Cesaro Bruna Campos De, Dos Santos Helen Barbosa, da Silva Francisco Norberto Moreira
Secretaria Estadual de Saúde do Rio Grande do Sul, Porto Alegre (RS), Brasil.
Ministério da Saúde, Área Técnica de Saúde do Homem, Brasília (DF), Brasil.
Rev Panam Salud Publica. 2018 Dec 27;42:e119. doi: 10.26633/RPSP.2018.119. eCollection 2018.
The present article problematizes the incorporation of masculinities as a dimension to propel management strategies within the Brazilian National Policy of Comprehensive Men's Health Care (PNAISH). A close reading of masculinities as perceived through their intersectional character may contribute to improving the present context of review of this policy, especially considering that sociocultural characteristics that are essentially Brazilian, such as social inequality and racism, are directly associated with the high morbidity and mortality rates affecting black, young, and poor men as a result of urban violence. It becomes clear that the discourses that view men as subjects that seek health care services only in the presence of worsening symptoms do not recognize the role of social markers of difference, such as social class and race, in producing health inequities. Intersectionality provides a view of health care access as dependent on the territory where men move and on the (social, political) means that influence the recognition of men as rightful subjects. Given that certain masculinities are invisible within the arena of public health care policies, a deeper reading regarding masculinity and health is proposed from a post-structuralist perspective, as a means of thinking and doing men's health. Finally, the article also describes aspects that are essential for the review of the guidelines and policies aimed at this population.
本文对将男性气质纳入巴西国家男性综合医疗保健政策（PNAISH）以推动管理策略的做法提出了质疑。通过男性气质的交叉特征来仔细审视男性气质，可能有助于改善该政策目前的审查背景，特别是考虑到巴西特有的社会文化特征，如社会不平等和种族主义，与城市暴力导致的黑人、青年和贫困男性的高发病率和死亡率直接相关。很明显，那些认为男性只有在症状恶化时才寻求医疗服务的观点，没有认识到社会差异标记，如社会阶层和种族，在产生健康不平等方面所起的作用。交叉性理论认为，获得医疗保健取决于男性所处的地域以及影响将男性视为合法主体的认可的（社会、政治）手段。鉴于某些男性气质在公共卫生保健政策领域中是无形的，本文从后结构主义视角提出了关于男性气质与健康的更深入解读，作为一种思考和开展男性健康工作的方式。最后，本文还描述了审查针对这一人群的指导方针和政策所必需的方面。
