Racial disparities in erectile dysfunction among participants in the California Men's Health Study.
BACKGROUND
The burden of erectile dysfunction (ED) among different racial and ethnic groups is unclear, in part, because prior studies have not included all four major racial and ethnic groups in the same population-based sample.


OBJECTIVE
To determine the prevalence and odds of ED among all four major racial and ethnic groups after adjustment for demographic, medical, socioeconomic, and lifestyle characteristics.


METHODS
This cross-sectional study was conducted using data from men, aged 45-69 years, without a diagnosis of prostate cancer (N = 78,445), who completed questionnaires as part of the California Men's Health Study, a large multiethnic cohort study with detailed demographic, medical and, socioeconomic data.


METHODS
Erectile dysfunction measured by a previously validated four-level response question.


RESULTS
The overall prevalence of ED by age category was 13%, 24%, and 44% for men aged 45-49 years, 50 and 59 years, and 60-69 years, respectively. In a multivariable model, relative to white men, Hispanic (OR 1.05, 95% CI 0.99, 1.12), Asian (OR 1.1, 95% CI 1.02, 1.19), and other men (OR 1.13, 95% CI 1.06, 1.1.21) had increased odds of moderate-severe ED, while black men were less likely to report moderate to severe ED (OR 0.86, 95% CI 0.81, 0.92). Black (OR 0.54, 95% CI 0.48, 0.61) and Asian men (OR 0.91, 95% CI 0.80, 1.04) were less likely to have severe ED after adjustment for age, socioeconomic status, medical co-morbidities, and lifestyle characteristics.


CONCLUSIONS
These data demonstrate that the prevalence of ED among different racial and ethnic groups is likely the result of complex phenomena and depends upon the interplay of socioeconomic, demographic, medical, cultural, and lifestyle characteristics. After accounting for these factors, these data suggest that Asian and black men are less likely to have severe ED relative to white men.
University of California, San Francisco, Department of Urology, San Francisco, CA 94143, USA. smithjf@urology.ucsf.edu
James F
JF
Smith
Bette J
BJ
Caan
Barbara
B
Sternfeld
Reina
R
Haque
Charles P
CP
Quesenberry
Virginia P
VP
Quinn
Jun
J
Shan
Thomas J
TJ
Walsh
Tom F
TF
Lue
Steven J
SJ
Jacobsen
Stephen K
SK
Van den Eeden
D000368:Aged; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups; D012720:Severity of Illness Index