Hiding Symptoms: Men's Perception of Health and Access to Care in Rural Thailand

Men's health in rural Thailand goes unspoken literally and figuratively by both men in the community and health service providers and is not well understood. Our qualitative study focused on how rural men perceive health and access health care services in Northeast Thailand.

We selected four villages in Nang Rong district on the criteria of distance to hospital, SES, gender of health director, and migration. We conducted 40 in-depth interviews with men in the chosen villages, along with local health service providers, men's partners and traditional healers using purposive sampling. Our questions focused on the perception of rural men's health status and care-seeking behavior. Additionally, we conducted 8 focus group discussions. The interviews were transcribed and the data were coded and analyzed.

The study was funded as part of a larger National Science Foundation project on social behavior. The human subjects review board of the University of Washington and Mahidol University (Thailand) approved the study.

We found rural Thai men 1) have less health capital and communication about health than women in Nang Rong; 2) are concerned about their health and risky behaviors but need a catalytic event to spur any behavior change; 3) often wait until their illness is unbearable before seeking treatment; and 4) frequently refuse to speak directly to service providers.

Our study implicates the social construction of Thai male identity inhibits positive health behavior and access to health care services. Thai men's silence about health needs explains much of the gap in men's health programming.