Indian and Pakistani Men's Accounts of Seeking Medical Help for Cardiac Chest Pain in the United Kingdom: Constructions of Marginalised Masculinity or Another Version of Hegemonic Masculinity?

Ethnicity and pre-hospital care for people with suspected cardiac pain: cross-sectional study

OBJECTIVES

Few studies have investigated the quality of pre-hospital care by ethnicity. We aimed to investigate ethnic differences in pre-hospital ambulance care of patients with suspected cardiac pain.

METHODS

We conducted a cross-sectional analysis of retrospective electronic clinical data for patients with suspected cardiac pain over one year (August 2011 to July 2012) extracted from a single regional ambulance service. This included patient demographic data, clinical measurements, drugs administered and outcomes, such as transportation to hospital or referral to primary care. We used multivariate regression to investigate differences in care by ethnicity comparing non-White with White patients.

RESULTS

There were 7046 patients with suspected cardiac pain, with 4825 who had ethnicity recorded including 4661 (96.6%) White and 164 (3.4%) non-White. After correcting for age, sex, socio-economic status and whether transported to hospital, non-White patients were significantly more likely to have temperature [odds ratio (OR) 2.96, P = 0.007], blood glucose (OR 3.95, P = 0.003), respiratory rate (OR 4.94, P = 0.03) and oxygen saturation (OR 2.43, P = 0.006) recorded. Non-White patients were significantly less likely to be transported to hospital (OR 0.43, P = 0.03).

CONCLUSION

There were significant differences in pre-hospital ambulance care for non-White compared with White patients with suspected cardiac pain. These differences could be due to differences in clinical condition or case-mix, language and cultural barriers, limited understanding of appropriate use of health care services, recording bias or true differences in provider management. Further analysis should involve larger and more complete data sets to explore ethnic differences in greater detail.

Beyond ballistics: expanding our conceptualization of men's health-related help seeking

Although the literature on men's help seeking offers important insights into health service engagement patterns within this population, there remain gaps in our understanding. In addition to insufficient attention to a range of male experiences and a restricted focus on sex-specific or associated diseases, much of the extant work is limited by insufficient attention to how men navigate needs and supports across illness and a narrow conceptualization of the core concept of help seeking. Specifically, as research focuses on masculinity as a determinant of the decision to seek medical help (emphasis on prediction), less is known about how men, as gendered beings, are experiencing help seeking over the course of illness (emphasis on understanding). In this article, it is argued that research on men's help seeking can benefit from the integration of a dynamic conceptualization of help seeking that is considerate of shifting needs and a diversity of supports and which emphasizes the subjective, interactive, and ongoing patterns in how men are perceiving, interpreting, and responding to the challenges of illness.