Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men.
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.


METHODS
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).


METHODS
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.
Hammond
Wizdom Powell
WP
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. wizdom.powell@unc.edu
Matthews
Derrick
D
Mohottige
Dinushika
D
Agyemang
Amma
A
Corbie-Smith
Giselle
G
D000328:Adult; D001741:Black or African American / Q000208:ethnology* / Q000523:psychology*; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D057228:Masculinity; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011314:Preventive Health Services; D012111:Residence Characteristics; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult