The Impact of Masculinity on Black/African American Men’s Preventive Healthcare Utilization

Black/African American (BAA) men have the lowest life expectancy among other major demographic groups in the United States, with BAA male mortality rates 40% higher than their White male counterparts. Despite known benefits of preventive healthcare utilization, BAA men are 43% more likely to use the emergency department for their usual care. Medical mistrust and religion have been identified as common barriers BAA men face in healthcare utilization with few studies examining how conformity to masculine norms may influence engagement with healthcare. Using the tenets of the Andersen Healthcare Utilization Model, this cross-sectional study of 176 BAA men explores BAA men’s current preventive healthcare practices while examining how predisposing, enabling, and need factors along with masculinity impact BAA men’s preventive healthcare utilization. While it is well known that higher income levels and higher education positively influence healthcare utilization, religious affiliation posed as a buffer to BAA men’s medical mistrust, high conformity to winning, heterosexual self-presentation, and self-reliance are prominent themes impacting BAA men’s engagement with healthcare. As BAA men’s higher conformity to heterosexual self-presentation and self-reliance were associated with a higher likelihood of ER visits or fewer preventive measures used within the past year, higher conformity to winning resulted in higher likelihood of a doctor visit within the past year. While perceptions of the healthcare system must be revised, culturally competent care to improve the patient-provider relationship coupled with an improved understanding of BAA men’s conformity to masculine norms would lead to improved initiatives to decrease the gapping health disparities experienced by BAA men.