Men Of Lower Socioeconomic Status Research Articles

The influence of psychological stress and socioeconomic status on platelet activation in men

Objective: Circulating monocyte- and neutrophil-platelet aggregates are sensitive markers of in vivo platelet activation. Socioeconomic status is inversely associated with risk of coronary heart disease. We assessed the impact of psychological stress on leukocyte-platelet aggregates in men from higher and lower socioeconomic status groups. Methods: Participants were 37 healthy non-smoking men aged 30–59 years, divided by occupation into higher and lower social status groups. Blood was drawn at baseline, immediately following stressful behavioural tasks, and at 30 and 75 min post-stress, and aggregates were analysed using flow cytometry. Cardiovascular and subjective stress responses were also monitored. Results: There were significant increases following stress in monocyte-, neutrophil-, lymphocyte- and total leukocyte-platelet aggregates (all P<0.05). The largest responses were in monocyte-platelet (21% increase) and neutrophil-platelet (16.7% increase) aggregates. Lower socioeconomic status men had greater numbers of leukocyte-platelet aggregates throughout, but the magnitude of stress responses did not vary with social status. The increase in monocyte- and leukocyte-platelet aggregates was associated with systolic blood pressure stress responsivity. Conclusions: Psychological stress induces platelet activation as indexed by leukocyte-platelet aggregates, and correlations with cardiovascular stress reactions suggest that sympathoadrenal responses may be responsible. Platelet activation may be a mechanism through which social position influences cardiovascular disease risk.

Quality of life after a diagnosis of prostate cancer among men of lower socioeconomic status: results from the Veterans Affairs Cancer of the Prostate Outcomes Study

Objectives To evaluate prospectively the health-related and disease-specific quality of life (QOL) at diagnosis and during the first year thereafter for patients with newly diagnosed prostate cancer who received care at Veterans Affairs Medical Centers. Methods Interviewers administered the European Organization for Research and Treatment of Cancer-QOL Questionnaire, a valid and reliable measure of health status, to 140 patients with prostate cancer at baseline (at diagnosis, before the initiation of treatment) and at 3 and 12 months thereafter at five Veterans Affairs Medical Centers. The mean changes from baseline values were analyzed statistically for patients with localized disease stratified by treatment group and separately for patients with metastatic disease. Results Among the 98 men with localized prostate cancer, significant disease-specific QOL changes noted at 3 and 12 months included worsening of urinary and sexual function among men treated with radical prostatectomy or radiotherapy and worsening of urinary function among those who opted for watchful waiting (each P <0.05). Among the 42 men with metastatic prostate cancer, significant decrements in role and social and sexual function were noted at 3 months, but had resolved on average by 12 months of follow-up. Conclusions At 12 months, disease-specific QOL decrements persisted for patients with localized disease, but for patients with metastatic disease, disease-specific QOL appeared to return to near baseline (at diagnosis, before treatment initiation) function. Our study, among the first to assess the QOL at baseline before treatment, provides meaningful information on general treatment effects, which are directly relevant to clinicians when discussing treatment options with patients.

Prolonged elevations in haemostatic and rheological responses following psychological stress in low socioeconomic status men and women

Low socioeconomic status (SES) and psychological stress are associated with increased risk of coronary heart disease, and both may influence haemostatic responses. Von Willebrand factor (vWF), Factor VIII, plasma viscosity, haematocrit, blood viscosity, tissue plasminogen activator (t-PA) and fibrin D-dimer were measured at rest and following stressful tasks in 238 middle-aged British civil servants. SES was defined by grade of employment. Lower SES was associated with higher resting vWF, Factor VIII and plasma viscosity. Psychological stress stimulated increases in haemostatic and rheological factors. Initial stress responses did not vary with SES, but Factor VIII, plasma viscosity and blood viscosity remained more elevated 45 minutes post-stress in lower SES participants. High blood pressure stress reactivity was also associated with greater haemostatic responses. We conclude that lower SES is characterised by more prolonged elevations in procoagulant responses following psychological stress, and that these processes might contribute to increased cardiac risk.

Patterns of use of the female condom after one year of mass marketing.

The female condom is an effective new contraceptive method that can reduce HIV transmission. This study examines use of the female condom after 1 year of its mass marketing and compares this with use of the male condom. It is based on exit interviews conducted among a random sample of male and female customers visiting outlets that sell the female condom. Compared with reported use of the male condom, which was five to eight times as high in nonmarital as in marital partnerships, reported use of the female condom varied less by partnership type (it was twice as high in nonmarital compared with marital partnerships). In marital and regular partnerships, use of the female and the male condom increased with socioeconomic status (SES). In casual partnerships, use of the male condom increased with SES, but use of the female condom was higher for those with lower SES. Men reported higher levels of male condom use than women, but there were no gender differences in use of the female condom. These findings suggest that the largest contribution to HIV protection through use of the female condom may be within marital partnerships and among low SES men and women who engage in casual sex. The absence of gender differentials in use of the female condom suggests that women are able to exert greater control over the use of the female condom than they are over the use of the male condom. However, the overall low levels of female condom use among relatively affluent persons at outlets that sell the female condom indicate that the introduction of the female condom will be resource intensive.

Biosocial aspects of domestic violence.

Domestic violence, defined as acts of verbal abuse and physical violence performed against women by current intimate main partners, was surveyed by means of the Conflict Tactics Scale. We examined the relationships between a biological variable (testosterone level), social variables (demographics, social integration), and behaviour (substance use) and self-reported domestic violence. Forced-entry OLS regression models allowed us to study how social and behavioural variables modified the effects of testosterone on this specific violent behaviour. The sample consisted of 54 men who had a main sexual partner and who identified themselves as Black, White, or Hispanic. The men were recruited from various social-service-agency sites in the area of Miami, Florida, on the basis of their risk factors for HIV/AIDS. The sample can best be described as culturally diverse men of low socioeconomic status who had a main sexual partner. A high percentage of participants reported some level of both verbal and physical aggression towards their partners. Testosterone levels were significantly associated with levels of both verbal aggression and physical violence self-reported by the men. Testosterone level, demographic characteristics, and alcohol consumption contributed to explaining the variance in self-reported verbal and physical abuse. The high heritability of testosterone level and its association with violent behaviour warrant the inclusion of this variable in studies of antisocial and criminal behaviour including domestic violence.

Excess mortality from avoidable and non-avoidable causes in men of low socioeconomic status: a prospective study in Korea

STUDY OBJECTIVEThe objective of this study was to evaluate the magnitude and contributory factors of socioeconomic differentials in mortality in a cohort of Korean male civil servants.DESIGNA prospective observational study...

Understanding Barriers to the Early Detection of Prostate Cancer Among Men of Lower Socioeconomic Status

ABSTRACTObjectives: Prostate cancer accounted for more than 180,000 new cases and almost 40,000 deaths in the United States in 1998. Higher rates of mortality have been noted among racial minorities and lower socioeconomic status groups, primarily because of advanced stage of cancer at presentation. Understanding barriers toward early detection of prostate cancer may help diminish these variations.Materials and Methods: Thirty‐two focus group sessions with individuals of lower socioeconomic status addressed attitudes toward physical examinations, prostate cancer, and sources of health‐care information. Barriers to early detection were identified, based on transcripts that were analyzed using the Health Belief Model.Results: Most men of lower socioeconomic status viewed physical examinations negatively, with barriers including time, monetary costs, negative impressions of the prostate examination, and lack of belief in early detection. Among the minority of men who had had prostate examinations, they typically did so as part of examinations for chronic medical conditions or because of employer requirements for routine check‐ups. The rectal examination was viewed very negatively because of concerns of physical pain, social embarrassment, and uncertain value. Fear and fatalism regarding prostate cancer were expressed by the majority of attendees. With respect to sources of health information, men typically received health‐care information from the media, with television being the most common source. No significant differences in barriers to early detection efforts were observed between focus groups composed of white versus African American poor men.Conclusions: The Health Belief Model provides a framework for evaluating the perceptions of men of lower socioeconomic status toward the early detection of prostate cancer. Negative perceptions regarding physical examinations and skepticism about the value of early detection were major barriers to the early detection of prostate cancer. Targeted strategies directed at each of these barriers are needed to improve the rates of early detection in men of lower socioeconomic status.

Correlates of condom failure in a sexually active cohort of men who have sex with men.

Condom failure (slippage or breakage) has been shown to be associated with HIV seroconversion among men who have sex with men (MSM), but predictors of failure have been poorly elucidated. Of 2592 HIV-seronegative MSM participants in the HIV Network for Prevention Trials (HIVNET) multisite Vaccine Preparedness Study who reported condom use for anal sex in the 6 months before enrollment, condom failure was reported by 16.6%, with failure rates of 2.1/100 episodes of condom usage (2.5 failures/100 episodes for receptive anal sex and 1.9/100 episodes for insertive anal sex). In separate multivariate models evaluating predictors of condom failure reported by the insertive and receptive partners, more frequent condom use was associated with a decreased per-condom failure rate and amphetamine and heavy alcohol use with increased rates in both models. Being employed, having private medical insurance, and using lubricants for >80% of anal sex acts were significantly associated with decreased failure rates in the insertive model. Safer sex counseling should particularly target men of lower socioeconomic status, promote proper and consistent use of condoms with appropriate lubricants, and address the impact of drug use, especially amphetamines and alcohol, on condom failure.

The role of socioeconomic status and serum fatty acids in the relationship between intake of animal foods and cardiovascular risk factors

Little is known regarding the relationship of serum fatty acids to cardiovascular risk factors in Nigerian populations. Civil servants with higher socioeconomic status (SES) in Nigeria appear to be in cultural transition toward a more Westernized lifestyle. For this study the food intakes of 397 civil servants were estimated from two 24-h recalls. Fatty acids in serum total lipids were measured in both absolute weight concentration and percentage composition. Daily meat intake was 43.5 g, and fish intake was 70.5 g. The intakes of meat, eggs, and milk were higher in high SES Nigerians than in low SES Nigerians. The concentration of total fatty acids (TFA, the sum of 12 serum fatty acids) was also higher in high SES men and women, as compared with low SES men and women (2064, 2060, 1831, and 1776 mg/L, respectively). There were significant direct associations between meat intake and serum level of arachidonic acid, and between fish intake and serum levels of eicosapentaenoic acid and docosahexaenoic acid. TFA was positively associated with cholesterol, low-density-lipoprotein cholesterol (LDLc), and triglycerides across gender and SES groups after adjustment for body mass index, fasting insulin level, and age. Nigerian women were compared with two groups of American women. We concluded that fatty acids in absolute weight concentration reflected the amount of fat intake. The level of TFA was directly related to cardiovascular risk factors in Nigerians. Follow-up of such populations in cultural transition can facilitate the understanding of the true roles of animal food intake in the early evolution of atherosclerosis.

Attitudes of African-Americans regarding prostate cancer clinical trials

The purpose of this study was to qualitatively assess attitudes associated with the willingness of African-Americans to participate in prostate cancer clinical trials. Fifty-six African-American males, 40 years of age and older, were recruited from South Central Los Angeles. Respondents were divided into lower or middle socio-economic groups based on education and occupation. Focus group discussions were conducted to assess their knowledge about prostate cancer and willingness to participate in prostate cancer clinical trials. In addition, information was obtained to identify their incentives and barriers towards participating in prostate cancer research. Middle socio-economic respondents expressed a greater willingness to participate in prostate cancer clinical trials than did men of lower socio-economic status. Many indicated that they would be more likely to participate if they were encouraged to do so by a physician or researcher who was viewed as being competent and compassionate. Barriers to participation in prostate cancer clinical trials included concerns about drug toxicity, medical experimentation and distrust of the medical establishment. Endeavors aimed at increasing minority representation in prostate cancer clinical studies should address these issues.

Relationship of hypertension to socioeconomic status in a west African population.

To determine whether hypertension rates were positively related to socioeconomic status (SES) in males in urban northern Nigerian civil servants in order to confirm this relationship previously observed in a southern Nigerian civil servant population which differed in tribal origin, religious practices and diet. Civil servants were recruited from the Sokoto State ministries, Sokoto, Nigeria. Professionals and administrators were designated as higher SES, and clerks and laborers as lower SES. In addition to blood pressure, the height and weight of individuals, as well as their urinary sodium- and potassium-creatinine, were also measured. The age-adjusted occurrence of hypertension (systolic pressure > or = 140 mmHg or diastolic pressure > or = 90 mmHg or current use of hypertension medication) was similar in male higher (n = 155) and lower (n = 255) SES groups aged 25-54, 19.3% and 19.8%, respectively. However, the age-adjusted rate of definite hypertension (systolic pressure > or = 160 mmHg or diastolic pressure > or = 95 mmHg or current use of hypertension medication) was considerably higher in the higher SES than in the lower SES men, 11.2% versus 3.6%. Age-adjusted body mass index (BMI, kg/m2) was higher among the higher than in the lower SES group, 21.4 versus 20.4. Over-night sodium excretion did not differ. Among female civil servants (n = 73) aged 20-44, there were few of higher SES (n = 19) precluding SES-specific analyses. Total and definite hypertension rates among women were 17.2% and 5.5%, respectively. Mean BMI was 22.2. In logistic regression, definite hypertensive status was related to age group, BMI tertile, sodium excretion and SES in men and to sodium excretion in women. Even in this very lean population, the higher risk for hypertension in males of higher SES was confirmed. This was explained, in part, by higher BMI.

Anger and impatience/irritability in patients of low socioeconomic status with acute coronary heart disease.

This case-control study examines the relationship between anger and impatience/irritability and acute coronary heart disease (CHD) in middle-aged men of low socioeconomic status (SES). Subjects included patients with myocardial infarction (MI) (N = 31) or unstable angina (AP) (N = 26), who were compared with hospital controls (N = 26). In separate multivariate analyses for each anger scale, MI was associated with Anger-Out and Impatience/Irritability, particularly in the subgroup of patients who did not have a previous MI. The same factors were associated with AP, but only when this acute ischemic event was not preceded by a MI. No relationship was found between Trait-Anger and Anger-In and either acute ischemic outcome. The results indicate that particularly overt behavioral expression of anger is related to CHD in lower SES patients and that there is similarity in the behavioral factors associated with acute CHD between low- and high-SES men.

The evolutionary psychology of men's coercive sexuality

AbstractPsychological adaptation underlies all human behavior. Thus, sexual coercion by men could either arise from a rape-specific psychological adaptation or it could be a side-effect of a more general psychological adaptation not directly related to rape. Determining the specific environmental cues that men's brains have been designed by selection to process may help us decide which these rival explanations is correct. We examine six testable predictions against existing data: (1) Both coercive and noncoercive will be associated with high levels of sexual arousal and performance in men. (2) Achieving physical control of a sexually unwilling woman will be sexually arousing to men. (3) Young men will be more sexually coercive than older men. (4) Men of low socioeconomic status will likewise be more sexually coercive. (5) A man's motivation to use sexual coercion will be influenced by its effects on social image. (6) Even in long-term relationships men will be motivated to use coercion when their mates show a lack of interest in resistance to sex because these are interpreted as signs of sexual infidelity. Current data support all six predictions and are hence consistent with the rape-specific hypothesis, but this does not eliminate the side-effect hypothesis, which is likewise compatible with the findings, as well as with the further evidence that forced matings increased the fitness of ancestral males during human evolution. We suggest some research that may help decide between the two hypotheses.

Trends in HIV/AIDS behavioural research among homosexual and bisexual men in the United States: 1981–1991

Reviewing the existing research this article traces the behavioral change among homosexual and bisexual men in the US between 1981-91 and discusses behavioral research goals for the future. First detected in 1981 AIDS quickly became associated with the homosexual and bisexual male community. Between 1981 and 1984 the research community made remarkable advances in coming to understand the epidemic. Case-control studies pointed out the high AIDS risk associated with some of the sexual practices of homosexual and bisexual men: multiple partners anonymous partners and unprotected anal intercourse. With the aid of behavioral experts the gay community began conducting an array of information and education programs. In 1983 the Center for Disease Control developed safer sex guidelines which revolved around the use of condoms. From 1984-88 education efforts led to dramatic behavioral changes which led some to believe that AIDS had been conquered among the homosexual and bisexual population. But the AIDS epidemic brought along with it discrimination against gays. Calls for HIV counseling and testing intensified. As the epidemic moves into its second decade researchers have noticed a relapse into unsafe sexual practices. Researchers have also found that the incidence of HIV has not decreased among special subgroups of the homosexual and bisexual community: younger men who recently became sexually active blacks and Hispanics men of lower socioeconomic status those who life outside large urban centers and those who do not identify with the gay lifestyle. For this decade behavioral research goals include maintaining the existing educational programs and revising them as new developments necessitate and working towards long-term maintenance of behavioral change.

Measuring socioeconomic mortality differentials over time

Using 1973 Current Population Survey data matched to 1973-1978 Social Security mortality records, this study measures the relationship between the income and education of men and their subsequent mortality. The estimated relationships are compared with socioeconomic mortality differentials found by Kitagawa and Hauser in their study of 1960 census-death certificate matched data. The comparison suggests that there has been no improvement in the relative mortality experience of low socioeconomic status men. More generally, the article discusses how Social Security data could be used to monitor, on a continual basis, our progress toward eradicating significant mortality differentials in the United States.