Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men
Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men
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DOI：
10.1007/s11606-010-1481-z
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发表时间：
2010-12-01
影响因子：
5.7
通讯作者：
Corbie-Smith, Giselle
中科院分区：
文献类型：
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作者：
Hammond, Wizdom Powell;Matthews, Derrick;Corbie-Smith, Giselle
背景：男性气质对男性医疗保健用途的贡献引起了公众对健康的日益关注；然而，很少有研究探讨非裔美国男性之间的这种关联，因为他们比非西班牙裔白人男性更经常延迟医疗保健，对男性气质的定义不同，并且报告的医疗不信任程度更高。 目的：研究传统男性气质规范、医疗不信任和预防性卫生服务延误之间的关联。 设计和参与者：使用主要从美国理发店招募的 610 名 20 岁及以上非裔美国男性的数据进行横断面分析。美国北部、南部、中西部和西部地区（2003-2009）。测量：自变量是对自力更生的传统男性气概规范的认可、传统男性气概规范的显着性和医疗不信任。因变量是自我报告的三项预防性健康服务的延误：常规检查、血压筛查和胆固醇筛查。我们控制了社会人口统计学、医疗保健获取和健康状况。结果：最终调整后，更认可自力更生的传统男性气概规范的男性（OR：0.77；95% CI：0.60-0.98）推迟血压筛查的可能性显着降低。当使用较长的血压筛查延迟间隔时，这种关系变得不显着。较高水平的传统男性气质身份显着性与延迟胆固醇筛查的可能性降低相关（OR：0.62；95% CI：0.45-0.86）。对医疗不信任程度较高的非裔美国男性明显更有可能推迟常规检查（OR：2.64；95% CI：1.34-5.20）、血压检查（OR：3.03；95% CI：1.45-6.32）和胆固醇筛查（OR：2.09；95% CI：1.03-4.23）。 结论：与之前的研究相反研究表明，较高的传统男性气质与非洲裔美国男性血压和胆固醇筛查延迟的减少有关。例行检查的延误更多地归因于医疗不信任。利用非裔美国男性将预防性服务利用作为示范的潜力，而不是否认男性气质，并实施政策来减少医疗服务中增加不信任的偏见，可能是消除非裔美国男性医疗保健利用差异的可行策略。
BACKGROUND: 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.OBJECTIVE: To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays.DESIGN AND PARTICIPANTS: 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).MEASUREMENTS: 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.RESULTS: 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).CONCLUSIONS: 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.