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An intersectional approach to understandings of mental health inequalities among men with disability

Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however...

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Autores principales: King, Tania L., Shields, Marissa, Shakespeare, Tom, Milner, Allison, Kavanagh, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700447/
https://www.ncbi.nlm.nih.gov/pubmed/31453312
http://dx.doi.org/10.1016/j.ssmph.2019.100464
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author King, Tania L.
Shields, Marissa
Shakespeare, Tom
Milner, Allison
Kavanagh, Anne
author_facet King, Tania L.
Shields, Marissa
Shakespeare, Tom
Milner, Allison
Kavanagh, Anne
author_sort King, Tania L.
collection PubMed
description Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however it is also known to be associated with adverse mental health outcomes in the broader adult male population. Intersectionality approaches offer a means of examining the way that the effect of self-reliance on mental health might vary between those with and without a disability. Among a sample of 12,052 men aged 18–55 years from the Ten-to-Men study, we used effect measure modification (EMM) to examine the way that self-reliance modifies the relationship between disability and depressive symptoms. Disability was assessed using the Washington Group Short Set of questions, which capture functional limitations. Results showed that men with disabilities who reported higher conformity to self-reliance norms had much worse mental health than non-disabled men with low conformity to self-reliance, as measured in terms of depressive symptoms (PRR: 9.40, 95%CI 7.88, 11.22, p-value<0.001). We found evidence of positive EMM of depressive symptoms by conformity to self-reliance on the additive scale (RERI: 2.84, 95%CI 1.26, 4.42, p-value<0.001). These results provide evidence that high conformity to self-reliance norms exerts a particularly damaging effect on the mental health of men with disabilities. Given that men with disabilities are more likely to rely on help and support from others, these results provide important insights for the delivery of services to men with disability.
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spelling pubmed-67004472019-08-26 An intersectional approach to understandings of mental health inequalities among men with disability King, Tania L. Shields, Marissa Shakespeare, Tom Milner, Allison Kavanagh, Anne SSM Popul Health Article Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however it is also known to be associated with adverse mental health outcomes in the broader adult male population. Intersectionality approaches offer a means of examining the way that the effect of self-reliance on mental health might vary between those with and without a disability. Among a sample of 12,052 men aged 18–55 years from the Ten-to-Men study, we used effect measure modification (EMM) to examine the way that self-reliance modifies the relationship between disability and depressive symptoms. Disability was assessed using the Washington Group Short Set of questions, which capture functional limitations. Results showed that men with disabilities who reported higher conformity to self-reliance norms had much worse mental health than non-disabled men with low conformity to self-reliance, as measured in terms of depressive symptoms (PRR: 9.40, 95%CI 7.88, 11.22, p-value<0.001). We found evidence of positive EMM of depressive symptoms by conformity to self-reliance on the additive scale (RERI: 2.84, 95%CI 1.26, 4.42, p-value<0.001). These results provide evidence that high conformity to self-reliance norms exerts a particularly damaging effect on the mental health of men with disabilities. Given that men with disabilities are more likely to rely on help and support from others, these results provide important insights for the delivery of services to men with disability. Elsevier 2019-08-02 /pmc/articles/PMC6700447/ /pubmed/31453312 http://dx.doi.org/10.1016/j.ssmph.2019.100464 Text en © 2019 Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
King, Tania L.
Shields, Marissa
Shakespeare, Tom
Milner, Allison
Kavanagh, Anne
An intersectional approach to understandings of mental health inequalities among men with disability
title An intersectional approach to understandings of mental health inequalities among men with disability
title_full An intersectional approach to understandings of mental health inequalities among men with disability
title_fullStr An intersectional approach to understandings of mental health inequalities among men with disability
title_full_unstemmed An intersectional approach to understandings of mental health inequalities among men with disability
title_short An intersectional approach to understandings of mental health inequalities among men with disability
title_sort intersectional approach to understandings of mental health inequalities among men with disability
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700447/
https://www.ncbi.nlm.nih.gov/pubmed/31453312
http://dx.doi.org/10.1016/j.ssmph.2019.100464
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