(Un)healthy prison masculinities : theorising men's health in prison
This thesis explores the interconnections between masculinity, health and prison. It contests reductionist, individualist and biomedical approaches to health care management in prisons and challenges gender-blindness within criminology and social science where masculinities have been overlooked as key factors of prison culture and organisation. The research set out to explore how masculinities manifest at institutional, social and cultural levels in prison as key determinants of health. The study was conducted in an enhanced wing of an adult male training prison in Southern England. A reflexive ethnographic approach was used, comprising sustained (non-participant)observation, focus group interviewing, and in-depth, semi-structured interviews with thirty-five inmates and four prison officers. The research revealed how prison masculinities were produced and performed by inmates and prison staff, and through the discourses and practices of the prison regime. They were manifested at social and organisational levels as key determinants of health – as ‘deprivations’ associated with imprisonment and as ‘importation factors’ reflecting inmates pre-prison health status. Values of the institution and those of inmates and staff combined to create a pervasively ‘masculine’ atmosphere and culture, which adversely affected the physical and mental health of many prisoners. This thesis recommends that health policy for prisons is developed and organised with consideration to issues of gender and power. The masculine ideology that underpinned the organisational and social fabric of the prison in this study was evident in the attitudes and behaviours of inmates and staff and in the ‘progressive regime’ advocated by the Prison Service. This research shows that a broad, holistic and ‘gendered’ view of prison health can provide alternative insight into men’s health in prisons, and therefore offer a positive and productive way forward for future prison health policy, in line with the World Health Organisation’s Healthy Prisons philosophy.