by MaryAlice Bitts-Jackson
Sorry, men in the Western world, but you don’t have the best track record when it comes to health care. Multiple studies reveal that you are harder to get into the doctor’s office and less likely to effectively manage chronic health conditions. So how can health-care providers inspire male patients to, um, “man up” in terms of their health?
Research on Peruvian men by Assistant Professor of Anthropology Amalia Pesantes and Izzy Ferrazza '24 (anthropology, health studies) points to an element of masculine identity in Latin America that could help health-care providers worldwide to inspire better health outcomes in male patients. The team has published and presented the results, and Ferrazza recently shared findings from a forthcoming second paper at an international conference in Colombia.
Pesantes, a medical anthropologist, studies health inequalities in vulnerable populations. Knowing that literature about masculinity and health behavior in less-wealthy countries is scarce, she hoped to gain insights into the ways that the Peruvian health-care system could be improved to better meet men’s needs. She chose to study Peruvian men with Type 2 diabetes.
Pesantes selected male diabetics for her study because of the seismic lifestyle changes that typically accompany a Type 2 diabetes diagnosis. Patients must understand and accept the importance of ongoing, consistent care—and they must follow through. Because male patients in general are prone to poorer management of chronic conditions, male diabetics are especially vulnerable to serious, even fatal, complications of this progressive condition. The professor traveled to Peru in summer 2022 and interviewed 18 men who’d been living with diagnosed Type 2 diabetes for at least one year. All were insured through Peru’s national insurance plan. Most were married, with an average of three children each. Some lived in Lima, where a wide variety of health-care options are available, and others, in Pucallpa, where those options were significantly less.
Back on campus, Pesantes and Ferrazza analyzed and coded the translated interview transcripts. The interviewees indicated that partners and children were key to helping them keep on track—an expected finding. And another theme emerged: Asked what motivated them to stay healthy and do the day-to-day work of managing their illness, the men indicated that their roles as fathers (and, in later life, as grandfathers) were key motivators in maintaining their health.
“It was something I hadn’t anticipated,” Pesantes says, noting that while motherhood has long been recognized as a transformative force and galvanizing factor in a woman’s identity and life, the biological and social role of fatherhood in health-behavior contexts is understudied.
As Pesantes notes, in Latin American context, fatherhood is not only a source of profound emotional connection but also an important aspect of adult gender identity. The interviewees directly connected the set of social expectations placed on men to provide, protect and care for children, and the emotions of fatherhood, to their daily health choices—in some cases, at the direct urging of their health practitioners. In other words, their paternal obligations caused worry when they felt their health was deteriorating and kept them on track when they felt they were managing their disease sufficiently. This insight could help health-care providers effectively motivate patients to be vigilant and consistent about their health care by appealing to their fatherly duties and love.
Pesantes and Ferrazza co-published their findings in the journal Frontiers in Clinical Diabetes and Healthcare, and Ferrazza presented findings at the 2023 Society for Applied Anthropology conference. A second paper, focused on the role family members take in diabetes management, is now under review. The student-faculty team is expanding the research to Type 2 diabetes care in Central Pennsylvania.
In early November, Ferrazza traveled solo to Cali, Colombia, to present findings at the World Social Marketing Conference. She spoke and answered questions for roughly 30 minutes about the role of family engagement in diabetes management. “It was a huge accomplishment for me, to be able to attend a conference of this level as an undergraduate researcher and also have the opportunity to present my own research,” says Ferrazza, who found herself in the company of Ph.D. candidates, postdoc researchers, professors and CEOs of social marketing companies and organizations.
Now, Ferrazza is readying for a third conference presentation, in 2024. Pesantes, who’s also working with students on transcripts of interviews with leprosy patients in Nepal, couldn’t be prouder. “I think it’s so important that Dickinson encourages faculty members to not only think about their own research but also to engage students in the process,” she says.
All of these opportunities and learning experiences are preparing Ferazza to pursue a master’s in public health and then attend medical school. “I am extremely grateful for the opportunities my undergraduate research with Professor Pesantes has given me, and I will never forget what I have learned," she says.
Published November 13, 2023