The Journal of the National Medical Association Reports Three Studies: The Lack of PSA Test Awareness among Black Men; Ethnic Disparities in Stroke Prevention, and the Mistrust of Health Care System
WASHINGTON, June 30 -- More than one-third of African-American men in the U.S have never heard of a Prostate- Specific Antigen (PSA) test, and more than half had never had a PSA test, according to an article in the July issue of the Journal of the National Medical Association (JNMA).
The study, “Awareness and Use of the Prostate-Specific Antigen Test among African American Men,” showed that 37 percent of Black men had not heard of a PSA test and 52 percent had not taken a PSA test. Louie Ross, Ph.D and a colleague from the Centers for Disease Control and Prevention (CDC), analyzed data from a sample of 736 non-Hispanic African-American men aged 45 or older who participated in the National Health Interview Survey in 2000.
The PSA test measures the level of a protein (Prostate- Specific Antigen) in the blood. Very high PSA levels may suggest prostate cancer. Lack of awareness exists despite evidence that African-American men have a greater burden of prostate cancer than whites and other racial and ethnic groups. In the US black men have about a 60 percent higher incidence and more than twice the number of deaths from this disease when compared to white men.
Their results showed that rural black men and those men with lower levels of income and education appear to be the least informed about the test and have the lowest levels of PSA test use. Additionally, single, never-married African-American men had very low percentages for both having heard of the PSA test and ever being tested.
“Black men should talk with their doctors about prostate cancer risk and whether they should be screened for this disease,” says Ross. “The lower level of awareness suggests that the group with the highest burden may be the least informed about this disease.”
Ethnic Disparities in Stroke Surgery
Ethnic disparities in stroke prevention surgery persist, according to investigator Richard Gillum, M.D. at the Center for Disease Control and Prevention’s National Center for Health Statistics, who analyzed data from the US Centers for Medicare and Medicaid Services for patients whose ethnicity was documented and who had under gone Carotid Endarterectomy between the years 1990 and 2000.
The study, “Cartoid Endarterectomy (CEA) in Older Women and Men in the United States: Trends in Ethnic Disparities,” compared the rates of carotid endarterectmony undergone by European Americans, African Americans and Hispanic Americans. CEA is surgery that removes blockages from the carotid arteries in the neck. The two arteries supply the brain with blood and oxygen. If fatty deposits block the carotid artery, blood supply to the brain is compromised and a patient may have a stroke.
Gillum found that while rates of CEA increased in all men and women 65 and older in the study period, the rates of European Americans were higher that those of African Americans, confirming prior studies on CEA and similar trends in cardiovascular surgery and diagnostic procedures.
Mistrust of Health Care System is Pervasive Among African Americans
The study, “The Legacy of Tuskegee and Trust in Medical Care: Is Tuskegee Responsible for Race Differences in Mistrust of Medical Care?” showed that only 41 percent of 378 white and black survey respondents have heard of the study, which was carried out for 40 years by the U.S. Public Health Service on men who had contracted syphilis. However, more than 76 percent of Black respondents believed such a study could occur today compared to 47 percent of whites, indicating a pervasive mistrust of health institutions among African Americans.
“We often think that Tuskegee is the reason for mistrust among African Americans, say Thomas LeVeist, Ph.D., director of Johns Hopkins Bloomberg School of Public Health’s Center for Health Disparities Solutions and co-author of the study. ”This study shows that mistrust is part of a broader skepticism of institutions, including health care. For African Americans in this study, Tuskegee was confirmation of things that believed could happen to them now" said Dwayne Brandon, Ph.D., the study’s lead author.
"Public health specialists looking for solutions to disparities thus need to look beyond Tuskegee. The study, in fact, found that being of African American descent could significantly predict mistrust, more than gender, education, age, income and insurance status. Current experiences and a general understanding of history, especially racism and encounters between African American and institutions, plays a stronger role in creating mistrust of the health care system.
The full text of these articles can be viewed on the National Medical Association’s (NMA) web site http://www.namnet.org/JNMA Journal Articles.
The Journal of the National Medical Association was established in 1895 and is published monthly. The NMA is the oldest and largest medical association representing the interest of African American physicians and the patients they serve.
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