When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data show that even after adjusting for biometrically measured health differences, working-age (40–59 years) men report poorer health when they are unemployed, and women (age 40+) and pension-age men (age 60+) report poorer health when they live without household earners. Life-history interviews show parallel patterns: When their economic circumstance is not troubled, individuals regularly minimize health concerns; conversely, when they have a troubled livelihood, individuals draw on poor health to explain it. When women and men cannot perform idealized gendered practices in the family, poor health becomes a tool to reduce the resulting cognitive dissonance. Poor health narratives recast perceived gender failures to an individualized, biological explanation. Our study illustrates how the epidemiological context can be a resource that forestalls a redefinition of gender norms when the gender order is in crisis.

当男人和女人无法获得理想化的经济供给和依赖的性别形式时，他们如何理解这种感知到的失败？在本文中，我们假设健康状况不佳的叙述可以作为一种性别工具来理解生计不足，即使这种不足可归因于结构性条件。我们借鉴了南非中老年农村人的调查和生活史访谈数据。调查数据显示，即使在调整了生物特征测量的健康差异后，工作年龄（40-59 岁）男性在失业时报告的健康状况较差，女性（40 岁以上）和退休年龄男性（60 岁以上）报告当他们没有家庭收入者时，他们的健康状况会更差。生活史访谈显示出相似的模式：当他们的经济环境没有问题时，个人经常尽量减少健康问题；相反，当他们的生计陷入困境时，个人会利用健康状况不佳来解释这一点。当女性和男性无法在家庭中进行理想化的性别化做法时，健康状况不佳成为减少由此产生的认知失调的工具。糟糕的健康叙述将感知到的性别失败重新定义为个性化的生物学解释。我们的研究说明了流行病学背景如何成为一种资源，在性别秩序处于危机时阻止重新定义性别规范。糟糕的健康叙述将感知到的性别失败重新定义为个性化的生物学解释。我们的研究说明了流行病学背景如何成为一种资源，在性别秩序处于危机时阻止重新定义性别规范。糟糕的健康叙述将感知到的性别失败重新定义为个性化的生物学解释。我们的研究说明了流行病学背景如何成为一种资源，在性别秩序处于危机时阻止重新定义性别规范。