journal of men's health

2012-06-01

Editor's Comments

Ajay Nehra — 2012-06-01

The current issue of the Journal of Men's Health discusses and emphasizes significant contributions on the social determinants related to Men's Health. From a social, civil, cultural, and economic perspective, social determinants are important influencers of Men's Health. It is vitally important that we generate interest in this topic in order to understand how social determinants may affect changes in health care behavior and exposure to environmental hazards that may have a significant detrimental effect on men's health.

Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men

Kisha B. Holden, Brian S. McGregor, Starla H. Blanks, Carlos Mahaffey — 2012-06-01

Abstract: 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.

How prostate cancer patients cope: evaluation and refinement of the Prostate Cancer Patients’ Coping Strategies Questionnaire

Christopher F. Sharpley, Vicki Bitsika, David R.H. Christie — 2012-06-01

Abstract: 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.

The potential influence of masculine identity on health-improving behavior in midlife and older African American men

2012-06-01

Abstract: 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.

Urine and extragenital gonococcal and Chlamydia infections in HIV positive young men who have sex with men (YMSM): enhanced detection of rectal Chlamydia when screening with nucleic acid amplified tests versus cultures

2012-06-01

Abstract: 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.

Sexual and reproductive health issues among rural and urban adolescent boys of eastern India

Subha Ray, Shailendra Kumar Mishra, Bhubon Mohan Das — 2012-06-01

Abstract: 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.

Importance of effect size, control groups, and frequency of use in preventing sexually-transmitted diseases

Brad E. Moore, L. Lee Glenn — 2012-06-01

The recent study by Milhausen et al that was published in the Journal of Men's Health concluded that a condom kit provided by the Kinsey Institute Homework Intervention Strategy (KIHIS) “found significant improvement in condom-use experiences, confidence in the ability to use condoms, self-efficiency for condom use and condom comfort, and reduction in important types of condom problems.” However, the conclusion is not supported by the data in the study, as explained below.

Want of a place to stand: social determinants and men's health

Henrie M. Treadwell, April M.W. Young, Matt T. Rosenberg — 2012-06-01

Around tables where social determinants of health are discussed, men have almost always lacked a seat, and even a place in the room to stand. This, despite the World Health Organization's casting a very wide topical net for dynamics that influence health, defining social determinants as “the conditions in which people are born, grow, live, work, and age” . Growing interest over the last decade in social determinants has yielded careful detail of the vulnerabilities of many groups to economic, civil, cultural, and other institutional realities. Yet, despite its expansive scope and rapid development, the discourse of social determinants has largely overlooked the impact of structural and systemic factors on the health of men.

An intersectional approach to Men's Health

Derek M. Griffith — 2012-06-01

Abstract: Men's lives and health are rooted in opportunity structures that are shaped by race, ethnicity and other characteristics that have important social, political, economic and cultural meaning. Within men's health, there is a need to consider how structural factors and men's socially-defined characteristics affect the relationship between sex, gender and health. The goal of an intersectional approach is to simultaneously examine the social and health effects of several key aspects of identity and context in ways that create a new understanding of these factors and that are a more accurate reflection of the lived experiences of the populations of interest. Despite their promise, intersectional approaches have been criticized for being difficult to operationalize and study systematically. This paper, however, presents a framework for studying the intersection of gender and other identities and characteristics that are relevant for men's health, and explicitly identifies key pathways and stratification variables to guide future research.This framework highlights pathways and ways to think about why race, gender, age and ethnicity affect men's health, and offers a tool for studying the relationship between socially-defined characteristics and men's health. Future research on men's health should begin by recognizing that comparing how men experience and embody masculinities may be most useful when researchers are explicit about their assumptions and theories about what and how socially-defined characteristics intersect with gender in a given national and local context. Research employing an intersectional approach also may elucidate how men of specific population groups create new normative masculinities for themselves.

Social determinants of oral health and disease in U.S. men

Scott L. Tomar — 2012-06-01

Abstract: 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.

Social determinants of cardiovascular disease risk factor presence among rural and urban Black and White men

Rakale Collins Quarells, Jinnan Liu, Sharon K. Davis — 2012-06-01

Abstract: 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.

Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men?

2012-06-01

Abstract: 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.

journal of men's health

Contents

Editor's Comments

Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men

How prostate cancer patients cope: evaluation and refinement of the Prostate Cancer Patients’ Coping Strategies Questionnaire

The potential influence of masculine identity on health-improving behavior in midlife and older African American men

Urine and extragenital gonococcal and Chlamydia infections in HIV positive young men who have sex with men (YMSM): enhanced detection of rectal Chlamydia when screening with nucleic acid amplified tests versus cultures

Sexual and reproductive health issues among rural and urban adolescent boys of eastern India

Importance of effect size, control groups, and frequency of use in preventing sexually-transmitted diseases

Want of a place to stand: social determinants and men's health

An intersectional approach to Men's Health

Social determinants of oral health and disease in U.S. men

Social determinants of cardiovascular disease risk factor presence among rural and urban Black and White men

Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men?