Race and Ethnicity Have a Significant Effect on the Disclosure of Erectile Function: An Analysis of NHANES Response Patterns

Abstract

Objectives: To determine if race/ethnicity impacts disclosure of erectile function.

Methods: Data on age, education, erectile function, and past medical history were obtained from the National Health and Nutrition Examination Survey. Response rates to a single survey question regarding erectile function were calculated and compared between race/ethnicity groups. Two subgroups were created by excluding non-responders to questions about hypertension and prostate disease to control for overall non-responsiveness and urologic health literacy.

Results: Our final cohort consisted of 4,694 men. Overall, 3,898 (83.0%) responded to the erectile function survey question. Race/ethnicity was a significant factor in overall response rates to the Erectile function question: 85.2% in non-hispanic white, 82.3% in non-hispanic black, 81.2% in hispanic, and 64.8% in other subjects (P<.001). Race/ethnicity remained significantly associated with responses rates among both subgroups. Multivariate logistic regression using the prostate disease subgroup showed that non-hispanic black (AOR = 2.02, 95% CI 1.01-4.03, P = .047) and hispanic (AOR = 2.18, 95% CI 1.19-4.00, P = .012) participants were significantly more likely to not disclose their erectile function compared to non-hispanic white participants after controlling for age and education.

Conclusion: Non-hispanic black and hispanic men were significantly less likely to disclose their erectile function than non-hispanic white men in an anonymous, nationally representative survey. A better understanding of how cultural differences affect reporting of erectile function is important in improving patient care and accurately studying outcomes of urological procedures.