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Determinants and policy implications of male circumcision in the United States.
Am J Public Health. 2009 Jan; 99(1):138-45.AJ

Abstract

OBJECTIVE

We sought to determine whether lack of state Medicaid coverage for infant male circumcision correlates with lower circumcision rates.

METHODS

We used data from the Nationwide Inpatient Sample on 417 282 male newborns to calculate hospital-level circumcision rates. We used weighted multiple regression to correlate hospital circumcision rates with hospital-level predictors and state Medicaid coverage of circumcision.

RESULTS

The mean neonatal male circumcision rate was 55.9%. When we controlled for other factors, hospitals in states in which Medicaid covers routine male circumcision had circumcision rates that were 24 percentage points higher than did hospitals in states without such coverage (P<.001). Hospitals serving greater proportions of Hispanic patients had lower circumcision rates; this was not true of hospitals serving more African Americans. Medicaid coverage had a smaller effect on circumcision rates when a hospital had a greater percentage of Hispanic births.

CONCLUSIONS

Lack of Medicaid coverage for neonatal male circumcision correlated with lower rates of circumcision. Because uncircumcised males face greater risk of HIV and other sexually transmitted infections, lack of Medicaid coverage for circumcision may translate into future health disparities for children born to poor families covered by Medicaid.

Authors+Show Affiliations

Department of Public Policy, UCLA School of Public Affairs, Box 951656, Los Angeles, CA 90095-1656, USA. arleen@ucla.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19008503

Citation

Leibowitz, Arleen A., et al. "Determinants and Policy Implications of Male Circumcision in the United States." American Journal of Public Health, vol. 99, no. 1, 2009, pp. 138-45.
Leibowitz AA, Desmond K, Belin T. Determinants and policy implications of male circumcision in the United States. Am J Public Health. 2009;99(1):138-45.
Leibowitz, A. A., Desmond, K., & Belin, T. (2009). Determinants and policy implications of male circumcision in the United States. American Journal of Public Health, 99(1), 138-45. https://doi.org/10.2105/AJPH.2008.134403
Leibowitz AA, Desmond K, Belin T. Determinants and Policy Implications of Male Circumcision in the United States. Am J Public Health. 2009;99(1):138-45. PubMed PMID: 19008503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants and policy implications of male circumcision in the United States. AU - Leibowitz,Arleen A, AU - Desmond,Katherine, AU - Belin,Thomas, Y1 - 2008/11/13/ PY - 2008/11/15/pubmed PY - 2009/1/14/medline PY - 2008/11/15/entrez SP - 138 EP - 45 JF - American journal of public health JO - Am J Public Health VL - 99 IS - 1 N2 - OBJECTIVE: We sought to determine whether lack of state Medicaid coverage for infant male circumcision correlates with lower circumcision rates. METHODS: We used data from the Nationwide Inpatient Sample on 417 282 male newborns to calculate hospital-level circumcision rates. We used weighted multiple regression to correlate hospital circumcision rates with hospital-level predictors and state Medicaid coverage of circumcision. RESULTS: The mean neonatal male circumcision rate was 55.9%. When we controlled for other factors, hospitals in states in which Medicaid covers routine male circumcision had circumcision rates that were 24 percentage points higher than did hospitals in states without such coverage (P<.001). Hospitals serving greater proportions of Hispanic patients had lower circumcision rates; this was not true of hospitals serving more African Americans. Medicaid coverage had a smaller effect on circumcision rates when a hospital had a greater percentage of Hispanic births. CONCLUSIONS: Lack of Medicaid coverage for neonatal male circumcision correlated with lower rates of circumcision. Because uncircumcised males face greater risk of HIV and other sexually transmitted infections, lack of Medicaid coverage for circumcision may translate into future health disparities for children born to poor families covered by Medicaid. SN - 1541-0048 UR - https://www.unboundmedicine.com/medline/citation/19008503/Determinants_and_policy_implications_of_male_circumcision_in_the_United_States_ L2 - https://www.ajph.org/doi/10.2105/AJPH.2008.134403?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -