Journal of Mens Health最新文献

The social determinants unique to African-American men's health contribute to limited access and utilization of health and mental health care services and can have a deleterious effect on their overall health and well-being. There is a need to examine the complex issues concerning African-American men's help-seeking behaviors relative to mental health concerns. Current research estimates that African-American men are approximately 30% more likely to report having a mental illness compared to non-Hispanic Whites and are less likely to receive proper diagnosis and treatment. There is an extensive body of research that supports the view that women are more likely to seek help for psychological problems than African-American men. This review explores the psychosocial, environmental and socio-cultural factors that influence mental health help-seeking behavior among African-American men and explains the urgency to engage various stakeholders to pursue effective behavioral strategies. Research literature concerning the relationships between social determinants of health and their mental health help-seeking behaviors is reviewed and discussed in this paper. The article illustrates the need for mental health providers and researchers to establish feasible, culturally competent prevention and intervention strategies to increase help seeking behavior among African-American men, thereby contributing to the reduction of mental health disparities.

Background

Adolescent boys in India constitute a large group with unmet sexual and reproductive health (SRH) needs. However, their problems and needs are poorly addressed by researchers and policy makers. Socio-demographic factors are considered to enrich the SRH knowledge and awareness of adolescents and to shape their behaviours. The present study investigated SRH awareness, attitudes and practices among adolescent males by place of residence and age. Furthermore, the study aimed to understand the socio-demographic correlates of SRH awareness and behaviours among them.

Methods

The study sample constituted 220 adolescent boys from rural (101) and urban (119) areas. These boys all belonged to a Bengali-speaking Hindu ethnic group. Data on socio-demographic characteristics, SRH awareness, attitudes and practices were collected using pretested questionnaires.

Results

Rural and urban boys differed significantly (P < 0.05) in their sexual attitudes and practices. Place of residence and exposure to media were found to be significant predictors of sexual activity among adolescents. Urban boys were significantly less likely to be involved in penetrative sexual activity (OR = 0.42) compared to rural ones.

Conclusion

Awareness of SRH issues was found to be associated with responsible sexual behaviours among adolescents. Media, along with schools, had an important role in educating adolescent boys on SRH issues and in promoting healthy sexual behaviours among them.

Objective

To gain a greater understanding of masculinity and its potential influence on health-improving behavior in midlife and older African American (AA) men.

Methods

Forty-nine AA men aged 45–88 years completed in-depth interviews to ascertain their perspectives on masculinity, how masculine identity in this population might be influenced by age and physical activity level, or how it might impact health. Taped interviews were transcribed and organized for analysis with common themes identified by multiple researchers.

Results

Most often cited attributes of someone considered “manly” included a leader of a family/household, provider, strong work ethic, and masculine physique. Terms such as responsible, principled, and man of character also described the typical man. Potential negative and positive influences of manhood on health included avoiding health care appointments and being a good example to children/others, respectively. Themes associated with age-related changes in manhood were acceptance and being more health conscious. Elements associated with how manhood was influenced by AA race included stress and perseverance.

Conclusions

Midlife and older AA men in this study primarily expressed views of masculinity that fit the traditional perception of manhood. However, the attributes revealed, such as family provider, responsibility, self-reliance, and perseverance, were viewed as having potential for both negative and positive impacts on health and health-improving behaviors. It will be essential to integrate these prevalent attributes of masculine identity into health promotion interventions such that they facilitate positive behavior change while not competing with gender role norms among this vulnerable group of men.

Oral diseases are among the most prevalent chronic diseases in the United States (U.S.), disproportionately affect males, and exhibit profound disparities among socioeconomic and ethnic groups. The potentially modifiable proximal risk factors for these diseases are relatively small in number though difficult to modify at the individual level, and largely are the same as those associated with increased risk for the major chronic diseases affecting Americans. This paper gives a brief overview of disparities in oral health in the U.S., presents a conceptual model of social determinants involved in one of the most common oral diseases, and discusses the implications of a social determinant perspective for oral health policy and research.

Background

Multiple studies have been done on adult men who have sex with men (MSM), but no studies have shown the rates of extragenital site sexually transmitted infections (STIs) among HIV positive young men who have sex with men (YMSM). The objective of this study was to document the rates of extragenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infection among HIV positive YMSM while conducting a validity study for the use of nucleic acid amplified tests (NAATs), to detect extragenital GC and CT.

Methods

Behaviorally infected HIV positive YMSM were enrolled in this study from one urban adolescent HIV clinic, and were screened for urine and extragenital site GC and CT over a 2 year period. Samples from these sites (pharyngeal and rectal) were tested for GC and CT using both traditional culture media and NAAT technology. Urine was tested using only NAAT.

Results

Of 67 screenings, 36% (n = 24) yielded at least one positive, and 69% of participants (18/26) had at least one positive GC or CT test result during the study period. Of those with at least one positive result, 89% (16/18) had at least one extragenital site infection. Urine testing was positive in 11% (2/18) of those with a corresponding extragenital site infection. None of the extragenital CT infections detected by NAATs were detected by culture, and only 38% (5/13) of the extragenital GC infections detected by NAATs were detected by culture.

Conclusions

Use of NAATs for extragenital STI screening yielded more confirmed positive results than did traditional cultures. By use of NAATs, the majority of routinely screened HIV positive YMSM in this sample was found to have an STI at an extragenital site.

Background

conventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of socioeconomic position (SEP) among African Americans. Specifically, this paper investigated the joint interactive effects of SEP and racial discrimination on the odds of depression among African Americans.

Methods

racial discrimination was measured using two measures, major and everyday discrimination. Study objectives were achieved using data from the National Survey of American Life, which included a nationally representative sample of African Americans (n = 3570). Logistic regression models were used to estimate the effects of SEP and racial discrimination on the odds of depression.

Results

reports of racial discrimination were associated with increased risk of depression among African American men who possessed greater levels of education and income. Among African American men, significant, positive interactions were observed between education and experiences of major discrimination, which were associated with greater odds of depression (P = 0.02). Additionally, there were positive interactions between income and both measures of racial discrimination (income x everyday discrimination, P = 0.013; income x major discrimination, P = 0.02), which were associated with increased odds of depression (P = 0.02).

Conclusions

it is possible that experiences of racial discrimination could, in part, diminish the effects of increased SEP among African American men.

Background

Social determinants of health are increasingly being addressed as a causal factor for disparities in health. The purpose of this study was to assess the effects of specified social determinants of health on cardiovascular disease (CVD) clinical risk factors in Black and White men residing in rural and urban Georgia.

Methods

Self-report data were collected on a total of 548 Black and White men aged >18 years from 2004–2005. Data were derived from a random telephone survey. Separate logistic regression models were conducted to examine the effects of specified social determinants on the presence of two or more CVD clinical risk factors. In addition, differences within rural and urban men were also assessed.

Results

Lower education, unemployment, lower income, and higher general stress were all significantly related to the presence of two or more CVD clinical risk factors. As expected, the covariates of age, race, and residential location also played a significant role in cardiovascular health. Rural men were nearly twice as likely to have two or more CVD risk factors compared to urban men (P <0.01). Models examining location separately found urban Black men to be 2.6 times as likely to have more than two CVD risk factors (P <0.02).

Conclusion

Findings reveal social determinants are associated with CVD risk factor differences between Black and White men and between rural and urban residents. It is important for policymakers and the healthcare industry to address these social determinants of health as they try to improve the health of the people they serve.

Background

Prostate cancer (PCa) patients suffer from identifiable stressors that may cause them anxiety and/or depression. In a previous study, an initial exploration of the ways in which PCa patients seek to cope with those stressors was described. However, several methodological limitations prevented direct comparisons of the relative effectiveness of patients’ coping strategies. To further investigate this issue, a standardised format was used to present the most commonly-used coping strategies to a new sample of PCa patients and to compare the effectiveness of those strategies.

Methods

A total of 147 PCa patients completed a background questionnaire and the Prostate Cancer Patients’ Coping Strategies Questionnaire (which includes 16 common stressors experienced by PCa patients plus a list of Coping Strategies for each stressor item).

Results

The most common stressors included physical, emotional, cognitive and relationship aspects of PCa. Although the coping strategies most used were “Just accepted it” and “Exercise/Activity”, these were not the most effective strategies. Data indicated that the strategies that received higher ratings of Overall Clinical Efficacy were either specific to particular stressors, which were clearly defined, or more general to less well-defined stressors. The strategies that were rated as “Very successful” by participants who used them were also a mixture of specific and general responses.

Conclusion

PCa patients’ ability to respond effectively to the kinds of stressors they encounter appears to be dependent upon the specificity of the stressor itself, with more general responses being made to stressors that were less specific in their effects upon patients. Implications for assessment of PCa patients’ ability to cope with the stress they experience, and methods of developing individualised coping strategies, are discussed.