title: Health seeking behavior for lower urinary tract symptoms in black men.
abstract: OBJECTIVE
  The clinical manifestations of benign prostatic hyperplasia that are more likely to bring black men in for care have not been well characterized. We examined associations between lower urinary tract symptom severity measures and subsequent health care seeking behavior in a population based sample of black men.
  
  
  METHODS
  In 2000, 165 black men from Genesee County, Michigan who were 40 to 79 years old without a history of prostate cancer/surgery provided information on lower urinary tract symptoms and health care seeking behaviors. The associations between physician visits regarding lower urinary tract symptoms and symptom frequency, perceived bother, impact on daily activities and quality of life were examined, controlling for age and sociodemographic characteristics.
  
  
  RESULTS
  Overall 22.2% of men sought medical advice for lower urinary tract symptoms. Men with moderate/severe symptom severity and associated bother had 4.9 and 3.0-fold increased odds, respectively, of having sought medical care for their symptoms compared to those with mild/no symptom severity or bother. Greater increases in physician visits were observed for increases in benign prostatic hyperplasia impact (OR 5.7, 95% CI 1.9-17.1), quality of life (OR 5.2, 95% CI 2.2-12.2) and worsening symptoms (OR 3.8, 95% CI 1.6-8.7). Health care seeking was associated with irritative and obstructive symptom severity (OR 1.4, 95% CI 1.2-1.6 and OR 1.2, 95% CI 1.1-1.3, respectively).
  
  
  CONCLUSIONS
  In this population based study of black American men we found that worsening urinary symptoms, associated bother, impact and quality of life were significantly associated with health care seeking behavior. Irritative symptom severity was most highly associated with health care seeking behavior. Further evaluations are necessary to determine whether racial differences exist in health care seeking behavior for lower urinary tract symptoms.
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan 48109-0759, USA. asarma@umich.edu
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Sarma
authors.forename: Lauren
authors.initials: L
authors.lastname: Wallner
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Dunn
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011470:Prostatic Hyperplasia / Q000628:therapy*; D053448:Prostatism / Q000628:therapy*