Mænd, sundhed og sygdom: Diskursive konstruktioner af maskulinitet, lægesøgning og mænds sundhed

This thesis answers the following question: How do discourses contribute to establishing frameworks for what can be said and done concerning men's health? The main focus of this thesis is an investigation of health communication through an analytical comparison of 1) authorities' perspectives on and problematization of men's health and 2) men's perspectives on health, illness, being a patient, and encounters with the healthcare system.

The empirical analysis consists of two parts. The first part investigates policy documents to understand how authorities describe and problematize inequalities in health-related to men. The second part focuses on men's encounters with the healthcare system. It draws upon three sources of empirical data: interviews conducted with men referred to cancer pathways; fieldwork and interviews in a public housing area from December 2019 to 2021 and observations from doctor-patient consultations and interviews with patients.

A core research contribution of this thesis is the production of qualitative empirical data using vignettes. Existing literature has already shown how vignettes are suitable for exploring sensitive topics and that it can be difficult to get men to talk about sensitive subjects. In this thesis, conversations with marginalized citizens about health, medical care, and illness were stimulated by creating realistic vignettes, resulting in rich empirical data on sensitive topics. By using vignettes during qualitative interviews, e.g. in a public housing area, men engaged in conversations about sensitive subjects in the vignette and drew parallels to their own lives, people, and situations they knew.

The primary analytical approach in this thesis is discourse analysis. Based on Carol Bacchi's idea of 'policy as discourse', the analysis of policy documents highlights the representation of men's health as an issue in offi-cial communication from the Danish state, regions, and municipalities. The analysis of the interviews uses a discourse psychology approach. In this approach, communication is the discursive negotiation of meanings based on men's experiences of health and illness within social categories such as illness, gender, and masculinity.

To bridge the analysis of interviews and policy documents, this thesis adopts the concept of intertextuality. The reciprocal reproduction of discourse is a sign of congruence between the two parts of the analysis insofar as men's health is framed similarly in policy documents and interviews. In this way, policy documents reinforce the framing of the discussion of inequalities in health and placement of responsibility.

Several findings emerge from the analysis of interviews and policy documents. First, the interviewed men reproduce the apparent policy document discourses and extends and expands upon them. These discourses state that men seek out their general practitioners too infrequently and have unhealthy lifestyles.
Second, in the analysis of the interviews, prominent examples of the interviewer and interviewee negotiating the authorities' problematizations of men's health appear, reinforcing the argument for using vignettes to stimulate conversations regarding sensitive subjects. Third, the analysis reveals how responsibility lies with individuals and authorities, and how men render 'appropriate patienthood' and 'health' differently.