Abstract
How do older men’s masculine ideals affect their health? Are masculine activities involved in this relationship? Masculine identity upholds beliefs about masculine enactment. These beliefs can be detrimental to men and can lead to behaviors that can put undue stress on them. We examine how masculine ideals are associated with health and depressive symptomatology in older men. We used 2011 data from the Wisconsin Longitudinal Study (n = 2,594) to investigate how masculine ideals inform older men’s health and how participation in masculine activities might shape these outcomes. Findings from this study illustrate that traditional masculine ideals are associated with worse self-rated health (SRH), greater chronic illness, and depressive symptomatology. For masculine activities, doing repairs and car maintenance was associated with less chronic illness and depression. Belonging to a senior men’s group was associated with worse SRH, greater chronic illness, and greater depression. Therefore, older men’s greater endorsement of traditional masculine ideals was generally associated with worse health, though certain masculine activities affected this relationship. We posit that more gender-equitable beliefs may be useful for improving the “men’s health gap.”
Keywords: chronic illness, depression, gender, self-rated health, masculinity
Introduction
How do older men’s masculine ideals affect their health, and how are masculine activities involved in this relationship? Masculine identity upholds beliefs about masculine enactment. These beliefs can be detrimental to men and can lead to behaviors that can put undue stress on them. Common traits of masculine that reify men’s socially dominant position include, but are not limited to, endurance, strength, virility, and competitiveness (Thompson & Langendoerfer, 2016; West & Zimmerman, 1987).
This paper focuses on masculine ideals and stereotypical masculine activities. When men hold traditional masculine beliefs, they may struggle with their aging bodies. Masculinity in the context of health often leads one to picture health, even when strength and health are arguably lacking (Courtenay, 2000). Adherence to masculine norms may lead to both less positive health behaviors, and more negative health behaviors (Mahalik et al., 2007; Read & Gorman, 2010; Sloan et al., 2015; Springer & Mouzon, 2011). Many older men find that it becomes more difficult to maintain the norms of hegemonic masculinity as they age (Messerschmidt, 2019). Although older men might lose elements of their autonomy and physicality due to their physical health, sentiments of control and toughness often remain (Hurd Clarke & Lefkowich, 2018; Tannenbaum & Frank, 2011; Thompson & Langendoerfer, 2016). Masculine activities may affect men’s health, especially for those who uphold strong masculine identities. We use data from the Wisconsin Longitudinal Study (WLS) to investigate how masculine ideals inform older men’s self-rated health (SRH), chronic illness, and depressive symptomatology.
Masculinities and Identities
Sex is classified by socially defined biological criteria that place females and males into distinct groups, leading to the application of sex categories in everyday life. Understanding of these sex categories is extended to normative attitudes and social activities within these groups and is defined as gender. People representing the female sex category are often gendered as women and expected to express feminine traits, while those representing the male sex category are often gendered as men and are expected to express masculine traits. Our study of masculine ideals is guided by the theory of “doing gender” which is the act of engaging in socially agreed activities that convey feminine and masculine conventions while conceiving other people as participants in these processes (West & Zimmerman, 1987). Men are often expected to do masculinity by engaging in interactions that display dominance over women who, in contrast, are expected to do femininity. Gender is negotiated through relationships of power that socially advantage men (Courtenay, 2000). By studying men’s beliefs of masculinity, we can understand how they internalize and externalize “doing gender” through masculine activities and their health outcomes. For instance, in a study about men and masculinity, older men reported a “blueprint” or cultural narrative based on 1950s and 1960s masculinity that included not being a “sissy,” being lauded for success, stoicism, and maintaining competitiveness (Thompson & Langendoerfer, 2016). The men in our study correspond with similarly aged men.
Masculinity is said to be a social determinant of health because stoic health practices and behaviors among men inform how we construct self and gender (Evans et al., 2011). Men may disconnect from traits that are considered feminine, such as dependence and vulnerability, to ultimately face risk and discomfort (Courtenay, 2000). As such, masculinity in the context of health often displays self-assurance, self-reliance, virility, and so on. In middle age, men may address their bodily changes by assuming a sense of responsibility, through strategies such as discipline, exercise, routine, and monitoring, to attempt to obstruct aging (Hurd Clarke & Lefkowich, 2018). With older men, it becomes more difficult to adhere to hegemonic masculine norms, so they are often faced with redefining themselves. As such, reaffirming androcentric social expectations hinges not only on hegemonic masculinity but also on perceived successful aging that shapes help-seeking behaviors among older men (Smith et al., 2007). Such an approach can affect health care seeking by which older men may be reluctant to consult with their health provider about their illness (Chapple & Ziebland, 2002; Smith et al., 2007). Older men may view themselves as either the virtuous regular health care user or masculine infrequent health care user (Noone & Stephens, 2008). From a mental health perspective, men recovering from depression may cultivate value through association with hegemonic masculine norms such as control and responsibility (Emslie et al., 2006; Hochschild, 2018). When investigating older men, it is imperative that the physical and psychological are considered just as much as the cultural forces that shape masculine normativity throughout the life course.
Health Lifestyles
Health lifestyles result from the interplay of agentic choices and social structure (Cockerham, 2005; Mollborn et al., 2021). Characteristics such as age, education, gender, race, and social class can influence life chances and influence certain dispositions and health practices. As such, social norms related to masculinity guide men’s social practices which translate to health behaviors (Evans et al., 2011). Considering injury and illness are associated with fragility and vulnerability, men’s circumvention of health-seeking behaviors is often understood as avoidance of femininity. Stronger beliefs in hegemonic masculinity are associated with less preventive care among older men (Springer & Mouzon, 2011). Inadequate achievement of masculine norms, such as breadwinner status, productivity, and familial respect, is linked to men’s depression (Apesoa-Varano et al., 2018; Smith et al., 2022). Evidence suggests that health behaviors influence most of the leading causes of death among men (Griffith et al., 2016). Masculine ideals reflect men’s beliefs about the way they believe gender ought to be, and this influences their lifestyle choices. Health behaviors such as substance use, risky sexual activity, and high-risk sports are influenced by the desire to achieve power and social status but ultimately undermine men’s health maintenance and promotion. In each phase of the life course, the meaning of masculinity evolves and, in turn, reshapes masculine performance (Griffith, 2012). However, the social and cultural pressures to fulfill masculinity persist throughout the life course and influence different role strains and stressors for older men.
Men’s Health
SRH is a measure that is commonly used in health research to investigate health, trends, and inequalities. Prior literature has identified that men report higher SRH than women, but this reverses later in life, particularly when physical functioning deficits are present (Zajacova et al., 2017). Despite men reporting better health than women, men are occasionally present in the poorest of health categories (Idler, 2003). This gender paradox is likely due to the different ways that men and women evaluate and report their health (Zajacova et al., 2017). More specifically, women are known to be more inclusive about mild and chronic conditions, while men tend to focus on serious and life-threatening conditions, thus, men’s chronic illness is important to examine. It is important to examine men’s mental health outcomes such as depressive symptomatology (Smith et al., 2018, 2022), as older men are at high risk for depression due to disability, loss, and isolation (Drentea, 2018; Smith et al., 2018). Because health and mental health are shaped by gender and culture, adding masculine ideals to this line of research can reveal links that further explain older men’s perception of health.
Masculine Activities
Men can continue to enact gender through stereotypically masculine activities. Due to their competitiveness, skillset, and expertise, sportsmen have served as ambassadors for contemporary Western masculinity. Social contexts that include competitive sports have been well-documented by sociologists as facilitators of masculine expression, regulation, and development (Barrett, 2014). Older men who engage in sports are often continuing a practice they had in their younger years (Thandi et al., 2018). Those who attempt to reengage with sports that were practiced in their earlier years might be intimidated due to a perceived diminished masculine identity and, as such, prefer to engage in sports with men their own age (Blake et al., 2022; Drummond, 2008). As older men experience fewer avenues to affirm their masculinity, sports engagement serves as an activity for developing comradery, empowerment, and health-related behaviors. In a scoping review, Blake et al. (2022) reported that, among middle-aged men, sports team involvement was associated with greater SRH, although there was no strong evidence of increased mental health. Men may engage in vigorous exercise (Grzywacz and Marks, 2001). Vigorous physical activity helps men maintain their physique and is a way of maintaining one’s masculinity and health. Staying active helps the health and aging experience. They may also redefine their masculinity by engaging in other typically masculine-defined activities such as hunting, fishing, and home and car repair. Similarly, they may socialize with other men in voluntary associations and men’s groups such as Lions Clubs and Masonic groups.
For our sample in Wisconsin in the 1950s, and even in contemporary American society, there is a strong culture of hunting and fishing among men. Like sports, hunting and fishing are ways to show one’s athleticism. Being a handyman, working on cars, and taking pride in one’s home through repairs was a typical masculine activity that also showed that the man was providing for the home. Senior men’s group activities for this generation may include volunteer groups such as church activities and Veteran’s groups (Fischer et al., 1991). As men age, continuing to engage in these masculine activities may help with their health in that they help men stay active and validate who they are. Alternatively, the activities may be detrimental to men’s health because they call upon masculine ideals. We know little about how older men’s masculine ideals and participation in masculine activities are related to their health.
Hypotheses
Three hypotheses test our ideas about masculine ideals’ influence on health outcomes among men. The first hypothesis addresses masculinity’s influence on health. (H1) Masculine ideals will be associated with worse SRH, greater chronic conditions, and greater depressive symptomatology. (H2a) Vigorous physical activity will be positively associated with SRH and negatively associated with chronic conditions and depressive symptomatology. (H2b) Sports team involvement, senior men’s group involvement, hunting/fishing, and repairs will be negatively associated with SRH and positively associated with chronic conditions and depressive symptomatology. (H3) Masculine activities will explain some of the effects of masculine ideals on SRH, chronic conditions, and depressive symptomatology.
Data and Methods
Data
Results from the WLS, a long-term cohort study of men and women who graduated from Wisconsin high schools, were used for this investigation. The WLS was used because it includes unique modules that relate to masculine ideals and masculine social participation (Herd et al., 2014). The WLS began with a 1/3 sample of all Wisconsin high school graduates in 1957 and followed them over time. A randomly selected sibling born between 1930 and 1948 was additionally included in the survey (Herd et al., 2014). The WLS started with 19,046 respondents. Following other researchers who used this study, we included both graduates and siblings to increase generational diversity (Pudrovska, 2010). We restricted our sample to male respondents (n = 9,408), followed by those who responded to the 2011 mail survey that included questions related to masculine ideals (n = 3,621). We excluded individuals who were missing reports of age (n = 134), education (n = 165), and alcohol use (n = 137) as well as mail survey responses related to tobacco use (n = 87), sports participation (n = 198), hunt/fish (n = 464), repair (n = 367), senior men’s group (n = 250), and vigorous exercise (n = 543), leading to an analytical sample of n = 2,594. The WLS is available via the Inter-university Consortium for Political and Social Research (ICPSR) and, as such, our institution does not require IRB approval.
Dependent Variables
SRH for both waves was measured through an item that asks: “How would you rate your health at the present time?” on a 5-point Likert-type scale that demonstrates better health with a higher number response. We recoded this item into the following three categories: (1) Fair/Very Poor; (2) Good; and (3) Excellent. Fair and Very Good were collapsed into one category because there were few in each category.
Chronic Illness was a count variable with seven conditions including doctor diagnosis of hypertension, high blood sugar, diabetes, cancer, heart condition, stroke, joint, and/or mental illness. It ranges from zero to seven conditions.
Depressive Symptomatology was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). This scale asks how many days during the past week the respondent felt about various topics such as “feel bothered by things that usually don’t bother you?,” “think your life had been a failure?,” and “feel happy?.” It included 20 questions and ranged from four response categories (i.e., less than 1 day; 1–2 days; 3–4 days; 5–7 days). Results were summed and could range from 0 to 60. When accounting for the subpopulation, CES-D was 0 to 44. The alpha reliability was .86.
Independent Variables
Masculine Ideals were measured as a trichotomous variable composed of seven items (Cronbach’s alpha coefficient: .66) from the Hegemonic Masculine for Older Men Scale which have been used in several studies (Campos-Castillo et al., 2020; Pudrovska, 2010; Springer & Mouzon, 2019). The seven items were as follows: “To what extent do you agree that. . .”: (1) when a husband and wife make decisions about buying major things for the home, the husband should have the final say?, (2) a man should always try to project an air of confidence even if he really doesn’t feel confident inside?, (3) It bothers me when a man does something that I consider feminine?, (4) men have greater sexual needs than women?, (5) when a man is feeling pain he should not let it show?, (6) in some kinds of situations a man should be ready to use his fists?, and (7) being larger, stronger-looking, and more muscular makes men more attractive to women? Each of these 5-point Likert-type scale items was reverse-coded so that a higher number reflects more masculine ideals: (1) “Strongly Disagree”; (2) “Disagree”; (3) “Neither Agree nor Disagree”; (4) “Agree”; and (5) “Strongly Agree.” Following prior research (Springer & Mouzon, 2019), our trichotomous indicator was coded so that the bottom 25% were labeled “Masculinity Rejectors,” the middle 50% were labeled “Masculinity Endorsers,” and the top 25% were labeled “Masculinity Idealists” (Springer & Mouzon, 2019).
Covariates
Age was measured using respondents’ age during the 2011 wave of the survey which ranged from 47 to 91. Education was measured through an item that summarizes “years of regular education based on most recent degree” which was categorized into five groups: (1) less than high school diploma; (2) high school diploma; (3) some college; (4) bachelor’s degree; and (5) graduate/professional degree. Tobacco use was measured with a binary variable that asked, “Have you ever smoked cigarettes regularly in your entire life?” Alcohol use was measured with a binary variable that asked, “Have you ever drunk alcoholic beverages, such as beer, wine, liquor, or mixed alcoholic drinks?”
We included five variables that we and previous research (Springer & Mouzon, 2019) typify as masculine activities. Respondents were asked about involvement in various clubs and organizations over the past 12 months. Sports Team Involvement was measured through the item that asks, “What is your level of involvement with sports teams?” For clarity, the measure is asking about actual participation in sports activity. Senior Men’s Group was measured through the item that asks, “In the past 12 months, how involved have you been with a group for senior men or women?” Both these questions were provided with five response options, (1) Not Involved; (2) Very Little; (3) Some; (4) Quite a Bit; and (5) A Great Deal, that were recoded into a binarized variable that distinguished no participation from any participation. The variables Hunt/Fish, Repairs, and Vigorous Physical Activity were informed by questions that asked, “During the past year, about how many hours per month did you spend . . .” “hunting or fishing in season?,” “making home repairs, car repairs, or doing other handy work?,” and “doing vigorous physical activities that you do alone, such as jogging, swimming, biking, or going to the gym by yourself?,” respectively. We recoded these three variables to distinguish those who reported 0 h from those who reported 1+ h. All missing and non-applicable responses were removed before statistical analyses.
Analytic Strategy
We first calculated descriptive statistics for our sample and presented them as percentages and means of the study variables. We next conducted three separate linear regression analyses to examine reports of SRH, chronic conditions, and depressive symptomatology. Each outcome-specific regression was progressively adjusted so that masculine ideals were included in Model 1, demographic characteristics (i.e., age, education) were included in Model 2, health behaviors (i.e., tobacco use, alcohol use) were added in Model 3, and masculine activities (i.e., sports team involvement, hunt/fish, repairs, senior men’s group, vigorous physical activity) were added in Model 4. All analyses were conducted on Stata, release 17.
Results
Table 1 lists the prevalence and means of all variables in our study (n = 2,594). For masculine ideals, 28.0% (n = 726) were masculinity rejectors, 50.6% (n = 1,312) were masculinity endorsers, and 21.4% (n = 556) were masculinity idealists. The mean age of respondents was 70.4 years. High school diploma was the most common form of educational attainment (40.9%; n = 1,062), followed by graduate/professional degree (22.7%; n = 590), some college (18.0%; n = 466), bachelor’s degree (17.3%; n = 448), and less than high school diploma (1.1%; n = 28). For health behaviors, 60.3% (n = 1,565) of respondents reported ever using tobacco, while 98.5% (n = 2,355) reported ever using alcohol. Among masculine activities, 24.8% (n = 643) reported sports team involvement, 41.7% (n = 1,081) reported hunting/fishing, 86.6% (n = 2,246) reported repairs, 11.3% (n = 292) were in a senior men’s groups, and 45.9% (n = 1,191) participated in vigorous physical activity. For SRH, 8.2% (n = 182) reported very poor/fair health, 60.6% (n = 1,339) had good health, and 31.1% (n = 687) claimed they had excellent health. The mean number of reported chronic conditions was 2.2, while the mean depressive symptomatology score was 15.9.
Table 1.
Sample Description (N = 2,594)
| n (%) | M (SD) | |||
|---|---|---|---|---|
| Masculine ideals | ||||
| Rejecters | 726 | (28.0) | ||
| Endorsers | 1,312 | (50.6) | ||
| Idealists | 556 | (21.4) | ||
| Age | 70.4 | (4.0) | ||
| Education | ||||
| Less than HS diploma | 28 | (1.1) | ||
| High school diploma | 1,062 | (40.9) | ||
| Associate’s/some college | 466 | (18.0) | ||
| Bachelor’s degree | 448 | (17.3) | ||
| Graduate degree | 590 | (22.7) | ||
| Tobacco use | 1,565 | (60.3) | ||
| Alcohol use | 2,555 | (98.5) | ||
| Sport team involvement | 643 | (24.8) | ||
| Hunt/fish | 1,081 | (41.7) | ||
| Repairs | 2,246 | (86.6) | ||
| Senior men’s group | 292 | (11.3) | ||
| Vigorous physical activity | 1,191 | (45.9) | ||
| Self-rated health | ||||
| Very poor/fair | 182 | (8.2) | ||
| Good | 1,339 | (60.6) | ||
| Excellent | 687 | (31.1) | ||
| Chronic conditions | 2.2 | (1.4) | ||
| Depressive symptomatology | 15.9 | (6.0) | ||
Note. HS = high school; SD = standard deviation.
Next, we examined the relationship between masculine ideals and SRH using linear regression, accounting for age, education, tobacco use, alcohol use, sports team involvement, hunting/fishing, repairs, senior men’s group, and vigorous physical activity (Table 2). In Model 1, we observed that, compared with masculinity rejectors, masculinity endorsers (b = −0.120; p = .000) and masculinity idealists (b = −0.163; p = .000) had significantly lower SRH. In Model 2, we observed that, compared with respondents with less than a high school education, those with a high school education (b = 0.254; p = .045), some college (b = 0.354; p = .006), college degree (b = 0.442; p = .001), and graduate/professional degree (b = 0.519; p = .000) all had significantly higher SRH; however, there was no significant relationship between age and SRH. In Model 3, neither tobacco use nor alcohol use had a significant relationship with SRH. In Model 4, being in a senior men’s group had a negative relationship with SRH (b = −0.095; p = .015), while vigorous physical activity had a positive relationship with SRH (b = 0.153; p = .000). The remaining masculine activities (i.e., sports team involvement, hunting/fishing, repairs) did not have a significant relationship with SRH. Having a high school education no longer had a relationship with SRH.
Table 2.
Linear Regression Reports of Self-Rated Health (N = 2,208)
| M1: Masculine ideals | M2: Demographics | M3: Health behaviors | M4: Masculine activities | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| b | CI | b | CI | b | CI | b | CI | |||||
| (Rejecters) | ||||||||||||
| Endorsers | −0.120*** | −0.18 | −0.06 | −0.082** | −0.14 | −0.03 | −0.083** | −0.14 | −0.03 | −0.079** | −0.13 | −0.02 |
| Idealists | −0.163*** | −0.23 | −0.09 | −0.112** | −0.18 | −0.04 | −0.111** | −0.18 | −0.04 | −0.099** | −0.17 | −0.03 |
| Age | −0.001 | −0.01 | 0.01 | −0.001 | −0.01 | 0.01 | 0.001 | −0.01 | 0.01 | |||
| (Less than HS) | ||||||||||||
| High school | 0.254* | 0.01 | 0.50 | 0.249* | 0.00 | 0.50 | 0.239 | −0.01 | 0.48 | |||
| Some college | 0.354** | 0.10 | 0.61 | 0.346** | 0.09 | 0.60 | 0.317* | 0.07 | 0.57 | |||
| College degree | 0.442*** | 0.19 | 0.69 | 0.433*** | 0.18 | 0.68 | 0.408** | 0.16 | 0.66 | |||
| Graduate/professional degree | 0.519*** | 0.27 | 0.77 | 0.505*** | 0.25 | 0.76 | 0.461*** | 0.21 | 0.71 | |||
| Tobacco use | −0.042 | −0.09 | 0.01 | −0.039 | −0.09 | 0.01 | ||||||
| Alcohol use | 0.037 | −0.16 | 0.23 | 0.011 | −0.18 | 0.21 | ||||||
| Sports team involvement | −0.030 | −0.09 | 0.03 | |||||||||
| Hunt/fish | 0.008 | −0.04 | 0.06 | |||||||||
| Repairs | 0.059 | −0.01 | 0.13 | |||||||||
| Senior men’s group | −0.095* | −0.17 | −0.02 | |||||||||
| Vigorous physical activity | 0.153*** | 0.10 | 0.20 | |||||||||
| Constant | 2.323 | 2.28 | 2.37 | 1.993 | 1.49 | 2.50 | 1.990 | 1.45 | 2.53 | 1.798 | 1.25 | 2.35 |
Note. b = beta coefficient; CI = confidence interval; HS = high school.
p < .05. **p < .01. ***p < .001.
We then examined the relationship between masculine ideals and chronic illness using linear regression, accounting for age, education, tobacco use, alcohol use, sports team involvement, hunting/fishing, repairs, senior men’s group, and vigorous physical activity (Table 3). In Model 1, we observed that, compared with masculinity rejectors, masculinity endorsers (b = 0.159; p = .016) and masculinity idealists (b = 0.299; p = .000) had significantly more chronic illness. In Model 2, we observed that age had a positive relationship with chronic illness (b = 0.029; p = .000). Compared with respondents with less than a high school education, those with a graduate/professional degree (b = 0.654; p = .017) had significantly lower chronic illness. Masculinity endorsers no longer had a relationship with chronic illness. In Model 3, tobacco use had a positive relationship with chronic illness (b = 0.370; p = .000), though alcohol use had no relationship. Having a graduate/professional degree no longer had a relationship with chronic illness. In Model 4, both doing repairs (b = −0.358; p = .000) and vigorous physical activity (b = −0.230; p = .000) were associated with less chronic illness, while being in a senior men’s group was associated with more chronic illness (b = 0.205; p = .020). The remaining masculine activities (i.e., sports team involvement, hunting/fishing) did not have a significant relationship with chronic illness.
Table 3.
Linear Regression Reports of Chronic Illness (N = 2,594)
| M1: Masculine ideals | M2: Demographics | M3: Health behaviors | M4: Masculine activities | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| b | CI | b | CI | b | CI | b | CI | |||||
| (Rejecters) | ||||||||||||
| Endorsers | 0.159* | 0.03 | 0.29 | 0.092 | −0.04 | 0.22 | 0.095 | −0.03 | 0.22 | 0.090 | −0.04 | 0.22 |
| Idealists | 0.299*** | 0.14 | 0.46 | 0.203* | 0.04 | 0.36 | 0.197* | 0.04 | 0.36 | 0.179* | 0.02 | 0.34 |
| Age | 0.029*** | 0.02 | 0.04 | 0.030*** | 0.02 | 0.04 | 0.025*** | 0.01 | 0.04 | |||
| (Less than HS) | 0.000 | 0.00 | 0.00 | 0.000 | 0.00 | 0.00 | 0.000 | 0.00 | 0.00 | |||
| High school | −0.234 | −0.76 | 0.30 | −0.178 | −0.70 | 0.35 | −0.147 | −0.67 | 0.38 | |||
| Some college | −0.341 | −0.88 | 0.20 | −0.269 | −0.81 | 0.27 | −0.205 | −0.74 | 0.33 | |||
| College degree | −0.481 | −1.02 | 0.06 | −0.393 | −0.93 | 0.14 | −0.333 | −0.87 | 0.20 | |||
| Graduate/professional degree | −0.654* | −1.19 | −0.12 | −0.524 | −1.06 | 0.01 | −0.440 | −0.97 | 0.09 | |||
| Tobacco use | 0.370*** | 0.26 | 0.48 | 0.364*** | 0.25 | 0.48 | ||||||
| Alcohol use | −0.074 | −0.52 | 0.37 | −0.057 | −0.50 | 0.39 | ||||||
| Sports team involvement | 0.004 | −0.12 | 0.13 | |||||||||
| Hunt/fish | 0.060 | −0.05 | 0.17 | |||||||||
| Repairs | −0.358*** | −0.52 | −0.20 | |||||||||
| Senior men’s group | 0.205* | 0.03 | 0.38 | |||||||||
| Vigorous physical activity | −0.230*** | −0.34 | −0.12 | |||||||||
| Constant | 2.072 | 1.97 | 2.18 | 0.453 | −0.66 | 1.57 | 0.206 | −1.00 | 1.41 | 0.849 | −0.37 | 2.07 |
Note. b = beta coefficient; CI = confidence interval; HS = high school.
p < .05. **p < .01. ***p < .001.
Finally, we examined the relationship between masculine ideals and depressive symptomatology using linear regression, accounting for age, education, tobacco use, alcohol use, sports team involvement, hunting/fishing, repairs, senior men’s group, and vigorous physical activity (Table 4). In Model 1, we observed that, compared with masculinity rejectors, only masculinity idealists (b = 1.745; p = .000) reported greater depressive symptomatology. In Model 2, we observed that age had a negative relationship with depressive symptomatology (b = −0.063; p = .031). However, educational attainment had no significant relationship with depressive symptomatology. In Model 3, neither tobacco use nor alcohol use had a significant relationship with depressive symptomatology. In Model 4, doing repairs was associated with less depressive symptomatology (b = −0.886; p = .012), while being in a senior men’s group was associated with greater depressive symptomatology (b = 1.136; p = .003). The remaining masculine activities (i.e., sports team involvement, hunting/fishing, vigorous physical activity) did not have a significant relationship with depressive symptomatology.
Table 4.
Linear Regression Reports of Depressive Symptomatology (N = 2,594)
| M1: Masculine ideals | M2: Demographics | M3: Health behaviors | M4: Masculine activities | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| b | CI | b | CI | b | CI | b | CI | |||||
| (Rejecters) | ||||||||||||
| Endorsers | 0.215 | −0.33 | 0.76 | 0.222 | −0.33 | 0.77 | 0.221 | −0.33 | 0.77 | 0.240 | −0.31 | 0.79 |
| Idealists | 1.745*** | 1.09 | 2.41 | 1.781*** | 1.11 | 2.45 | 1.773*** | 1.10 | 2.44 | 1.729*** | 1.06 | 2.40 |
| Age | −0.063* | −0.12 | −0.01 | −0.062* | −0.12 | −0.01 | −0.078** | −0.14 | −0.02 | |||
| (Less than HS) | ||||||||||||
| High school | −0.482 | −2.72 | 1.76 | −0.406 | −2.65 | 1.84 | −0.414 | −2.65 | 1.83 | |||
| Some college | 0.034 | −2.25 | 2.32 | 0.122 | −2.16 | 2.41 | 0.121 | −2.16 | 2.40 | |||
| College degree | −0.807 | −3.09 | 1.48 | −0.697 | −2.98 | 1.59 | −0.822 | −3.11 | 1.46 | |||
| Graduate/professional degree | −0.353 | −2.62 | 1.92 | −0.200 | −2.47 | 2.07 | −0.300 | −2.57 | 1.97 | |||
| Tobacco use | 0.416 | −0.07 | 0.90 | 0.454 | −0.03 | 0.94 | ||||||
| Alcohol use | 0.501 | −1.41 | 2.41 | 0.501 | −1.41 | 2.41 | ||||||
| Sports team involvement | 0.309 | −0.23 | 0.85 | |||||||||
| Hunt/fish | −0.459 | −0.94 | 0.02 | |||||||||
| Repairs | −0.886 * |
−1.58 | −0.20 | |||||||||
| Senior men’s group | 1.136** | 0.40 | 1.87 | |||||||||
| Vigorous physical activity | 0.007 | −0.47 | 0.49 | |||||||||
| Constant | 15.444 | 15.01 | 15.88 | 20.271 | 15.56 | 24.98 | 19.366 | 14.24 | 24.50 | 21.271 | 16.06 | 26.49 |
Note. b = beta coefficient; CI = confidence interval; HS = high school.
p < .05. **p < .01. ***p < .001.
Discussion
Findings from this study illustrate that traditional hegemonic masculine ideals are associated with worse SRH, greater chronic illness morbidities, and depressive symptomatology. This was especially the case for the masculinity idealists, compared with the rejectors. Neither sports team involvement nor hunting and fishing had an association with health outcomes. About 25% of older men were very active on sports teams. In addition, 42% of the sample hunted and/or fished. So, while relatively popular among these older men, they were not associated with health outcomes. Doing repairs and car maintenance was associated with less chronic illness and depression. While adherence to this masculine-identified task was actually helpful for these older men, it may signal as a proxy for level of activity and ability. In other words, the complex activity of repairs, which can involve planning, shopping, and ultimately fixing, is good for the well-being of men. Finally, in all three regressions, being in a senior men’s group was associated with worse SRH, greater chronic illness, and greater depression. Perhaps for these older men, the types of organizations the men belong to may be places with higher masculine ideals. We know little about the voluntary associations in Wisconsin for older adults. One very relevant study examined Minnesota older adults and their voluntary association work. The authors reported that Minnesota was homogeneous, and volunteer work entailed most commonly church work, then service to organizations such as fundraising, and then service to citizenship organizations such as American Legion, Shriners, Masons, and Lions Clubs (Fischer et al., 1991). Wisconsin would similarly have this population, with many also involved in the Veterans of Foreign Wars (VFWs) and Elks Clubs. It may be that, in this population of similar older men in Wisconsin who graduated high school in the 1950s, the senior groups may have more hegemonic masculine beliefs that are problematic for health (Read & Gorman, 2010; Smith et al., 2022). Our research supports existing literature that reports masculine identity can be a hindrance for later life health and well-being. Conversely, some research has reported that femininity is associated with worse physical health. Ahmed et al. (2018) reported that being more feminine on the Bem Sex-Role Inventory was associated with worse physical performance. However, this research examined an international sample of men and women on lower extremity movement. Future research may consider how the Bem Sex-Role inventory and continuum of so-called masculine versus feminine traits compare with masculine ideologies. Future research could also examine how voluntary organization involvement varies by area of the country.
The meaning of masculinity changes for men as they age which allow for the diminishment of hegemonic beliefs (Griffith, 2012). In our results, when older men adhere to more traditional masculine beliefs, they may not be experiencing the more mature aspects of masculinity that revolve around family and service (Griffith, 2012). This highlights how older men’s life chances (i.e., Greatest Generation, Silent Generation, and Baby Boomer men from Wisconsin) interplay with their life choices (Cockerham, 2005) to influence health behaviors that negatively affect health outcomes (Griffith et al., 2016; Sloan et al., 2015). Education’s positive relationship with SRH speaks to health outcomes because greater educational attainment suggests stronger dispositions to participate in positive health behaviors (Cockerham, 2005; Evans et al., 2011).
In sum, we find support for our first hypothesis. Men’s greater endorsement of traditional masculine ideals was associated with worse health outcomes. This was especially the case for those who were masculinity idealists, who reported worse SRH, greater chronic illness, and greater depressive symptomatology. Hypotheses 2a and 2b were partially supported because senior men’s group involvement was associated with worse SRH, greater chronic illness, and greater depressive symptomatology. Men’s vigorous activity was associated with lower chronic illness and higher SRH. Doing repairs and maintenance was associated with lower depressive symptomatology and less chronic illness. No other masculine activities were significant. Finally, as anticipated for Hypothesis 3, being in a men’s group and vigorous activity partially explained the relationship between masculine ideals and SRH repairs, hunting/fishing, and vigorous activity explained some of the effects on chronic illness. Finally, repairs and being in a senior men’s group explained some of the effects on depression
Limitations:
Although our study provides a unique insight into how masculinity informs the health of older men, it is not without its limitations. First, though our study relied on a well-known study, these data are limited to older men from one U.S. state. It represents predominantly white men who graduated high school in Wisconsin (Herd et al., 2014). As such, the sample raises generalizability concerns as it pertains to men of color and those representing younger generations. While a few of the siblings did not graduate high school, adding some variation in age and education, the sample was still very limited to this particular group of men. Second, our study’s sample is represented by a select group of respondents who were randomly assigned, answered, and returned the WLS mail-in questions. Therefore, our sample, and possibly results, might have had been different if these surveys were completed in-person. While these limitations are important to consider, especially when using WLS data, its rich history, important and original measures, and strong participation rates yield it to be important and useful data in social sciences (Herd et al., 2014; Smith et al., 2022).
Conclusion
Men have a mortality and morbidity health gap that is associated with excess death. Research points to health lifestyle gender differences associated with these disparities. Research also calls for more research and action to eliminate what is coined as the “men’s health gap,” the gender-based disparity in health outcomes (Baker et al., 2014). We found that men’s greater endorsement of traditional masculine ideals was generally associated with worse health outcomes. These findings support prior research that masculine norms and behaviors are associated with worse health and mental health for men (Courtenay, 2000; Mahalik et al., 2007; Read & Gorman, 2010; Smith et al., 2022). In the future, as each successive cohort of men replaces these older men, it will be interesting to see how this affects younger men’s health and well-being (Gerson, 2009; Powell et al., 2010). Highly traditional gender beliefs are becoming rarer over time (Scarborough et al., 2019). Though the process of “doing gender” is becoming more flexible, so masculine ideals and performance are subject to change. More gender-equitable beliefs may be useful for improving the “men’s health gap” (Baker et al., 2014). Because involvement in men’s senior groups was also associated with worse health, in part through masculine ideals, perhaps in the future as masculine ideals change, these volunteer associations may become more gender equitable and not be a space where men further adhere to these beliefs. Also, in an era of increased awareness of challenging gendered beliefs, health lifestyles may become more gender equitable. Future research in this area would benefit from studying other forms of masculine performance, including more recent generations of men and men of color, and paying attention to the organizations to which these men belong.
Footnotes
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Publication of this manuscript was partially funded by Patricia Drentea and the University of Alabama at Birmingham Libraries’ Article Processing Charge Fund as well as Philippa J. Clarke at the University of Michigan Institute for Social Research.
ORCID iD: Shane D. Burns 
https://orcid.org/0000-0003-2211-8707
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