Doing health, doing gender: Testing a social constructionist view of health and risk behavior engagement
The sex differential in health-related behaviors is well established. What is less clear is precisely how health behavioral differences vary within sex groups. This dissertation looked through the lens of gender to explore within-sex health behavior differentials. Taking a social constructionist position, I argued that health behaviors are gendered enactments. Due to a combination of individual agency, structural opportunities and constraints, people construct gender in myriad ways. I therefore expected to find gendered health behavior variation among men and among women, perhaps as much as has been found between the sexes.
In this cross-sectional analysis (1995-6 National Survey of Mid-life in the U.S., N=3,690), a number of different gender indicators were used to interrogate this idea. I examined two individual level indicators: attitudes about gender and gendered personality traits. And since people use gender to guide social interactions within institutions, I looked within two highly gendered institutions, paid employment and the family. I also examined how the intersection between my individual level and institutional gender indicators affected health-related behaviors. The health behaviors in this study included self-care and medical check-ups, and the risk behaviors included risky sexual behavior and several substance abuse measures.
The findings showed that my four measures of gender were far more widely associated with risk behavior than health behavior, especially among women. Additionally, the gendered institutions were more widely associated with the health-related behaviors than the individual level gender measures. Not only were the health-related relationships to the family and paid employment more widespread than those to attitudes about gender and gendered personality traits, but the strength of these associations were often relatively strong.
As expected, the individual level gender indicators showed that nontraditionally oriented women were more likely than traditionally oriented women to engage in a variety of risk behaviors, such as cigarette smoking, risky alcohol and drug use, risky sexual behavior, and leading an overall riskier health lifestyle. But the interactions between attitudes about gender and family structure indicated these associations to risk behavior were exacerbated when nontraditionally oriented women also had family responsibilities. Under these circumstances, nontraditional women's engagement in physical activity was also diminished.
Nontraditionally oriented men on the whole did not behave quite as healthily as traditional men in this study. However, in circumstances where men with egalitarian attitudes hold occupations that are feminine or sex-balanced, their engagement in health-positive behavior was greater than that of men with traditional attitudes about gender doing the same type of work. One possible explanation for these findings is that when a misalignment occurs between an individual's attitudes about gender and her or his involvement in gendered institutions, role strain is the result. This tension may manifest itself in less engagement in health-positive behaviors.