Financial Hardship, Unmet Medical Need, and Health Self-Efficacy Among African American Men

• Published in: Health education & behavior 2015-06, Vol.42 (3), p.285-292
• Main Authors: Tucker-Seeley, Reginald D., Mitchell, Jamie A., Shires, Deirdre A., Modlin, Charles S.
• Format: Article
• Language: English
• Subjects: Adult; African Americans; African Americans - ethnology; African Americans - statistics & numerical data; Aged; Brief Report; Correlation; Costs; Cross-Sectional Studies; Educational Attainment; Health Behavior; Health care; Health Insurance; Health Needs; Health Services Accessibility - economics; Humans; Income; Male; Males; Marital Status; Men; Middle Aged; Ohio; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - statistics & numerical data; Personal finance; Poverty - statistics & numerical data; Regression (Statistics); Self Efficacy; Socioeconomic Factors; Socioeconomic Status; Statistical Analysis; Surveys
• ISSN: 1090-1981; 1552-6127
• DOI: 10.1177/1090198114557125

Background. Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Method. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast. Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p < .05), more likely to report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Conclusion. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy.