Exploring men’s health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants

Background: Men’s health is influenced by a complex interplay of social, economic, and
cultural determinants. Understanding how these aspects affect the health of adult cisgender
men in medium and high-complexity healthcare settings is essential for improving healthcare
services and promoting better health outcomes.
Objective: This study aimed to analyze the health status of adult cisgender men in medium
and high-complexity healthcare settings based on social determinants and conditioners.
Methods: This study employed a qualitative design involving 45 adult cisgender men receiving
care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were
conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren
and Whitehead’s Model of Social Determinants of Health using deductive thematic analysis.
Results: Proximal determinants included biological aspects, preventive behaviors,
lifestyle/social life, and aging processes. Intermediate factors included work conditions,
access/utilization of healthcare services/medications, and psychosocial factors. Macro
determinants involved income distribution, power dynamics, resource allocation, health
inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and
structural elements.
Conclusion: The health status of men in medium/high complexity care was profoundly
influenced by structural social determinants. These determinants impacted healthcare
attention, service organization, cultural influences, the reproduction of hegemonic masculinity
patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right
to health. Nursing practices should conduct comprehensive assessments that extend beyond
physical health indicators.