‘Dudes Are Meant to be Tough as Nails’: The Complex Nexus Between Masculinities, Culture and Health Literacy From the Perspective of Young Aboriginal and Torres Strait Islander Males – Implications for Policy and Practice

Abstract

Health literacy is generally conceptualized as skills related to successfully navigating health – ultimately linked to well-being and improved health outcomes. Culture, gender and age are considered to be influential determinants of health literacy. The nexus between these determinants, and their collective relationship with health literacy, remains understudied, especially with respect to Indigenous people globally. This article presents findings from a recent study that examined the intersections between masculinities, culture, age and health literacy among young Aboriginal and Torres Strait Islander males, aged 14–25 years in the Northern Territory, Australia. A mixed-methods approach was utilized to engage young Aboriginal and Torres Strait Islander males. The qualitative components included Yarning Sessions and Photovoice using Facebook, which are used in this article. Thematic Analysis and Framework Analysis were used to group and analyse the data. Ethics approval was granted by Charles Darwin University Human Research Ethics Committee (H18043). This cohort constructs a complex interface comprising Western and Aboriginal cultural paradigms, through which they navigate health. Alternative Indigenous masculinities, which embrace and resist hegemonic masculine norms simultaneously shaped this interface. External support structures – including family, friends and community engagement programs – were critical in fostering health literacy abilities among this cohort. Young Aboriginal and Torres Strait Islander males possess health literacy abilities that enable them to support the well-being of themselves and others. Health policymakers, researchers and practitioners can help strengthen and expand existing support structures for this population by listening more attentively to their unique perspectives.

COVID-19, Equity and Men’s Health

“…This evidence reinforces the importance of investing in contextually-relevant, culturally-responsive, ageappropriate and gender-sensitive health promotion interventions for boys and men when responding to vulnerabilities associated with pandemics. 31,33,67,83 We acknowledge that this commentary only provides a partial snapshot of how men's health inequities could have been addressed during COVID-19. Yet, it provides a useful starting point for ensuring more assertive public health research, policy, and practice responses are directed towards the most vulnerable and marginalised populations of boys and men during future pandemics.…”

“…[68][69][70][71][72][73] Commentary in this space has frequently examined links between gender, specifically masculinities, and men's health. 33,[64][65][66][67]71,[74][75][76][77][78][79][80][81][82][83][84] This has typically focused on vulnerable, marginalised, and minority groups of boys and men. [66][67]76,[81][82][83][84][85][86][87][88][89] Importantly, this scholarship has frequently used intersectionality as a conceptual framework, whereby the nexus between age, gender, race, sexual orientation, disability, geography and/or socio-economic status has been explored.…”

“…• settings-and place-based health promotion approaches, with a particular focus on engagement through faith-based settings, [117][118][119] barber shops, 120,121 sports clubs/organisations, 83 and colleges and universities; 82,[122][123][124] • strategies that explicitly address healing, intergenerational trauma and racism; 61,101,[125][126][127][128][129][130] • involving peers and family; 84,131,132 • strengths-based approaches that focus on achievement, success and building leadership capacity; 133,134 and • approaches that address specific health issues, such as mental health and wellbeing and respective mechanisms associated with coping and resilience. 82,84,103,104,123 Importantly, there are now multiple organisations, services and programs that exist to address health and social inequities experienced by boys and young men of colour.…”

Chronic disease health literacy in First Nations people: A mixed methods study

“…While Australia has reported the nation's health literacy in 2006 and 2018 (Australian Bureau of Statistics [ABS], 2008; 2018), different methods were used on each occasion with the most recent results, indicating that those with chronic diseases had lower health literacy abilities and were also less engaged with the healthcare system. Previous Australian studies have examined First Nations people's health literacy in dental care (Parker et al, 2012; Soares et al, 2020), men's health (Smith et al, 2020), cancer care (Treloar et al, 2013), chronic disease (de‐identified for review) and primary health care (Lakhan et al, 2017). Four of these studies assessed only functional health literacy (Lakhan et al, 2017; Parker et al, 2012; Soares et al, 2020) while three studies explored First Nations people's health literacy qualitatively (Rheault et al, 2021; Smith et al, 2020; Treloar et al, 2013 (de‐identified for review)), indicating that communication with healthcare providers is problematic.…”

“…Previous Australian studies have examined First Nations people's health literacy in dental care (Parker et al, 2012; Soares et al, 2020), men's health (Smith et al, 2020), cancer care (Treloar et al, 2013), chronic disease (de‐identified for review) and primary health care (Lakhan et al, 2017). Four of these studies assessed only functional health literacy (Lakhan et al, 2017; Parker et al, 2012; Soares et al, 2020) while three studies explored First Nations people's health literacy qualitatively (Rheault et al, 2021; Smith et al, 2020; Treloar et al, 2013 (de‐identified for review)), indicating that communication with healthcare providers is problematic. Greater understanding of the multidimensional health literacy capabilities of First Nations people is urgently needed particularly in the context of chronic disease.…”