title: Getting Black Men to Undergo Prostate Cancer Screening: The Role of Social Capital.
abstract: Despite higher rates of prostate cancer-related mortality and later stage of prostate cancer diagnosis, Black/African American men are significantly less likely than non-Hispanic White men to use early detection screening tools, like prostate-specific antigen (PSA) testing for prostate cancer. Lower screening rates may be due, in part, to controversy over the value of prostate cancer screenings as part of routine preventive care for men, but Black men represent a high-risk group for prostate cancer that may still benefit from PSA testing. Exploring the role of social factors that might be associated with PSA testing can increase knowledge of what might promote screening behaviors for prostate cancer and other health conditions for which Black men are at high risk. Using multilevel logistic regression, this study analyzed self-report lifetime use of PSA test for 829 Black men older than 45 years across 381 Philadelphia census tracts. This study included individual demographic and aggregated social capital data from the Public Health Management Corporation's 2004, 2006, and 2008 waves of the Community Health Database, and sociodemographic characteristics from the 2000 U.S. Census. Each unit increase in community participation was associated with a 3 to 3.5 times greater likelihood of having had a PSA test (odds ratio = 3.35). Findings suggest that structural forms of social capital may play a role in screening behaviors for Black men in Philadelphia. A better understanding of the mechanism underlying the link between social capital and screening behaviors can inform how researchers and interventionists develop tools to promote screening for those who need it.
authors.affiliation: School of Medicine, University of Pennsylvania, Philadelphia, PA, USA ldean@post.harvard.edu.
authors.forename: Lorraine T
authors.initials: LT
authors.lastname: Dean
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.affiliation: School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Camille
authors.initials: C
authors.lastname: Zubrinsky Charles
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000367:Age Factors; D044383:Black People; D003256:Community Participation; D006306:Health Surveys; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D015143:Philadelphia / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000517:prevention & control*; D066270:Social Capital; D001741:Black or African American
chemical_list: D017430:Prostate-Specific Antigen
keywords: Black/African American men; Philadelphia; community participation; prostate cancer; prostate-specific antigen (PSA); screening; social capital