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

Abstract

Background Health self-efficacy (the confidence to take care of one’s health) is a key component in ensuring 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. Methods Cross sectional analysis was conducted using data from a convenience sample of African-American men who attended a one-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 socio-demographic characteristics, those reporting financial hardship were 2.91 times (exp(β)=2.91; CI: 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.

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