Objectives: To explore how masculinity influences white, Indian and Pakistani men's interpretation of cardiac chest pain and the decision to seek or delay seeking medical help.
Method: Semi-structured interviews were conducted with 36 men of white ethnicity (UK ancestry) and 20 men of South Asian ethnicity (Indian or Pakistani ancestry) who had a confirmed diagnosis of acute myocardial infarction or angina pectoris. The study setting was two coronary care units and eight cardiology wards situated in two teaching hospitals in the North of England. All interviews were tape-recorded, transcribed verbatim and analysed using a constant comparative method.
Results: Displaying a high threshold for pain and discomfort was a masculine attribute valued by white men in the study but not by the Indian and Pakistani men. White men's fears of being seen to be weak contributed to delays in seeking medical treatment and led to reluctance to disclose symptoms to others. Indian and Pakistani men emphasized wisdom, education and responsibility for the family and their own health as more valued masculine attributes, and this contributed to a greater willingness to seek medical help.
Conclusion: Masculinity had a differing role in white and South Asian men's decisions to seek or delay seeking medical help for chest pain. The study supports the development of coronary heart disease policy and practice that acknowledges men's gender as an important determinant of their health behaviour, but illustrates that there is no probable single appropriate approach to tackling the delay in how men seek treatment for chest pain.