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This Electronic Thesis Or Dissertation Has Been Downloaded from Explore Bristol Research This electronic thesis or dissertation has been downloaded from Explore Bristol Research, http://research-information.bristol.ac.uk Author: De Viggiani, Nicholas P. A Title: (Un)healthy prison masculinities : theorising men's health in prison General rights Access to the thesis is subject to the Creative Commons Attribution - NonCommercial-No Derivatives 4.0 International Public License. A copy of this may be found at https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode This license sets out your rights and the restrictions that apply to your access to the thesis so it is important you read this before proceeding. Take down policy Some pages of this thesis may have been removed for copyright restrictions prior to having it been deposited in Explore Bristol Research. However, if you have discovered material within the thesis that you consider to be unlawful e.g. breaches of copyright (either yours or that of a third party) or any other law, including but not limited to those relating to patent, trademark, confidentiality, data protection, obscenity, defamation, libel, then please contact [email protected] and include the following information in your message: •Your contact details •Bibliographic details for the item, including a URL •An outline nature of the complaint Your claim will be investigated and, where appropriate, the item in question will be removed from public view as soon as possible. De Viggiani, N. (2003) (Un)healthy prison masculinities: Theoris- ing men’s health in prison. PhD, University of Bristol. We recommend you cite the published version. The publisher’s URL is http://eprints.uwe.ac.uk/16941/ Refereed: No (no note) Disclaimer UWE has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material. UWE makes no representation or warranties of commercial utility, title, or fit- ness for a particular purpose or any other warranty, express or implied in respect of any material deposited. UWE makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights. UWE accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pend- ing investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT. (UN)HEALTHY PRISON MASCULINITIES: THEORISING MEN’S HEALTH IN PRISON Nicholas PA de Viggiani A dissertation submitted to the University of Bristol in accordance with the requirements of the degree of PhD in the Faculty of Social Sciences, School for Policy Studies. September 2003 Wordcount: 79,993 ABSTRACT This thesis explores the interconnections between masculinity, health and prison. It contests reductionist, individualist and biomedical approaches to health care mana gement 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) obser vation, 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 discourse s 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 o f 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 devel oped 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 ‘progr essive 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 futu re prison health policy, in line with the World Health Organisation’s Healthy Prisons philosophy. 2 DEDICATION AND ACKNOWLEDGEMENTS I am indebted to many people who supported me throughout this extensive period of study. In particular, I must thank the prisoners and staff who gave up their time and commitment, making it possible for me to proceed with the research. I would also like to thank my PhD advisors, Professor Lesley Doyal and Dr Sarah Payne for their sensitivity and constructive guidance throug hout the period of study, and Professor Rod Morgan in the Law Department at the University of Bristol, whose enthusiasm and useful contacts helped to translate my initial ideas into reality. I am also immensely grateful to my work colleagues at the Univers ity of the West of England who enabled me to concentrate on completing the PhD. Above all, I am indebted to my family, in particular my wife, Andrea, who supported me throughout the research period with her patience and commitment. This thesis is dedicate d to my son, Joe, who arrived on Christmas Eve 2001. 3 AUTHOR’S DECLARATION I declare that the work in this thesis was carried out in accordance with the Regulations of the University of Bristol. The work was original except where indicated by special re ference in the text and no part of the thesis has been submitted for any other degree. Any views expressed in the dissertation are those of the author and in no way represent those of the University of Bristol. The thesis has not been presented to any ot her university for examination in the United Kingdom or overseas. Nick de Viggiani, September 2003. 4 TABLE OF CONTENTS Page Abstract 2 Dedication and Acknowledgements 3 Author’s Declaration 4 1.0 INTRODUCTION : PRISON, HEALTH AND MASCULINITY 10 A: PRISON, HEALTH AND MASCULINITY: A REVIEW OF THE LITERATURE 2.0 UNHEALTHY PRISON S? EXPLAINING PRISON HEALTH 15 2.1 Introduction 15 2.2 Deprivation and Prisonisation 15 2.3 Importation 21 2.4 Explaining Prison He alth 22 2.5 The State of Prison Health 24 2.5.1 General Health Surveys 24 2.5.2 Physical Health Surveys 26 2.5.3 Mental Health Surveys 26 2.5.4 Suicide and Self Harm 28 2.5.5 Drug Misuse 28 2.5.6 Violence and Bull ying 29 2.5.7 Summary 29 2.6 Determinants of Health in Prisons 30 2.6.1 Deprivation Factors as Determinants of Health 31 2.6.2 Importation Factors as Determinants of Health 33 2.6.3 Summary 34 2.7 Health Policy for Prisons 35 2.7.1 Prison Health Care 35 2.7.2 Healthy Prisons 38 2.8 Conclusion 40 3.0 UNHEALTHY MASCUL INITIES? EXPLAINING MEN’S HEALTH 42 3.1 Introduction 42 3.2 Theories of Masculinity 42 3.2.1 Traditional Perspectives on Masculinity 42 3.2.2 Deconstructing Masculinity 44 3.2.3 Hegemonic Masculinity 47 3.2.4 Compensatory Masculinity 50 3.2.5 Summary 51 3.3 Epidemiology of Men’s Health and Illness 52 3.4 The Biological Basis of Men’s Health 54 3.5 Alternative Explanations for Men’s Health 56 3.5.1 Masculine Role as a Determinant of Health 57 3.5.2 Hegemonic Masculinity and Health 59 3.5.3 Lifestyle, Risk and Masculinity 60 3.5.4 Health Threats and Masculinity 62 3.6 Conclusion 64 4.0 UNHEALTHY PRISON MAS CULINITIES? EXPLAINI NG MEN’S HEALTH IN PRISON 66 4.1 Introduction 66 4.2 The Institutional Basis of Masculinist Ideology 66 4.3 Criminal Masculinities 68 4.4 Prison Masculinities 69 4.4.1 The Masculine Prison Code 69 4.4.2 Hegemonic Prison Masculinities 70 4.5 (Un)healthy Prison Masculinities 76 4.6 Conclusion 77 5 B: THE STUDY 5.0 THE RESEARCH C ONTEXT 80 5.1 Introduction 80 5.2 The Prison Est ate 80 5.3 The Prison Population 82 5.3.1 Demographic Trends 82 5.3.2 Demographic Composition 83 5.4 The ‘Progressive Regime’ 85 5.4.1 Reception and Induction 85 5.4.2 Sentence Plans 85 5.4.3 Incentives and Privi leges 86 5.5 Support for Prisoners 87 5.6 The Research Setting 88 5.6.1 Population 88 5.6.2 Accommodation 89 5.6.3 Education and Employment 90 5.6.4 Recreation, Association and Welfare 91 5.7 Conclusion 92 6.0 RESEARCH METHODO LOGY AND DESIGN 93 6.1 Introduction 93 6.2 Ethnography 93 6.2.1 Realist Ethnography 94 6.2.2 Alternatives to Realism 95 6.3 Achieving Validity and Reflexivity 96 6.4 Research Methodological Standpoi nt 99 6.5 The Research Process 99 6.5.1 Physical Access 99 6.5.2 Social Access 100 6.5.3 Personal Transition 101 6.6 The Formal Data Collection 103 6.6.1 Sampling Approach 104 6.6.2 Triangulation 105 6.6.3 Participant Observation 107 6.6.4 Focus Group Intervention 108 6.6.5 In -depth Interviewing 111 6.7 Data Analysis 113 6.8 Conclusion 119 C: THE RESEARCH FINDINGS 7.0 LIVING UNDER A P ROGRESSIVE REGIME 121 7.1 Introduc tion 121 7.2 Vulnerability and Fear 121 7.3 Visibility/Surveillance 123 7.4 Boredom, ‘Bang -Up’ and Motivation Stagnation 124 7.5 Divide and Rule 127 7.6 Discussion 128 8.0 INMATE -STAFF RELATIONS 131 8.1 Int roduction 131 8.2 The Line Between Cons and Screws 131 8.3 Male/Female Distinctions 132 8.4 Parent -Child Relationship 133 8.5 Censure and Nepotism 135 8.6 Staff Complacency 136 8.7 Discussion 138 6 9.0 PURPOSE, WORTH AND OCCUPATION 140 9.1 Introduction 140 9.2 Idleness and Underemployment 140 9.3 Wage Dependency 141 9.4 Limits to Training 143 9.5 Offending Behaviour Programmes 144 9.6 Preparation for Release? 146 9.7 Dis cussion 148 10.0 SOCIAL RELATION S AMONG INMATES 150 10.1 Introduction 150 10.2 Tension and Transience 150 10.3 Front Management 151 10.3.1 Inmate Banter 152 10.3.2 Physical Recreation and Oneupmanship 153 10.3.
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