Current trends in the study of gender norms and health behaviors

doi:10.1016/j.copsyc.2015.05.001

Current Opinion in Psychology

Volume 5, October 2015, Pages 72-77

https://doi.org/10.1016/j.copsyc.2015.05.001 Get rights and content

Highlights

•
Gender norms play an important role in men and women's health behaviors.
•
Research on gender norms is most developed in studies of sexual behaviors.
•
Recent studies of gender norms and health behaviors are more focused on masculinity.
•
Gender norms and health research is expanding to new populations.

Gender norms are recognized as one of the major social determinants of health and gender norms can have implications for an individual's health behaviors. This paper reviews the recent advances in research on the role of gender norms on the health behaviors most associated with morbidity and mortality. We find that first, the study of gender norms and health behaviors is varied across different types of health behaviors, second, research on masculinity and masculine norms appears to have taken on an increasing proportion of studies on the relationship between gender norms and health, and third, there are new and varied populations integrated into the study of gender norms and health behaviors.

Introduction

Gender is recognized as one of the major social determinants of health. According to the American Psychological Association, gender norms refer to, ‘the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for boys and men or girls and women’ [1]. While gender is sometimes viewed as something that an individual is, current social science understandings of gender emphasize that it is something that an individual does through their behaviors and interactions with others [2]. Thus, a person's behaviors are critical to their ability to fit into cultural gender norms. These gender norms can play a powerful role in a person's life since deviating from the norms associated with one's biological sex can be met with censure from peers, social exclusion, and sometimes even emotional or physical violence [3], [4].

Conforming to gender norms can have implications for an individual's health because certain behaviors considered to be normative for a particular gender may be associated with health outcomes [4], [5]. For example, it is normative for men in many cultures to drink alcohol excessively [6], avoid certain healthy food options [7], or avoid health-care [8]. Each of these behaviors has implications for the overall health of men. Similarly, for women, gender norms may have effects such as lessening decision-making power over family planning behaviors [9] or limiting physical activity out of a concern for appearing less feminine [10]. The role of gender norms on health behaviors is typically slightly different for men and women. Risky health behaviors are expressions of masculinity for men, but, for women, gender norms can constrain women's power and limit their ability to take control of their health [11], [12]. In both cases, the influence of gender norms on health operates through health behaviors.

In a foundational article, Mokdad and colleagues identify the major health behaviors that are the leading causes of death in the United States [13]. Below, we review the recent advances in research on the role of gender norms on each of these types of health behaviors. While numerous studies explore gender differences in health behaviors (e.g. differences in smoking patterns between males and females), we focus on those articles that are exploring and explaining how gender norms, masculinity, or femininity influence these behaviors.

Section snippets

Diet and physical activity

Empirical research on the role of gender norms in diet and physical activity related behaviors is limited and lacks coherent trends. Two recent articles examined the role of gender dynamics — specifically the role of wives as food-preparers — in men's eating habits [14], [15]. These studies highlight the lack of power and control that men have over their diets because food preparation is a traditionally female domain. Other research explored whether or not food choices are used to construct

Conclusions

There are several key findings and trends to note. First, the study of gender norms and health behaviors is varied across different types of health behaviors. There were far more articles examining gender norms and sexual or violent behaviors, and those fields have had a longer history of researching this relationship. Thus, the studies discussed here are more varied and tackle more dimensions of the relationship. In contrast, research on other types of health behaviors appears to be more

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

• of special interest
•• of outstanding interest

Acknowledgements

We are grateful to the Carolina Population Center for training support (T32 HD007168) and for general support (R24 HD050924). Mr. Fleming was supported by the National Institute of Allergy and Infectious Diseases under grant number T32 AI007001.

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Previous research has investigated the relationship between an individuals' gender role attitudes (GRAs) and their psychological health. We hypothesized that holding traditional GRAs or having a husband who holds traditional GRAs may adversely affect a woman's health.
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Our results show that one's own or one's husband's attitude towards women's economic participation affects not only the employment status of married women but also their mental and subjective health. Policymakers should implement policies that encourage positive attitudes towards women's economic activities.
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The mechanisms in which chronic stress influences atherosclerosis might be crucial, because it may be an important pathophysiologic mechanism driving CVD differently among men and women.106 Gender norms are recognised as major social determinants of health because they have important implications for individual health behaviours.107 Individuals’ behaviours are critical in their ability to fit into cultural gender norms, because deviating from them can have important consequences, even to the extent of social exclusion, censure from peers, and even violence.108
Cardiovascular diseases are leading causes of mortality and morbidity in adults worldwide. Multiple studies suggest that there are clinically relevant sex differences in cardiovascular disease. Women and men differ substantially in terms of prevalence, presentation, management, and outcomes of cardiovascular disease. To date, however, little is known about why cardiovascular disease affects women and men differently. Because many studies do not differentiate the concept of sex and gender, it is sometimes difficult to discriminate sociocultural vs biological contributors that drive observed clinical differences. Female sex has some biological advantages in relation to cardiovascular disease, but many of these advantages seem to disappear as soon as women develop cardiovascular risk factors (eg, type 2 diabetes, hypertension, dyslipidemia). Furthermore, stress and allostatic load could play an important role in the relationship between sex/gender and cardiovascular diseases. In this narrative review, we argue that chronic stress and psychosocial factors might better encompass the patterns of allostatic load increases seen in women, while biological risk factors and unhealthy behaviours might be more important mechanisms that drive increased allostatic load in men. Indeed, men show allostatic load patterns that are more associated with impaired anthropometric, metabolic, and cardiovascular functioning and women have greater dysregulation in neuroendocrine and immune functioning. Thus gender-related factors might contribute to the pathogenesis of cardiovascular disease especially through stress mechanisms. It is important to continue to study the mechanisms by which gender influences chronic stress, because chronic stress could influence modifiable gendered factors to promote cardiovascular disease prevention.
Les maladies cardiovasculaires figurent parmi les principales causes de morbidité et de mortalité chez les adultes du monde entier. De nombreuses études révèlent des différences entre les sexes pertinentes sur le plan clinique en ce qui concerne la maladie cardiovasculaire. La prévalence, le tableau clinique, la prise en charge et les résultats diffèrent considérablement chez les hommes et les femmes. À ce jour, on en sait toutefois peu sur les raisons pour lesquelles la maladie cardiovasculaire touche différemment les hommes et les femmes. Comme de nombreuses études ne font pas de distinction entre les concepts de sexe et de genre, il est parfois difficile de distinguer les facteurs biologiques des facteurs socioculturels qui sont à l’origine des différences cliniques observées. Le sexe féminin présente certains avantages biologiques en ce qui a trait à la maladie cardiovasculaire, mais un grand nombre de ces avantages semblent disparaître en présence de facteurs de risque cardiovasculaire (p. ex., diabète de type 2, hypertension, dyslipidémie). En outre, le stress et la charge allostatique pourraient jouer un rôle important dans le lien entre le sexe/genre et les maladies cardiovasculaires. Dans cette revue narrative, nous soutenons que le stress chronique et les facteurs psychosociaux pourraient expliquer les augmentations de la charge allostatique chez la femme, tandis que des facteurs de risque biologiques et des facteurs comportementaux pourraient contribuer davantage à l’accroissement de la charge allostatique chez l’homme. En effet, on remarque que chez les hommes, la charge allostatique est davantage associée à un dérèglement de la fonction cardiovasculaire, métabolique et anthropométrique, tandis que chez les femmes, on observe plus souvent un dérèglement de la fonction immunitaire et neuroendocrinienne. Des facteurs liés au sexe pourraient donc contribuer à la pathogenèse de la maladie cardiovasculaire, particulièrement par des mécanismes liés au stress. Il est important de continuer à étudier les liens entre le sexe et le stress chronique, car ce dernier pourrait influencer des facteurs modifiables propres au sexe afin de promouvoir la prévention de la maladie cardiovasculaire.
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View all citing articles on Scopus

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Current trends in the study of gender norms and health behaviors

Highlights

Introduction

Section snippets

Diet and physical activity

Conclusions

References and recommended reading

Acknowledgements

Soc Sci Med

Soc Sci Med

Soc Sci Med

Appetite

Psychol Men Masc

Eat Behav

Am J Sex Educ

AIDS Care

Am J Mens Health

Br Med J

Soc Sci Med

Prev Sci

J Interpers Violence

Pers Soc Psychol Bull

Answers to your questions about transgender people, gender identity, and gender expression

Doing gender

Gend Soc

Embodied discourse: on gender and fear of violence

Gend Place Cult

College alcohol use and the embodiment of hegemonic masculinity among European American men

Sex Roles

Men, meat, and marriage: models of masculinity

Food Foodways

Men, masculine identities, and health care utilisation

Sociol Health Illn

Understanding gender norms, nutrition, and physical activity in adolescent girls: a scoping review

Int J Behav Nutr Phys Act

Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women

Health Educ Behav

Defining and measuring gender: a social determinant of health whose time has come

Int J Equity Health

Actual causes of death in the United States, 2000

J Am Med Assoc

“You’ve got to walk before you run”: positive evaluations of a walking program as part of a gender-sensitized, weight-management program delivered to men through professional football clubs

Health Psychol

Real men don’t eat (vegetable) quiche: masculinity and the justification of meat consumption

Psychol Men Masc

Self-objectification, feminist activism and conformity to feminine norms among female vegetarians, semi-vegetarians, and non-vegetarians

Eat Behav

Influence of gender role orientation (masculinity versus femininity) on body satisfaction and eating attitudes in homosexuals, heterosexuals and transsexuals

Eat Weight Disord

‘Fat is your fault’. Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity

Appetite

Media matters for boys too! The role of specific magazine types and television programs in the drive for thinness and muscularity in adolescent boys

Eat Behav

Gender equity predicts condom use among adolescent and young adult parents in Toronto, Canada

Can J Hum Sex

Masculinity and HIV risk among homeless men in Los Angeles

Psychol Men Masc

Using the inequitable gender norms scale and associated HIV risk behaviors among men at high risk for HIV in Ghana and Tanzania

Men Masc

HIV risk behaviors in the U.S. transgender population: prevalence and predictors in a large Internet sample

J Homosex

Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color

Sex Roles

Moderno love: sexual role-based identities and HIV/STI prevention among men who have sex with men in Lima, Peru

AIDS Behav