Journal of General Internal Medicine

, Volume 25, Issue 12, pp 1300–1308

Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

  • Wizdom Powell Hammond
  • Derrick Matthews
  • Dinushika Mohottige
  • Amma Agyemang
  • Giselle Corbie-Smith
Original Research

Abstract

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.

DESIGN AND PARTICIPANTS

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).

MEASUREMENTS

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.

KEY WORDS

masculinity medical mistrust preventive health services delays African-American men 

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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Wizdom Powell Hammond
    • 1
    • 2
  • Derrick Matthews
    • 1
  • Dinushika Mohottige
    • 3
  • Amma Agyemang
    • 1
  • Giselle Corbie-Smith
    • 4
    • 5
  1. 1.Department of Health Behavior and Health EducationUniversity of North Carolina at Chapel Hill, Gillings School of Global Public HealthChapel HillUSA
  2. 2.UNC Lineberger Comprehensive Cancer CenterChapel HillUSA
  3. 3.UNC School of MedicineChapel HillUSA
  4. 4.Department of EpidemiologyUniversity of North Carolina at Chapel Hill, Gillings School of Global Public HealthChapel HillUSA
  5. 5.Department of Social MedicineUNC School of MedicineChapel HillUSA

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