Relationships between men's scores on sub scales of the Conformity to Masculine Norms Inventory-46 (CMNI-46) and the Health Behavior Inventory-20 (HBI-20) are complex. Some subscales appear to act as risk factors, as predicted by the Gender Role Strain Paradigm (GRSP), and others as protective buffers, as predicted by positive masculinity and social norms theories. We compared the relative strengths of these two theories in explaining the buffering effects by assessing the roles of two theorized positive aspects of the traditional masculine role (general self-efficacy and emotional stability) and a key construct of social norms theory (perceptions of men's normative health behaviors) in mediating the relationships between CMNI-46 and HBI-20. We evaluated a multiple mediator model of these relationships with 585 men who responded to an online survey. Emotional stability was not a mediator, but general self-efficacy and perceptions of normative health behaviors together partially mediated the relationship between CMNI-46 and HBI-20, transmitting a protective buffering effect. However, an examination of the individual mediating effects indicated that perceptions of normative health behaviors better accounted for the buffering effect. The results are discussed in terms of future research, implications for health care practitioners, and limitations.
Keywords: men's health behaviors, conformity to masculine norms, positive masculinity, social norms, multiple mediator model
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Recent research estimates that half of all morbidity and mortality may be attributable to behaviors that put one's health at risk (Mokdad, Marks, Stroup, & Gerberding, 2004). Gender is the strongest socio-demographic predictor of health behaviors, with men engaging in more risky and fewer health-promoting behaviors than women (Courtenay, 2000a, 2000b). Men compare unfavorably with women on such health practices as spending time with their physicians (Kandrack, Grant & Segall, 1991), eating a nutritional diet (Garfield, Isacco, & Rogers, 2008), having proper sleep habits (Garfield et al., 2008), exercising (Garfield et al., 2008), managing weight (Galuska, Serdula, Pamuk, Siegal, & Byers, 1996), engaging in preventive health behaviors (Kandrack et al., 1991), limiting alcohol and tobacco consumption (Garfield et al., 2008), and foregoing violent behavior (Centers for Disease Control, 2004), risky behaviors such as unsafe driving and "daredevil" acts (Centers for Disease Control, 2004), and risky sexual practices (Levant & Brooks, eds., 1997). The poor health practices of American men as compared to American women appear to be a major contributor to their lower life expectancy of 5.2 years (Courtenay, 2000b; Minino, Heron, Murphy, & Kocharek, 2007), especially since biological factors are relatively weak predictors of gender differences in morbidity and mortality (Courtenay, 2000a). Research on the variables that influence men's health behaviors is thus of considerable importance (Addis et al., 2007; Baker, 2001; Bonhomme, 2007).
The Gender Role Strain Paradigm (GRSP), the perspective used in the present study, has been described as one of the most influential theoretical paradigms for investigating aspects of men's health (Cochran, 2010; Wong, Steinfeldt, Speight, & Hickman, 2010). It is a social constructionist perspective developed within the tradition of quantitative empirical psychology (Levant, 2011; Pleck, 1995), sharing fundamental views of the origin and maintenance of gender roles...