Masculine Beliefs, Parental Communication, and Male Adolescents' Health Care Use

Abstract

OBJECTIVES-Male adolescents frequently become disconnected from health care, especially as they get older, which limits physicians' abilities to address their health needs and results in missed opportunities to connect them to the health care system as they enter adulthood. In this study we tested the ability of modifiable (beliefs about masculinity, parental communication, sex education, and health insurance) and nonmodifiable (age, race/ethnicity, and region of residence) factors to prospectively predict health care use by male adolescents. PATIENTS AND METHODS-We conducted a prospective analysis of data from 1677 male participants aged 15 to 19 years who completed the National Survey of Adolescent Males, a household probability survey conducted throughout the United States in 1988 (wave 1, participation rate: 74%) and in 1990-1991 (wave 2, follow-up rate: 89%). We present percentages and adjusted relative risks of the factors that predict male adolescents' self-report of a physical examination by a regular provider in the past year measured at wave 2.RESULTS-On average, 1067 (66%) of 1677 male adolescents at wave 2 reported having a physical examination within the last year. Factors associated with a lower likelihood of a physical examination included living in the South, Midwest, and West; being older in age; and holding more traditional masculine beliefs. Factors associated with a higher likelihood of a physical examination included communicating about reproductive health with both parents and being insured. Male adolescents who were sexually active or engaged in ≥2 other risk behaviors had neither a higher nor lower likelihood of a physical examination.CONCLUSIONS-Efforts to enhance male adolescents' health through health care should include work to modify masculine stereotypes, improve mothers' and fathers' communication about health with their sons, expand health insurance coverage, and identify interventions to connect male adolescents at increased risk for health problems with health care. Two modifiable factors that may influence adolescent male health care use have been largely ignored in the research literature. First, although parent-teen communication has been shown to be an important contributor to adolescent health, the relationship between parental communication and access to care for sons has received little attention. Second, the way in which men are socialized in the United States (eg, to be tough, competitive, and inexpressive), defined as beliefs about masculinity, has been shown to influence adult men's health care use 24-26 but has not been examined in adolescence.The National Survey of Adolescent Males (NSAM) provides a unique opportunity to address gaps in our knowledge. The main objective of this prospective study is to test the combined influence of modifiable and non-modifiable factors, organized around Andersen's Behavioral Model of Health Services Use framework, to predict the report of health care use by male adolescents. We also specifically focus on the relationship amo...

Adolescents’ Beliefs about Preferred Resources for Help Vary Depending on the Health Issue

“…The way in which men and women are socialized in the United States (e.g., men are taught to be tough, competitive, and inexpressive, whereas women are taught to be sensitive, expressive, and emotional) may contribute to our findings about gender. In fact, Marcell et al found that male adolescents who hold more traditional beliefs are less likely to have a physical examination compared to males who hold more neutral beliefs [16]. Together these findings support the need to identify methods to increase males' resource networks and acceptance of help-seeking.…”

Male Adolescent Sexual and Reproductive Health Care

“…Young men might also hold more traditional masculine beliefs that preclude them from seeking care despite having symptoms. 138,139 In addition, the components of young men's sexual/reproductive health care have been poorly defined and have historically received little attention. Unlike females, who have historically received bundled sexual/reproductive health care as part of gynecologic examinations, birth control visits, and prenatal care, 140 this is not typically true for young men.…”

Adolescent and Young Adult Male Health: A Review

“…Increase the number of primary care settings that implement evidence-based alcohol screening and brief intervention SA- 13 Reduce past-month use of illicit substances SA- 14 Reduce the proportion of persons engaging in binge drinking of alcoholic beverages SA- 18 Reduce steroid use among adolescents Sexual and reproductive health FP-9 Increase the proportion of adolescents aged 17 yr and under who have never had sexual intercourse FP-9. 2 Increase the proportion of male adolescents aged 15 to 17 yr who have never had sexual intercourse FP-9.…”

“…11,12 Among adolescents and young adult males, masculine beliefs have not only been associated with poor sexual health outcomes, but also poorer mental health outcomes and lower levels of engagement with health services. [13][14][15][16] Thus masculinity has implications for both engaging young men in health care and for maximizing their health status.…”

“…Care-seeking and access also vary as a function of adherence to conventional masculine values, with less care-seeking and lower access among young men with stronger masculine values. 14,15 Chronic Illness…”