'Sexist gender stereotyping reinforces unhealthy societies'

From health books that look like motor manuals to plum-fondling blondes, Dr Alex Scott Samual says health promotion messages should never use images which push gender stereotypes. Why? Because it's unhealthy and that defeats the object.

Why did I squirm when I first saw a Haynes health manual, and when I saw the June 2005 MHF cover showing England footballers holding up these books? (England football manager Sven Goran Ericcson is pictured, right)

And why do I instinctively associate this approach to health education with more obviously unacceptable publications portraying violence or pornography? The use of footballers and car manuals in health education exemplifies gender stereotyping in action. This in turn asserts the acceptability of prevalent masculine gender roles. Violence and pornography involve the acting out of prevalent — if excessive — masculine gender roles.

We are not talking about either/or situations here, where these gender roles are either present or absent: there is a continuum that begins with gender stereotyping in parenting and socialisation (in clothes, in competitive, risky and aggressive behaviours, in male emotional illiteracy) and extends through sexist education (girls don't do engineering), advertising (female 'bits' on hoardings), bullying in the workplace (especially in total institutions like the armed forces) to politics (male-dominated parliaments preside over more wars and more violent societies) and to most aspects of our wellbeing.

In other words, the apparently harmless gender stereotyping represented by health advice in car manuals is but one end of an insidious spectrum of patriarchy which continues to dominate most human societies in the twenty-first century. Unsurprisingly (and paradoxically, given the aim of these manuals) the impact of patriarchy extends to health itself. Our research suggesting links between patriarchy and men's shorter life expectancy has attracted widespread interest (and was the journal's most-downloaded paper in the month of publication).

On the one hand, it might seem pointless to draw attention to phenomena as common around the Cabinet table as in the public bar, and prevalent in virtually all races throughout the world. On the other, such behaviours are potentially preventable through changes in parenting and socialisation, and more effective prevention of the ways in which patriarchy expresses itself in society.

There are, of course, other problems with the car manual approach: I heard on the radio just the other day a woman saying she felt patronised by the way that pink gadgets such as mobile phones and MP3 players are currently being marketed. In the same way, men are arguably being patronised by the inference that they are too stupid to think about their health except when it's disguised as football and cars, while the fact that many men are not attracted by these stereotypes and research suggesting that there are many 'masculinities' that are not characterised by the avoidance of preventive health behaviours is ignored.

It was interesting to see MHF president Ian Banks (MHF, October 2005) defending the manuals in terms of men's tendency to think about their health in a mechanistic way. Quite the contrary: we should be actively seeking to eliminate the kind of misleading, mechanistic thinking that turns our bodies into engines and our health into a commodity to be bought and sold.

The car manual approach to health oversteps the carefully drawn line between, on the one hand, valid attempts to engage difficult-to-reach people through effective social marketing and, on the other, patronising, sexist gender stereotyping which reinforces patriarchal and unhealthy societies.

Dr Alex Scott-Samuel is Senior Lecturer in Public Health at the University of Liverpool. he would like to acknowledge the intellectual contributions of Clare Bambra and Debbi Stanistreet.

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