Implications of critical race theory for Aboriginal and Torres Strait Islander men's health
Authors: Anthony Merlino, Kootsy Canuto, James A Smith
Journal: The Lancet Global Health (2021)

Since 2020, the global public health community, spurred by the Black Lives Matter movement, has increasingly asked itself hard questions concerning health equity. Advancing such conversations, Eileen Yam and colleagues (April, 2021)1Yam EA Silva M Ranganathan M White J Hope TM Ford CL Time to take critical race theory seriously: moving beyond a colour-blind gender lens in global health.Lancet Glob Health. 2021; 9: e389-e390Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar compellingly argue that critical race theory, and especially intersectionality, must more firmly support public health action aiming to address the nexus between gender oppression and global health outcomes. We contend that women-focused public health is not the only discipline currently neglecting critical race theory. We believe a greater focus on intersectionality within the global men's health community is equally imperative. By definition, men's health has traditionally treated gender as its most fundamental category. However, this framing has generated research that is unattuned to more subtle drivers of health and has reinforced simplistic, binary conceptualisations of gender. Symptomatically, appeals to better address interconnections between health, masculinities, and cultural identities have started to emerge.2Smith JA Watkins DC Griffith DM Equity, gender and health: new directions for global men's health promotion.Health Promot J Austr. 2020; 31: 161-165Crossref PubMed Scopus (19) Google Scholar Studies have shown, for example, that understanding these interconnections illuminates public health opportunities with Aboriginal and Torres Strait Islander men, the First Nations peoples of Australia.3Smith JA Merlino A Christie B et al.'Dudes are meant to be tough as nails': the complex nexus between masculinities, culture and health literacy from the perspective of young Aboriginal and Torres Strait Islander males — implications for policy and practice.Am J Mens Health. 2020; 141557988320936121Crossref Scopus (12) Google Scholar, 4Canuto K Wittert G Harfield S Brown A "I feel more comfortable speaking to a male": Aboriginal and Torres Strait Islander men's discourse on utilizing primary health care services.Int J Equity Health. 2018; 17: 185Crossref PubMed Scopus (20) Google Scholar Intersectionality often remains ignored in men's health, despite its potential to "improve health equity outcomes".5Merlino A Smith JA Adams M et al.What do we know about the nexus between culture, age, gender and health literacy? Implications for improving the health and wellbeing of young indigenous males.Int J Men's Soc Comm Health. 2020; 3: 46-57Crossref Scopus (5) Google Scholar In 2020, the organisation Global Action on Men's Health reported that by "failing to adopt an intersectional approach" it appears to international public health communities "that all men are equally privileged and powerful and therefore not deserving of attention".6Baker P From the margins to the mainstream: advocating the inclusion of men's health in policy. Global Action on Men's Health, London2020http://gamh.org/wp-content/uploads/2020/06/From-the-Margins-to-The-Mainstream-Report.pdfDate accessed: February 16, 2021Google Scholar We therefore argue that emphasising intersectionality within men's health is crucial to ensure the discipline remains relevant. This attention to intersectionality must extend to the national and subnational contexts discussed by Yam and colleagues. Listening to, and genuinely engaging with, Aboriginal and Torres Strait Islander men, for example, must be a key priority for men's health in Australia.4Canuto K Wittert G Harfield S Brown A "I feel more comfortable speaking to a male": Aboriginal and Torres Strait Islander men's discourse on utilizing primary health care services.Int J Equity Health. 2018; 17: 185Crossref PubMed Scopus (20) Google Scholar From this foundation, researchers, policy makers, and practitioners can work collaboratively with these communities to enact public health approaches that respond to the links between health, gender, and culture. Yam and colleagues also note the importance of recognising additional social categories, such as sexuality, which intersect with gender and culture to influence health outcomes. Men's health initiatives must do the same. Indeed, we should explicitly ask: what social categories warrant closer attention to promote Aboriginal and Torres Strait Islander men's health? Although whole-population approaches can support many broad-scale public health responses, greater attention is necessary regarding the interconnections between masculinities and culture, ethnicity, and race. As our world changes, so too must our approaches to Aboriginal and Torres Strait Islander men's health. We declare no competing interests. This publication was supported by the National Health and Medical Research Council Emerging Leadership 1 Investigator grant to KC (grant number APP1175214). The authors are also supported in undertaking health research by Masonic Charities Trust through the Freemasons Centre for Male Health and Wellbeing. Time to take critical race theory seriously: moving beyond a colour-blind gender lens in global healthIn 2020, as worldwide protests demanded racial justice, the COVID-19 pandemic shed a stark light on racial inequities in global health: one need look no further than the disproportionate burden shouldered by Black and other racial minority groups in the Americas and Europe.1 Yet, despite the purported racial reckoning of the moment, the global health community has been slow to consciously centre race in our work. This seeming racial inertia persists despite fervent advocacy and conceptual rigour around addressing gender inequity, even in the face of ample awareness of the intertwined disadvantages faced worldwide by women who are racial minorities. Full-Text PDF Open Access