Haitian Men’s Health and Health Seeking Behavior

Abstract

The notion that earlier medical interventions result in better patient outcomes is a widely held assumption in the medical community that is supported by extensive research. However, the decision to seek medical care in a timely manner is complex, especially in low- and middle-income countries (LMICs). A significant number of deaths in LMICs result from conditions for which effective treatments are available, such as high blood pressure. In Haiti, the greater life expectancy for women compared to men (67 vs. 62) may be par-tially explained by investments into maternal and reproductive services; however, several other factors are likely contributing to this difference. Given the limited research on men’s health and care-seeking behaviors in Haiti, this study was conducted to investigate the factors that influence men’s health-seeking behaviors and overall knowledge of health and disease. The long-term goal of this research is to identify, and implement, effective interventions that promote primary disease prevention by positively influencing the health-seeking behaviors of Haitian men in Jérémie and the Grand’Anse.

Methods
This study was a cross-sectional survey. A structured questionnaire was used to conduct 115 in-depth inter-views with Haitian men recruited from five churches of different denominations equidistant from Jérémie, Haiti. Questions investigated factors pertaining to socioeconomic status, church involvement, household composition, awareness of family and own health, health-seeking behaviors, and levels of knowledge of health and disease. Each participant had the opportunity to receive a blood pressure reading, and health education sessions were conducted at the conclusion of the study.

Results
Mean age was 48 years, average household size was six, and 48% were married. Sixteen percent of men reported having multiple occupations, with 83% engaging in manual labor. Sixty seven percent reported being the primary decision-makers for health care. Sixty three percent had seen a health care provider in the last year; however, 70% had not sought care when sick due to cost (54%) or perceived severity (35%). Men reported they knew an average of 2.2 illnesses or diseases, with HIV/AIDs (30%) and cancer (30%) being the most common. Fifty eight percent of men thought disease and illness are preventable, and 9% believed early care was required for successful treatment. The preferred method of receiving health care information among men included health care provider (HCP) (33%), hospitals (26%), community health workers (22%), church (18%), and radio (18%). Sixty four percent had their blood pressure taken within the past year, and 32% were told that it was high. Only three of the 25 men, who were told their BP was high, reported HTN as a chronic (long-term) disease. Of the 115 men who received a BP measurement as part of the study, 28% had high blood pressure readings (>130/90).

Conclusion
Men in the community of rural Jérémie, Haiti, have limited knowledge of illness and disease, which may stem from insufficient resources being allocated to their health care. The cumulative effect of this may have negatively influenced their understanding of chronic, yet life-threatening, conditions such as high blood pressure. Consequently, a greater emphasis on health education and healthy lifestyle choices could have a substantial impact on not only primary prevention, but early detection and management of diseases as well. Therefore, in order to improve the health of both the men and their family members in this community, novel and targeted approaches to disseminate important health information to these men should be further investigated and readily implemented.