Gender X = Mental Illness Y = Physical Illness Z…

Needham, B., & Hill, T. (2010). Do gender differences in mental health contribute to gender differences in physical health?☆ Social Science & Medicine DOI: 10.1016/j.socscimed.2010.07.016

The vexed issue of gender and health rests on the archaic notion of nature vs. nurture or, put more bluntly, are men inherently fucked or do we fuck up our own health? Needham and Hill (2010) take this argument ten degrees to the right by arguing that perhaps ‘gender differences in mental health contribute to gendered patterns of (physical) disease’ (n.pag.), a controversial argument since:

a) there is no objective test to prove the existence of even one so-called mental ‘illness’; and

b) the phenomenon of physical ill health is so often confounded by so many different variables…

For example, women are more culturally attuned to seek help for their physical health problems while men are more likely to resist seeking such help. Further, men tend to engage in risk-taking behaviours more often than women do. These behaviours, which include driving too fast, drinking too much booze, and eating too much shitty food, are potentially or actually harmful to men’s physical health. My considered view about the alleged gender differences between men and women’s physical health is that the higher morbidity and mortality rates seen in us men are primarily due to our poor lifestyle choices.

In short, yes, we fuck up our own health, although for diverse and complex background reasons…

Needham and Hill (2010) start to join the dots that depression and anxiety, amongst other mood disorders, are positively associated with poor physical health. There is nothing new about this hypothesis, since feeling ‘low’ or ‘high’ can precede or be the consequence of specific medical problems such as headaches, stomachaches, muscle aches, lethargy, and exhaustion. However, the proposition canvassed by the authors (2010) here, that gambling ‘addiction’ and substance misuse can be equally construed as mental illnesses that have a corresponding physical pathology component is, I think, a fluffy soufflé of a half-baked idea.

I have no doubt that men gamble, drink alcohol, and abuse illegal drugs for all sorts of reasons, including to ‘numb’ the psychological torment associated with underlying trauma or because they really love the blast they get from being pissed, stoned or chucking their whole pay check into a one-armed bandit. Living on the edge, after all, is a culturally valorised masculine ideal. That is not to say that poor lifestyle choices can be automatically elevated to the realm of ‘mental illness’ in the absence of empirical evidence. By so doing, Needham and Hill (2010) sabotage their own research findings that:

Women

= more internalised mental illnesses (depression, anxiety, etc.)

= physical health problems ‘x’ (debilitating health conditions).

Men

= more externalised mental illnesses (gambling addiction, substance misuse, etc.)

= physical health problems ‘y’ (life threatening health conditions).

The categorisation of mental illness according to gender and resultant physical health problems did not ring true for nine ‘of the sixteen conditions examined’ in Needham and Hill’s (2010) comprehensive research study. Moreover, even when a positive association could be (partially) found between men who had an externalising mental illness and a discrete physical health problem like heart disease (2010), I would question not only the actuality of that alleged mental illness but also the sheer audacity of drawing a straight line from dot mental to dot physical. There are, as I mentioned earlier, so many confounding variables when it comes to the phenomenon of physical ill health. Ditto if not even stronger, when it comes to the phenomenon of mental ill health.

Transcending the individual actor, for example, men who decide to make poor lifestyle choices and who, in the process, bugger up their own ticker, has that pseudo-shaman effect of absolving every man of every misdeed, but to serve what useful end…?