Coal to swole: A survey of anabolic steroid use and muscularity concerns in coalfield areas of Wales

BACKGROUND: Growing male anabolic steroid use is often framed as symptomatic of a post-industrial masculinity crisis, but little quantitative evidence exists for this account. We examine whether steroid use is associated with geographic exposure to industrial decline, namely historical coal mining, and whether any association is mediated by masculine norms. METHODS: We fielded a quota-sampled survey of 18-49 year-old men in Wales (N = 1425). Data were geo-linked to the extent of historic coal mining locally to respondents. Generalised linear mixed models were fitted to test our hypotheses. RESULTS: Steroid use (odds ratio = 1.99, 1.10-3.60), but not body image (B = 1.06, -2.02-4.13), was positively associated with mining extent. However, this was not mediated by conformity to masculine norms. DISCUSSION: While use of steroids is more common in former mining areas, this is not due to more prevalent body image issues nor mediated by masculine norms. Thus, accounts of a post-industrial 'thwarted masculinity' do not fit the data. Steroid use in post-industrial areas is an issue for public health and these communities may benefit from targeted interventions to reduce risk of harms.

https://doi.org/10.1016/j.healthplace.2025.103456