctant to seek help for it. This article explores the role of media representations in the construction of men’s views about health. We investigate how a small group of lower socio-economic status men make sense of the reluctance to seek help notion through an analysis of texts from three sources: a television health documentary, individual interviews with the men and a focus group discussion in which the men discuss the documentary. The television documentary frames its presentation to promote early detection and help-seeking. We conclude that televised coverage of men’s health is an important site of social discourse through which men’s health is rendered meaningful. However, it is not accepted passively, but negotiated, resisted and interpreted into men’s lives.

Men and Dieting: A Qualitative Analysis

This article describes a qualitative study in which men were interviewed about their experiences of dieting and views on related issues such as health and body image. Data from this research were analysed using a combination of discourse analysis and grounded theory. Men engaged in dieting and weight loss constructed themselves differently from women dieters: they described women who diet as doing so for cosmetic reasons, whereas men preferred to think of themselves as dieting for ‘legitimate’ reasons such as health. Dieting and related initiatives such as joining a slimming club were positioned as female activities, which (heterosexual) men were less willing to undertake without receiving ‘support’ from partners, family and peers.

Examining Media Representations: Benefits for Health Psychology

Health psychology has tended to undervalue analyses of media representations of health, disease and illness. In this article I argue that critical approaches to media texts and images are valuable for health psychologists because:

(1) individuals are socially located and gain their beliefs about health and illness from the discourses and constructions that are available to them;

(2) media representations of health, illness and disease produce and reproduce meaning concerning health and illness, for lay people and professionals alike; and

(3) media representations mediate individuals’ lived experiences. These arguments are illustrated throughout with examples from critical and feminist research on representations of women, menopause and midlife. I go on to argue that critical approaches are particularly important in analysing media representations because they explicitly examine the social, cultural and political context of health and illness. Critical approaches increase awareness of control and power issues surrounding dominant representations and also provide possibilities for change and resistance.

Narratives of Obesity as Presented in the Context of a Television Talk Show

Media representations of health and illness have come under scrutiny for their ability to mislead and misinform the public about health issues. However, the media also provide a public forum in which talk about health and illness may be circulated in a more positive fashion. This article consists of a narrative analysis of an episode of the BBC talk show Kilroy, in which the topic of obesity is discussed by the show’s host and a group of lay guests. Two narratives in particular are examined for their similarities and differences. Both are structured around the idea of a ‘turning point’ that results in successful recovery from obesity, although what constitutes recovery differs in both cases, and is linked to the overall structure of the narrative. It is argued that personal narratives are important conceptual tools for health psychologists to work with, although we cannot lose sight of the mediated context in which these data are produced.

"We've got to break down the shame": portrayals of men's depression

News articles play a role in reproducing or challenging stigma. Stigma, in turn, can be a barrier to men's mental health help seeking. We used discursive analytic principles to analyze portrayals of men's communication about depression in news articles over a 5-year period. We found that news articles depicted men who were open about depression as experiencing positive outcomes such as recovery. Such depictions might challenge stigma associated with talking about mental health concerns. However, some articles problematically positioned depressed men as individually responsible for defying stigma and achieving recovery. We suggest that portraying depression as something that impacts a plurality of men is one way that media messages might dispel stigma. We drew recommendations from the findings about the language that could be used by media, mental health campaigns, and health service providers to mitigate the impact of stigma on men's mental health help seeking.

Gender relations and couple negotiations of British men's food practice changes after prostate cancer

Nutrition plays an important role in the health of men diagnosed with prostate cancer and dietary interventions can therefore be a significant part of prostate cancer survivorship supportive care. Family food provision, however, involves complex social interactions, which shape how men engage with their diets and dietary interventions. The role that gender plays in shaping prostate cancer couples' food practices and men's diets after a prostate cancer diagnosis is thought to be important but is little understood. This study explored couples' accounts of nutrition information seeking and diet change to gain a better understanding of how gender relations shaped men's food practices after prostate cancer diagnosis. Qualitative health interviews with men and their partners were conducted and analysed using interpretive descriptive methods. Findings demonstrated how couples navigated food change journeys that involved seeking information, deciding what changes were warranted and implementing and regulating diet changes. Two overarching themes that illustrated couples' food negotiations were called 'Seeking information and deciding on food changes' and 'Monitoring food changes'. Additional sub-themes described who led food changes, women's filtering of information, and moderation or 'treats'. Throughout these food change journeys, interactions between men and women were at play, demonstrating how gender relations and dynamics acted to shape couples' food negotiations and men's food practices. Findings reveal that attention to gender relations and the men's family food dynamics should inform diet interventions for men with prostate cancer in order to improve uptake.

The experiences of male sudden cardiac arrest survivors and their partners: a gender analysis

AIM

To explore how masculinities shape the experiences of men and their partners after survival from out-of-hospital cardiac arrest.

BACKGROUND

Survivors of out-of-hospital cardiac arrest report depression, dependence on others for daily functioning, decreased participation in society and significant decreases in quality of life. There is growing evidence that masculine gender identities play a central role in the recovery experiences of men and their families following other major cardiac events. However, to date, there has been no examination of how masculinities shape men's experiences of recovery following out-of-hospital cardiac arrest.

DESIGN

Interview study guided by an interpretive description approach. Data were subjected to thematic analysis.

METHOD

A purposive sample of seven male sudden cardiac arrest survivors and 6 female partners was recruited in 2010 from a secondary care centre in British Columbia, Canada.

RESULTS

Three themes were prominent in the experiences of the participants: (1) Support and self-reliance; (2) Dealing with emotional (in) vulnerability; and (3) No longer a 'He-man'.

CONCLUSION

Masculinities played a role in men's experiences of recovery and adaptation following out-of-hospital cardiac arrest. Hegemonic masculinity partly explained men's experiences, notably their reluctance to seek professional support and reactions to changes in lifestyle. However, the study also suggests that the popular stereotype of men being 'strong and silent' in the face of ill-health may only be a part of a more complex story. Nurses would benefit from taking into consideration the potential influence of male gender identities on men's recovery postcardiac arrest.

An intersectional approach to social determinants of stress for African American men: men's and women's perspectives

Stress is a key factor that helps explain racial and gender differences in health, but few studies have examined gendered stressors that affect men. This study uses an intersectional approach to examine the sources of stress in African American men's lives from the perspectives of African American men and important women in their lives. Phenomenological analysis was used to examine data from 18 exploratory focus groups with 150 African American men, ages 30 years and older, and eight groups with 77 African American women. The two primary sources of stress identified were seeking to fulfill socially and culturally important gender roles and being an African American man in a racially stratified society. A central focus of African American men's daily lives was trying to navigate chronic stressors at home and at work and a lack of time to fulfill roles and responsibilities in different life domains that are traditionally the responsibility of men. Health was rarely mentioned by men as a source of stress, though women noted that men's aging and weathering bodies were a source of stress for men. Because of the intersection of racism and economic and social stressors, men and women reported that the stress that African American men experienced was shaped by the intersection of race, ethnicity, age, marital status, and other factors that combined in unique ways. The intersection of these identities and characteristics led to stressors that were perceived to be of greater quantity and qualitatively different than the stress experienced by men of other races.

"Their depression is something different . . . it would have to be": findings from a qualitative study of black women's perceptions of depression in black men

This study reports findings from the Black Women's Perceptions of Black Men's Depression (BWP) study, which included eight focus groups with Black women (N = 46) from southeastern Michigan. Four themes illustrated the impressions of Black women from different socioeconomic backgrounds: Black men's depression is a cultured and gendered phenomenon, the role of Black women in Black men's depression, intergenerational differences with how depression is handled by Black men, and the need (and ways) to reach Black men with depression resources. Results underscore not only the importance of understanding the kind of depression in Black men that meets criteria described by the Diagnostic and Statistical Manual of Mental Disorders (DSM) but also the psychological distress that may coexist with (or be separate from) DSM depression. Implications for interventions that educate, diagnose, and treat depression in Black men are discussed.

"I'm ready to eat and grab whatever I can get": Determinants and patterns of African American men's eating practices

This article examines determinants and patterns of African American men's dietary practices. Thematic content analysis was used to analyze data from nine exploratory focus groups conducted with 83 urban, middle-aged and older African American men from southeast Michigan. The men distinguished between healthy and unhealthy foods and "meals" versus other instances of eating. Eating patterns and content differed depending on the meal, work and family schedules, food availability, and whether it was a weekday or weekend. When eating alone or outside the home, men prioritized convenience and preferences for tasty, unhealthy foods. Men often reported skipping breakfast or lunch and grabbing snacks or fast food during the day. They emphasized sharing dinner with their spouses and families-usually a home-cooked, "healthy" meal. On weekends, spouses often cooked less and men snacked and dined out more frequently. Sunday dinners involving favorite, unhealthy comfort foods were the highlight of men's eating practices. African American men tended not to follow healthy eating recommendations because of their busy lives, reliance on spouses to prepare food, and preferences for unhealthy foods. These findings suggest that healthy eating interventions must consider how the contexts of African American men's lives shape their eating practices.

Beyond the caveman: Rethinking masculinity in relation to men’s help-seeking

Statistically, men make less use of health-care services than women. This has been interpreted as the result of the ‘hegemonic’ masculine code in which ‘real’ men are understood to be physically fit, uninterested in their health and self-reliant. However, less attention has been paid to understanding how hegemonic masculinity intersects with the wider western socio-cultural contexts of men’s help-seeking, particularly the valorization of health as a form of social achievement. This article presents the results of interviews with 14 higher socio-economic status (SES) men to uncover their ‘interpretive repertoires’ in relation to health and illness, help-seeking and masculinity. Although many interviewees drew on the stereotype of the ‘Neanderthal Man’ who avoids the doctors to explain help-seeking by men ‘in general’, they constructed their own experiences of help-seeking in terms of being responsible, problem-solving and in control. It is argued that the framing of help-seeking in terms of ‘taking action’ chimes with an increasingly pro-active ‘expert patient’ approach within western health-care. This conceptual reconstruction of the dominant masculine code in relation to help-seeking, from ‘Neanderthal Man’ to ‘Action Man’, may lead to greater gender equality in terms of accessing health-care. However, it has the potential to exacerbate social inequalities between men from different SES groups.

I can't get my husband to go and have a colonoscopy: gender and screening for colorectal cancer

It is anticipated that a colorectal cancer (CRC) screening programme will be introduced in New Zealand making it the first screening programme in this country to include both males and females. In-depth interviews were carried out with 80 participants (53 females and 27 males) about their knowledge and attitudes to screening programmes in general, as well as their understanding and perceptions of CRC screening in particular. The study highlighted the perceived marginalization of men's health with a sense that women had advocated for, and therefore monopolized, screening while men's health had been left unattended. There were also perceptions of women's responsibility for ensuring men's access to health services. There are arguments that such perceptions disempower or 'infantalize' men which have no long term benefits. While health is perceived as being a feminine matter, it may be difficult to encourage men to engage in preventative behaviours, such as taking up the offer of screening. This article also highlights the heterogeneity of men, where different performances of masculinities were presented. A stereotypical 'staunch' or 'macho image' discourse was evident in some of the interviews where much emphasis was on maintaining and controlling bodily boundaries. Letting the barrier of embodied 'staunchness' down to access health services is a threat to identity. What is required for successful implementation of the CRC screening programme is a normalization of men's health help-seeking, taking into account the fact that men are not homogenous. Studies in relation to men's health need to attend to cultural diversity which is likely to present a challenge to individualism. Critical studies of men would be enhanced by more engagement with the work of black male scholars.

'I see her being obesed!': Public pedagogy, reality media and the obesity crisis

In recent years a proliferation of reality based media focusing on the body, diet and exercise have sought not only to entertain audiences, but also to operate as pedagogical sites through which to encourage populations to undertake surveillance of their own and others' bodies in order to address a so-called 'obesity epidemic' sweeping across western society. This article examines how reality media function within a broader 'surveillant assemblage' (Haggerty and Ericson, 2000) of obesity. Specifically, the article explores how this assemblage functions through interdependent connections between parenting, social class and broader political discourses of parenting and health risks which produce affective relationalities of the body.

Patterns of self-referral in men with symptoms of prostate disease

OBJECTIVE

Analysis of health statistics reveals that, although men have a shorter life expectancy and a higher mortality rate than women, they have less contact with their GP. This study investigates men's experiences of prostate disease, with a particular focus on how they made the decision to seek medical help.

METHOD

Semi-structured interviews were carried out with 20 men aged 51-75 with prostate disease who had recently contacted their GP. These were audiotaped, transcribed and subjected to interpretative phenomenological analysis.

RESULTS

Analysis revealed that their referral behaviours were profoundly influenced by a need to live up to traditional images of masculinity. Far from being uncaring, men were extremely anxious about their health and fears about the effects of illness and treatment emerged as major influences on their decision to seek help. Their delay in approaching their GP was due to their beliefs about symptoms as markers of serious disease, their ability to hide symptoms from others and their attitude towards male GPs who were often seen as having negative attitudes towards male patients.

CONCLUSIONS

This study identifies some reasons why men with prostate disease may fail to seek medical care and has implications for increasing referral rates for men.

Men's experiences of living with osteoporosis: focus group interviews

Osteoporotic fractures in men are an increasing public health problem. Male osteoporosis is often a low-prioritized issue, however. To examine men's experiences with osteoporosis and how they handle osteoporosis in their everyday lives, the authors collected data from four focus groups with a total of 16 men aged 51 to 82 years diagnosed with osteoporosis. Critical psychology was used as a theoretical framework for the data analysis, which aimed to elicit information about the men's daily lives. The men handled osteoporosis in different ways using different strategies. The authors found patterns that resonated with the social construction of hegemonic masculinity as displayed through the men's fear of weakness and endurance through physical activity, as well as identity construction through active decision making in relation to health. Understanding and implementation of these issues is necessary in the development of preventive, screening, and monitoring strategies, as well as in the clinical care of men with osteoporosis.

Men's business, women's work: gender influences and fathers' smoking

To further understand men's continued smoking during their partner's pregnancy and the postpartum period, a study was undertaken to explore women's perspectives of men's smoking. Using a gender lens, a thematic analysis of transcribed interviews with 27 women was completed. Women's constructions of men's smoking and linkages to masculine and feminine ideals are described. The findings highlight the ways women position themselves both as defenders and regulators of men's smoking. Femininities that aligned women with hegemonic masculine principles underpinned their roles in relation to men's smoking and presented challenges in influencing their partner's tobacco reduction. By positioning the decision to quit smoking as a man's solitary pursuit, women reduced potential relationship conflict and managed to maintain their identity as a supportive partner. Insights from this study provide direction for developing gender-specific tobacco reduction initiatives targeting expectant and new fathers. Indeed, a lack of intervention aimed at encouraging men's tobacco reduction has the potential to increase relationship tensions, and inadvertently maintain pressure on women to regulate fathers' smoking. This study illustrates how gender-based analyses can provide new directions for men's health promotion programmes and policies.

'Real men don't diet': an analysis of contemporary newspaper representations of men, food and health

Little research to date has focused on the meanings men attach to food and the relationship between diet and health. This is an important topic in light of the current 'crisis' in men's health and the role of lifestyle factors such as diet in illness prevention. Since the mass media is a powerful source of information about health matters generally, media representations bear critical examination. The present paper reports on an in-depth qualitative analysis of contemporary UK newspaper articles on the topic of men and diet (N=44). The findings indicate a persistent adherence to hegemonic masculinities predicated on health-defeating diets, special occasion cooking of hearty meals, and a general distancing from the feminised realm of dieting. At the same time, men are constructed as naïve and vulnerable when it comes to diet and health, while women are viewed as experts. The implications for health promotion with men are discussed.

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

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.

'Hardcore drinking': portrayals of alcohol consumption in young women's and men's magazines

Young adults and young women in particular are drinking more alcohol than ever before, with implications for risky behaviours and long-term health. This study explored the ways in which alcohol and drinking were represented in six monthly UK magazines (three targeted at young men, three at young women) across a three-month period (18 magazines). We identified three main discourses across the texts, namely the drug alcohol; masculinity and machismo; and drinking as normality. These discourses constructed women's and men's drinks and drinking behaviours in sharp contrast. Drinking was aligned with traditional masculine images, although new kinds of drinks were aligned with traditional feminine images--and derided in men's magazines. Findings highlight how gender, constructed in relation to the other, is an important aspect of representations of drinking patterns in young adults.

A decade of research on health content in the media: the focus on health challenges and sociocultural context and attendant informational and ideological problems

There is a burgeoning interest in the health and illness content of popular media in the domains of advertising, journalism, and entertainment. This article reviews the past 10 years of this research, describing the relationship between the health topics addressed in the research, the shifting focus of concerns about the media, and, ultimately, the variation in problems for health promotion. I suggest that research attending to topics related to bodily health challenges focused on whether popular media accurately or appropriately represented health challenges. The implication was that there is some consensus about more right or wrong, complete or incomplete ways of representing an issue; the problem was that the media are generally wrong. Alternatively, research addressing topics related to sociocultural context issues focused on how certain interests are privileged in the media. The implication was that competing groups are making claims on the system, but the problem was that popular media marginalizes certain interests. In short, popular media is not likely to facilitate understandings helpful to individuals coping with health challenges and is likely to perpetuate social and political power differentials with regard to health-related issues. I conclude by offering some possibilities for future health media content research.

Masculinity, infertility, stigma and media reports

There is growing concern about the health of men in the developed West. Compared with women they have higher rates of morbidity and mortality and are less likely to seek out and employ medical services. Several authors have drawn on social constructionist models, such as the concept of hegemonic masculinity, to account for these gender differences in risk and behaviour. One might anticipate that certain conditions, such as male infertility, would be perceived as posing a particular threat to conventional views of masculinity. There is some support for this, although there is little research into the social construction of male infertility. In this study Discourse Analysis was employed to analyse newspaper accounts of a reported decline in sperm counts in order to study the way in which infertility and masculinity were represented and constructed in the media. The results indicate a construction of fertility as being in crisis and of male infertility as conflated with impotence. Men were positioned as vulnerable and threatened by forces outside their control. The accounts drew on a range of stereotypically masculine reference points, such as warfare and mechanical analogies. These results are consistent with concepts of hegemonic masculinity and suggest that men are offered a highly restricted set of options in terms of perceiving and representing their bodies and their health.

'My Wife Ordered Me to Come!': A Discursive Analysis of Doctors' and Nurses' Accounts of Men's Use of General Practitioners

This study used a discursive approach to analysing doctors' and nurses' accounts of men's health in the context of general practice. The analysis worked intensively with interview material from a small sample of general practitioners and their nursing colleagues. We examine the contradictory discursive framework through which this sample made sense of their male patients. The 'interpretative repertoires' through which doctors and nurses constructed their representations of male patients and the 'subject positions' these afforded men are outlined in detail. We describe how hegemonic masculinity is both critiqued for its detrimental consequences for health and paradoxically also indulged and protected. These constructions reflect a series of ideological dilemmas for men and health professionals between the maintenance of hegemonic masculine identities and negotiating adequate health care. Men who step outside 'typical' gender constructions tended to be marked as deviant or rendered invisible as a consequence.

Productive readings: the portrayal of health "experts" in women's magazines

This article illustrates how health practitioners are portrayed through advice columns, articles, personal accounts, and advertisements in women's magazines. Magazines provide a valuable source of information about health services and also influence lay knowledge about health and illness. A wide variety of health practitioners provide information and advice in women's magazines, ranging from orthodox medical practitioners to alternative practitioners. However, there is a blurring of boundaries between these, with orthodox practitioners sometimes including alternative therapies in their practice and alternative therapists sometimes encompassing a number of orthodox therapies within their practice. The way health practitioners are represented in the media has implications for how their expertise in health issues is evaluated and used by consumers of health care services.