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- Randell, Eva, 1960-
(författare)
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Adolescent boys’ health : managing emotions, masculinities and subjective social status
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The health of adolescent boys is complex and surprisingly little is known about how adolescent boys perceive, conceptualise and experience their health. Thus, the overall aim of this thesis was to explore adolescent boys’ perceptions and experiences of health, emotions, masculinity and subjective social status (SSS).This thesis consists of a qualitative, a quantitative and a mixed methods study. The qualitative study aimed to explore how adolescent boys understand the concept of health and what they find important for its achievement. Furthermore, the adolescent boys’ views of masculinity, emotion management and their potential effects on wellbeing were explored. For this purpose, individual interviews were conducted with 33 adolescent boys aged 16-17 years. The quantitative study aimed to investigate the associations between pride, shame and health in adolescence. Data were collected through a cross-sectional postal survey with 705 adolescents. The purpose of the mixed methods study was to investigate associations between SSS in school, socioeconomic status (SES) and self-rated health (SRH), and to explore the concept of SSS in school. Cross-sectional data were combined with interview data in which the meaning of SSS was further explored. Individual interviews with 35 adolescents aged 17-18 years were conducted.In the qualitative study, data were analysed using Grounded Theory. In the quantitative study, statistical analyses (e.g., chi-square test and uni- and multivariable logistic regression analyses) were performed. In the mixed method study, a combination of statistical analyses and thematic network analysis was applied.The results showed that there was a complexity in how the adolescent boys viewed, experienced, dealt with and valued health. On a conceptual level, they perceived health as holistic but when dealing with difficult emotions, they were prone to separate the body from the mind. Thus, the adolescent boys experienced a difference between health as a concept and health as an experience (paper I). Concerning emotional orientation in masculinity, two main categories of masculine conceptions were identified: a gender-normative masculinity and a non-gender-normative masculinity (paper II). Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite that their expressions are in contrast to each other. Non-gender-normative masculinity included an orientation towards sincerity, emphasising the personal values of the boys. Emotions were expressed more independently of peer group norms. The findings suggest that different masculinities and the expression of emotions are intricately intertwined and that managing emotions is vital for wellbeing. The present findings also showed that both shame and pride were significantly associated with SRH, and furthermore, that there seems to be a protective effect of experiencing pride for health (paper III). The results also demonstrated that SSS is strongly related to SRH, and high SRH is related to high SSS, and further that the positioning was done in a gendered space (paper IV).Results from all studies suggest that the emotional and relational aspects, as well as perceived SSS, were strongly related to SRH. Positive emotions, trustful relationships and having a sense of belonging were important factors for health and pride was an important emotion protecting health. Physical health, on the other hand, had a more subordinated value, but the body was experienced as an important tool to achieve health. Even though health was mainly perceived in a holistic manner by the boys, there were boys who were prone to dichotomise the health experience into a mind-body dualism when having to deal with difficult emotions.In conclusion, this thesis demonstrates that young, masculine health is largely experienced through emotions and relationships between individuals and their contexts affected by gendered practices. Health is to feel and function well in mind and body and to have trusting relationships. The results support theories on health as a social construction of interconnected processes. Having confidence in self-esteem, access to trustful relationships and the courage to resist traditional masculine norms while still reinforcing and maintaining social status are all conducive to good health. Researchers as well as professionals need to consider the complexity of adolescent boys’ health in which norms, values, relationships and gender form its social determinants. Those working with young boys should encourage them to integrate physical, social and emotional aspects of health into an interconnected and holistic experience.
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| 2. |
- Vaezghasemi, Masoud, 1978-
(författare)
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Nutrition transition and the double burden of malnutrition in Indonesia : a mixed method approach exploring social and contextual determinants of malnutrition
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionNutrition transition concerns the broad changes in the human diet that have occurred over time and space. In low- to middle-income countries such as Indonesia, nutrient transition describes shifts from traditional diets high in cereal and fibre towards Western pattern diets high in sugars, fat, and animal-source foods. This causes a swift increase in the prevalence of overweight and obesity while undernutrition remains a great public health concern. Thus a double burden of malnutrition occurs in the population. The main aim of this investigation was to explore social and contextual determinants of malnutrition in Indonesia. The specific objectives were: (i) to examine body mass index (BMI) changes at the population level, and between and within socioeconomic groups; (ii) to estimate which context (i.e., household or district) has a greater effect on the variation of BMI; (iii) to assess the prevalence of double burden households (defined as the coexistence of underweight and overweight individuals residing in the same household) and its variation among communities as well as its determining factors; and (iv) to explore and understand what contributes to a double burden of malnutrition within a household by focusing on gender relations.MethodsA mixed method approach was adopted in this study. For the quantitative analyses, nationally representative repeated cross-sectional survey data from four Indonesian Family Life Surveys (IFLS; 1993, 1997, 2000, 2007) were used. The IFLS contains information about individual-level, household-level and area-level characteristics. The analyses covered single and multilevel regressions. Data for the qualitative component were collected from sixteen focus group discussions conducted in Central Java and in the capital city Jakarta among 123 rural and urban men and women. Connell’s relational theory of gender and Charmaz’s constructive grounded theory were used to analyse the qualitative data.ResultsGreater increases in BMI were observed at higher percentiles compared to the segment of the population at lower percentiles. While inequalities in mean BMI decreased between socioeconomic groups, within group dispersion increased over time. Households were identified as an important social context in which the variation of BMI increased over time. Ignoring the household level did not change the relative variance contribution of districts on BMI in the contextual analysis. Approximately one-fifth of all households exhibited a double burden of malnutrition. Living in households with a higher socioeconomic status resulted in higher odds of double burden of malnutrition with the exception of women-headed households and communities with high social capital. The qualitative analysis resulted in the construction of three categories: capturing the significance of gendered power relations, the emerging obesogenic environment, and generational relations for child malnutrition.ConclusionAt the population level, greater increases in within-group inequalities imply that growing inequalities in BMI were not merely driven by socioeconomic factors. This suggests that other under-recognised social and contextual factors may have a greater effect on the variation in BMI. At the contextual level, recognition of increased variation among households is important for creating strategies that respond to the differential needs of individuals within the same household. At the household level, women’s empowerment and community social capital should be promoted to reduce inequalities in the double burden of malnutrition across different socioeconomic groups. Ultimately community health and nutrition programmes will need to address gender empowerment and engage men in the fight against the emerging obesogenic environment and increased malnutrition that is evident within households, especially overweight and obesity among children.
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