title: Healthcare practices among blacks and whites with urinary tract symptoms.
abstract: BACKGROUND
  The reasons for African-American men to seek care for lower urinary care symptoms has not been determined due to sparse population-based data.
  
  
  OBJECTIVE
  Our study examines the solicitation and receipt of medical care for urinary symptoms among racially oversampled elderly urban and rural cohort of African Americans and whites.
  
  
  METHODS
  Longitudinal analyses were conducted on five North Carolina counties through the Piedmont Health Survey of the Elderly Established Populations for the Epidemiological Study of the Elderly. In 1994, the analytic cohort included 482 African Americans and 407 whites; by 1998, 249 and 222, respectively.
  
  
  RESULTS
  In 1994, 49.4% of African Americans presented with lower urinary tract symptoms compared to 56.8% of whites. By 1998, these percentages increased to 60.6% and 70.3%, respectively. African Americans reported more interference with activities of daily living than whites. African Americans were less likely than whites to have regular digital rectal exams (DRE) and were more likely to have never received a DRE at all. Additionally, elders with less educational attainment, those who smoked, those who delayed care quite often and those who used less-experienced physicians were less likely to receive regular DREs.
  
  
  CONCLUSIONS
  Poor health behavior has the greatest impact on healthcare seeking for lower urinary tract symptoms. These health behavior risk factors are systemic of a lack of health education. Increases in health education among African Americans regarding lower urinary tract symptoms may close the racial disparity in healthcare-seeking behaviors.
authors: The Institute for Health, Social, and Community Research, Raleigh, NC 27601, USA. howardd@shawu.edu
authors: Daniel L
authors: DL
authors: Howard
authors: Bennett G
authors: BG
authors: Edwards
authors: Kimberly
authors: K
authors: Whitehead
authors: M Ahinee
authors: MA
authors: Amamoo
authors: Paul A
authors: PA
authors: Godley
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003469:Culture; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D014481:United States; D014551:Urinary Tract / Q000473:pathology; D014570:Urologic Diseases / Q000175:diagnosis* / Q000208:ethnology*; D044465:White People / Q000523:psychology*