Racial Disparities in Erectile Dysfunction among Participants in the California Men's Health Study

Introduction. The burden of erectile dysfunction (ED) among different racial and ethnic groups is unclear, in part, because prior studies have not included all four major racial and ethnic groups in the same population-based sample. Aim. To determine the prevalence and odds of ED among all four major racial and ethnic groups after adjustment for demographic, medical, socioeconomic, and lifestyle characteristics. Methods. This cross-sectional study was conducted using data from men, aged 45-69 years, without a diagnosis of prostate cancer (N = 78,445), who completed questionnaires as part of the California Men's Health Study, a large multiethnic cohort study with detailed demographic, medical and, socioeconomic data. Main Outcome Measure. Erectile dysfunction measured by a previously validated four-level response question. Results. The overall prevalence of ED by age category was 13%, 24%, and 44% for men aged 45-49 years, 50 and 59 years, and 60-69 years, respectively. In a multivariable model, relative to white men, Hispanic (OR 1.05, 95% CI 0.99, 1.12), Asian (OR 1.1, 95% CI 1.02, 1.19), and other men (OR 1.13, 95% CI 1.06, 1.1.21) had increased odds of moderate-severe ED, while black men were less likely to report moderate to severe ED (OR 0.86, 95% CI 0.81, 0.92). Black (OR 0.54, 95% CI 0.48, 0.61) and Asian men (OR 0.91, 95% CI 0.80, 1.04) were less likely to have severe ED after adjustment for age, socioeconomic status, medical co-morbidities, and lifestyle characteristics. Conclusion. These data demonstrate that the prevalence of ED among different racial and ethnic groups is likely the result of complex phenomena and depends upon the interplay of socioeconomic, demographic, medical, cultural, and lifestyle characteristics. After accounting for these factors, these data suggest that Asian and black men are less likely to have severe ED relative to white men. Smith JF, Caan BJ, Sternfeld B, Haque R, Quesenberry CP, Jr, Quinn VP, Shan J, Walsh TJ, Lue TF, Jacobsen SJ, and Van Den Eeden SK. Racial disparities in erectile dysfunction among participants in the California men's health study. J Sex Med 2009;6:3433-3439.