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- Title
Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men.
- Authors
Hammond, Wizdom; Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle; Hammond, Wizdom Powell
- Abstract
<bold>Background: </bold>The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men.<bold>Objective: </bold>To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays.<bold>Design and Participants: </bold>A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009).<bold>Measurements: </bold>Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status.<bold>Results: </bold>After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23).<bold>Conclusions: </bold>Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men's potential to frame preventive services utilization as a demonstration, as opposed to, denial of masculinity and implementing policies to reduce biases in healthcare delivery that increase mistrust, may be viable strategies to eliminate disparities in African-American male healthcare utilization.
- Subjects
MEDICAL care of African Americans; MASCULINITY; PUBLIC health; PREVENTIVE health services; CROSS-sectional method; SELF-reliance; BLOOD pressure measurement; CHOLESTEROL
- Publication
JGIM: Journal of General Internal Medicine, 2010, Vol 25, Issue 12, p1300
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-010-1481-z