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Identifying Work as a Barrier to Men's Access to Chronic Illness (Arthritis) Self-Management Programs

Gibbs, Lisa. International Journal of Men's Health; Harriman Vol. 6, Iss. 2,  (Summer 2007): 143-155. DOI:10.3149/jmh.0602.143

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Why are men under-represented as users of arthritis self-management programs? What are the main barriers to service access? This paper explores the interaction between work, gender, and self-management of a chronic illness from a socio-constructive perspective. A qualitative study was conducted involving in-depth interviews with 17 men with arthritis. This paper discusses the role of work as one of the factors affecting men's access to arthritis self-management services. Work was found to be a significant conceptual, structural, and social barrier due to: its role in relation to men's concepts of health and fitness; practical difficulties in accessing services during business hours; and sociocultural influences resulting in prioritising of work commitments over health concerns. The structural, conceptual, and sociocultural work influences were more of a constraint for men in the middle stages of life when work and family obligations were greatest. Further research extending this understanding would inform the development of gender-sensitive delivery of self-management services.

Keywords: masculinity, work, gender, arthritis, qualitative research, self-management services

There are well established gender differences in the utilization of primary health care services and in health management behaviours. For instance, women are more likely to use general health services than men (Australian Bureau of Statistics, 1996; Baum, 1998; Courtenay, 2000a), men and women access health services in different ways and for different reasons (Broom, 1991; Hegelson, 1995), and women can influenee the health management behaviour of men more so than vice versa (Norcross, Ramirez, & Palinkas, 1996). These gender differences in the extent and patterns of primary health services use also occur in relation to chronic illness self-management services. For example, male participation rates in the Arthritis Victoria Telephone Information Service were reported as 23% (Gibbs & Reidpath, 2005). The rates were remarkably similar for the Cancer Helpline (22%) (Metcalfe, Akkermann, & Cohen, 1997),...