Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, USA.
J Gen Intern Med. 2010 Dec;25(12):1300-8. doi: 10.1007/s11606-010-1481-z. Epub 2010 Aug 17.
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.
To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays.
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).
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.
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).
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.
男子气概对男性保健使用的影响引起了公众健康的关注；然而，很少有研究调查过非裔美国男性的这种关联，他们更经常延迟医疗保健，对男子气概有不同的定义，并且比非西班牙裔白人男性报告更高水平的医疗不信任。
检验传统男子气概规范、医疗不信任与预防性保健服务延迟之间的关联。
使用主要从美国北部、南部、中西部和西部地区的理发店招募的 610 名 20 岁及以上非裔美国男性的数据进行横断面分析（2003-2009 年）。
自变量为对自力更生、传统男子气概规范凸显程度的传统男子气概规范的认可和医疗不信任。因变量是三种预防性保健服务的自我报告延迟：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。
经过最终调整，对自力更生的传统男子气概规范认可度较高的男性（OR：0.77；95%CI：0.60-0.98），进行血压筛查的可能性显著降低。当使用更长的 BP 筛查延迟间隔时，这种关系变得不显著。传统男子气概认同水平较高与降低胆固醇筛查延迟的可能性相关（OR：0.62；95%CI：0.45-0.86）。医疗不信任程度较高的非裔美国男性更有可能延迟常规检查（OR：2.64；95%CI：1.34-5.20）、血压（OR：3.03；95%CI：1.45-6.32）和胆固醇筛查（OR：2.09；95%CI：1.03-4.23）。
与之前的研究相反，较高的传统男子气概与非裔美国男性的血压和胆固醇筛查延迟减少有关。常规检查的延迟更多归因于医疗不信任。在非裔美国男性有可能将预防性服务的利用框架构建为一种展示，而不是对男子气概的否认，并实施减少增加不信任的医疗保健提供中的偏见的政策的基础上，可能是消除非裔美国男性医疗保健利用差距的可行策略。
