Gender Difference in Response to Preventative Health Care

Gender Differences in Response to Preventive Health Care Maggie Buchta, Hans Carlson, Carrie Eisele, Brennan Harvey, & Jenna Reishus Luther College December 2008 Psychology of Health and Illness Introduction Health care in the United States today is largely associated with treating symptoms of illness or disease once a problem has already developed. This method is usually referred to as tertiary prevention. Although it is less effective than primary medicine, which is aimed at early detection and prevention of illness, tertiary treatment is widely favored in the United States’ health care system (Sanderson & Vertovec, 2004). However, according to the American Heart Association American Heart Association, 2008), prevention is more beneficial to patients than expensive medical interventions, and it is more cost effective (American Heart Association, 2008). The AHA believes that “basic preventive health care services should be an integral part of an equitable, comprehensive health care plan, accessible to all” (American Heart Association, 2008). To that end, it is necessary that people complete regular health screens that aid in early detection and help to maintain good health. However, for various reasons, many people avoid these preventive measures. Luther College recently implemented a 3-step mandate to better the health of Luther College’s faculty and staff. This mandate helped to better understand current health risks of those covered by Luther College’s insurance policy. The plan includes a Health Risk Appraisal questionnaire, a blood screening, and a physical examination given by the faculty member’s own doctor. If these three steps are not completed every two years, a $25 increase is placed on their monthly premium. This extra measure was added to ensure that Luther’s faculty and staff are doing everything they can to prevent illness and disease. Even with the penalty of $25 per month for noncompliance, many of Luther’s faculty and staff are choosing not to complete all three steps of the policy. Objectives The purpose of the study was evaluate Luther College’s faculty and staff completion (or non-completion) of the new health mandate and also to better understand reason’s for non-participation.
Methods & Participants
Luther College is working to “slow down our increased health care spending” and “guide people towards a healthier lifestyle” through a recently approved mandate (Putnam & Smith, 2008). This policy requires all those covered by Luther College’s health insurance to have a blood screening, fill out a health risk assessment on a Web site called WorldDoc, and have a physical assessment completed by a physician who will review the patient’s blood work every two years in order to avoid a $25 increase in monthly premiums (Putnam & Smith, 2008). All three items are free on even years.
Our group’s interest in this new policy came about when there was talk that not all of those under Luther College’s health insurance were willing to take these preventive measures to avoid the $25 increase in monthly premiums. We wanted to know who these individuals were, with specific attention paid to their gender, and why they were not willing to go through this process.
Participants For our research, we asked all of Luther College’s faculty and staff to fill out a survey which our group created with questions pertaining to this new requirement of the college. We had responses from 154 men and 214 women of various ethnicities and ages ranging from 22 to 73 years old.
Procedure Our group wanted to learn more about the new proposal passed by Luther College, so we elected one of our group members to interview Director of Wellness, Greg Lonning. Lonning, along with the Health Care Council, helped to get the employee health care proposal passed by the administration. He has a wealth of information on the topic, and he had some questions that he also wanted answered. We then drafted a survey, comprised of questions pertaining to the blood screenings, the physical assessment, the online health risk assessment, and various individual health behavior questions. The questions allowed the respondents to give us their opinions about the now policy, and their responses allowed our group to understand the current opinions and health behaviors of Luther College’s faculty and staff. We then sent the survey electronically to the Human Subjects Review Board to be approved. After being approved, we e-mailed our survey to 648 Luther faculty and staff; we had 386 responses to the survey. We then used the data to look for consistent trends among the collected responses.
Measures
7 questions regarding participants opinion for each of the following three: physical exam, blood screening, and health risk assessment.
Effective in promoting good health.
Effective in early detection of illness and disease.
Convenient
Necessary for good health.
Helpful to staying healthy.
Something I would be likely to do, even without a potential health insurance increase of $25/month.
Something I am comfortable doing.
Hypotheses
Males would have a lower rating in all three sections of the survey.
Physical: Female participants would be more apt to participate in the physical and therefore, would rate the benefits higher than men.
Blood Screening: Female participants would be more willing to receive a blood screening than male participants.
Health Risk Assessment: These ratings would be fairly similar among males and females because it is taken in the context of a health facility.
Results When looking into the results we found based on gender, the differences between the male and female subjects of our survey were as predicted. The women who took our survey had a higher average rating on every single question as compared to the men (See figures below). The largest disparity between men and women occurred when the subjects were asked whether they would perform the three tasks without the insurance increase. On average, the female subjects rated this question approximately half a point higher (on a 4 point scale) in each of the three sections. We found that the men and women had similar views when it came to whether these three procedures helped to promote health, and if they aided in early detection, but the women still rated these slightly higher. We ran a one way ANOVA and using the significance level of .05, found a significant difference between men and women in 6 of the 7 questions regarding the physical examination. The only one that did not yield a significant difference was the question of the effectiveness of the physical in early detection. Men and women both agreed that this was helpful. We ran another one way ANOVA regarding the blood screening and found a significant difference between men and women in all seven questions. Finally, we ran a one way ANOVA regarding the health risk assessment and found a significant difference between men and women in 4 of the 7 questions. The three questions that did not yield a significant difference between men and women were, the effectiveness of the HRA in promoting good health, the HRA convenience, and HRA being something the subjects are comfortable doing. Conclusions
References
Matterne, U. & Sieverding, M. (2008). What Makes Men Attend Early Detection Cancer Screenings? An
Investigation into the Roles of Cues to Action. International Journal of Men’s Health , Vol 7(1), 3-20.
Näslindh-Ylispangar, A., Sihvonen, M. Kekki, P. (2008). Health, utilization of health services, ‘core’ information, and reasons for non-participation: a triangulation study amongst non-respondents. Journal of Clinical Nursing , 17, 2972-2978.
Owens, G. (2008). Gender differences in health care expenditures, resource, utilization, and quality of care. Journal of Managed Care Pharmacy , 14, 2-6. Health Line (2008). Physical Examination Health Article. Retrieved 17 November 2008 from http://www.healthline.com/galecontent/physical-examination-1/
American Heart Association (2008). Preventive Health Care. Retrieved 15 Nov.
2008 from <www.americanheart.org/presenter.jhtml?identifier=4734>.
Rudolph, L., Deitchman, S., Dervin, K. (2001). Integrating Occupational Health Services and Occupational Prevention Services. American Journal of Industrial Medicine , Vol 40(3), 307-318.
Sanderson, C., Vertovec, T. (Ed.). (2004). Health Psychology . New Jersey: John Wiley & Sons, Inc.
(2007, April 12). Preventive Care Services . Retrieved December 6, 2008, from Blue Cross Blue Shield of Minnesota: St. Olaf College: http://stolaf.edu/services/hr/benefits/index.html .
The results between the two groups of participants, males and females, were mostly as predicted. However, the rating of comfort towards the health risk assessment was unpredicted by our group. Both groups of participants rated their comfort level with completing the health risk assessment significantly higher than we had predicted. Based on the complaints that have gone on around campus about the health risk assessment in regards to how uncomfortable faculty and staff feel about putting their health information online, we found the statistics on this question to be unexpected. The comfort towards the health risk assessment was ranked higher than all other questions related to the health risk assessment. This could be because the complaints were only representative of a few individuals on campus. It could also be because the health risk assessment does not involve direct one-on-one contact with another person, automatically getting rid of a potentially uncomfortable interaction, when one must talk openly about their health. The results from this study suggest some directions for future research. Attention should be drawn to taking a look at the ways to improve the current health care policy and portray its’ importance within the minds of the faculty and staff on Luther College. At the present time, surveys and studies involving gender differences in response to preventive health care measures have been done on a few college campuses. Taking a deeper look into the reasoning behind the males’ resistance to these measures and the females complaints about the procedure can provide future research options for similar situations and techniques.

Gender Difference in Response to Preventative Health Care

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Gender Difference in Response to Preventative Health Care — Presentation Transcript