Abstract
African-American men are disproportionately affected by preventable medical conditions, yet they underutilize primary care health services. Because healthcare utilization is strongly dependent on health beliefs, the purpose of this qualitative study was to identify and explore African-American men's perceptions of health and health influences. We conducted eight focus group interviews with select subgroups of African-American men, including adolescents, trauma survivors, HIV-positive men, homeless men, men who have sex with men, substance abusers, church-affiliated men and a mixed sample (N=71). Definitions of health, beliefs about health maintenance and influences on health were elicited. Participants' definitions of health went beyond the traditional "absence of disease" definition and included physical, mental, emotional, economic and spiritual well-being. Being healthy also included fulfilling social roles, such as having a job and providing for one's family. Health maintenance strategies included spirituality and self-empowerment. Stress was cited as a dominant negative influence on health, attributed to lack of income, racism, "unhealthy" neighborhoods and conflict in relationships. Positive influences included a supportive social network and feeling valued by loved ones. This study provides insight into African-American men's general health perceptions and may have implications for future efforts to improve healthcare utilization in this population.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aday L. A., Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974 Fall;9(3):208–220. [PMC free article] [PubMed] [Google Scholar]
- Andersen R. M. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995 Mar;36(1):1–10. [PubMed] [Google Scholar]
- Bliss Erika B., Meyers David S., Phillips Robert L., Jr, Fryer George E., Dovey Susan M., Green Larry A. Variation in participation in health care settings associated with race and ethnicity. J Gen Intern Med. 2004 Sep;19(9):931–936. doi: 10.1007/s11606-004-0008-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Din-Dzietham Rebecca, Nembhard Wendy N., Collins Rakale, Davis Sharon K. Perceived stress following race-based discrimination at work is associated with hypertension in African-Americans. The metro Atlanta heart disease study, 1999-2001. Soc Sci Med. 2004 Feb;58(3):449–461. doi: 10.1016/s0277-9536(03)00211-9. [DOI] [PubMed] [Google Scholar]
- Dunlop Dorothy D., Manheim Larry M., Song Jing, Chang Rowland W. Gender and ethnic/racial disparities in health care utilization among older adults. J Gerontol B Psychol Sci Soc Sci. 2002 Jul;57(4):S221–S233. doi: 10.1093/geronb/57.4.s221. [DOI] [PubMed] [Google Scholar]
- James S. A. John Henryism and the health of African-Americans. Cult Med Psychiatry. 1994 Jun;18(2):163–182. doi: 10.1007/BF01379448. [DOI] [PubMed] [Google Scholar]
- James S. A., LaCroix A. Z., Kleinbaum D. G., Strogatz D. S. John Henryism and blood pressure differences among black men. II. The role of occupational stressors. J Behav Med. 1984 Sep;7(3):259–275. doi: 10.1007/BF00845359. [DOI] [PubMed] [Google Scholar]
- Lambrew J. M., DeFriese G. H., Carey T. S., Ricketts T. C., Biddle A. K. The effects of having a regular doctor on access to primary care. Med Care. 1996 Feb;34(2):138–151. doi: 10.1097/00005650-199602000-00006. [DOI] [PubMed] [Google Scholar]
- Malebranche David J. Black men who have sex with men and the HIV epidemic: next steps for public health. Am J Public Health. 2003 Jun;93(6):862–865. doi: 10.2105/ajph.93.6.862. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCaig Linda F., Burt Catharine W. National Hospital Ambulatory Medical Care Survey: 2001 emergency department summary. Adv Data. 2003 Jun 4;(335):1–29. [PubMed] [Google Scholar]
- Merzel Cheryl, Moon-Howard Joyce. Access to health services in an urban community: does source of care make a difference? J Urban Health. 2002 Jun;79(2):186–199. doi: 10.1093/jurban/79.2.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moy E., Bartman B. A., Weir M. R. Access to hypertensive care. Effects of income, insurance, and source of care. Arch Intern Med. 1995 Jul 24;155(14):1497–1502. [PubMed] [Google Scholar]
- Peters D. A. Improving quality requires consumer input: using focus groups. J Nurs Care Qual. 1993 Jan;7(2):34–41. doi: 10.1097/00001786-199301000-00006. [DOI] [PubMed] [Google Scholar]
- Phillips K. A., Morrison K. R., Andersen R., Aday L. A. Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization. Health Serv Res. 1998 Aug;33(3 Pt 1):571–596. [PMC free article] [PubMed] [Google Scholar]
- Rich J. A. Primary care for young African American men. J Am Coll Health. 2001 Jan;49(4):183–186. doi: 10.1080/07448480109596301. [DOI] [PubMed] [Google Scholar]
- Satcher David. Overlooked and underserved: improving the health of men of color. Am J Public Health. 2003 May;93(5):707–709. doi: 10.2105/ajph.93.5.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Saylor Coleen. The circle of health: a health definition model. J Holist Nurs. 2004 Jun;22(2):97–115. doi: 10.1177/0898010104264775. [DOI] [PubMed] [Google Scholar]
- Schneider E. C., Cleary P. D., Zaslavsky A. M., Epstein A. M. Racial disparity in influenza vaccination: does managed care narrow the gap between African Americans and whites? JAMA. 2001 Sep 26;286(12):1455–1460. doi: 10.1001/jama.286.12.1455. [DOI] [PubMed] [Google Scholar]
- Schneider Eric C., Zaslavsky Alan M., Epstein Arnold M. Racial disparities in the quality of care for enrollees in medicare managed care. JAMA. 2002 Mar 13;287(10):1288–1294. doi: 10.1001/jama.287.10.1288. [DOI] [PubMed] [Google Scholar]
- Shea S., Misra D., Ehrlich M. H., Field L., Francis C. K. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med. 1992 Sep 10;327(11):776–781. doi: 10.1056/NEJM199209103271107. [DOI] [PubMed] [Google Scholar]
- Sim J. Collecting and analysing qualitative data: issues raised by the focus group. J Adv Nurs. 1998 Aug;28(2):345–352. doi: 10.1046/j.1365-2648.1998.00692.x. [DOI] [PubMed] [Google Scholar]
- Williams David R., Neighbors Harold W., Jackson James S. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2003 Feb;93(2):200–208. doi: 10.2105/ajph.93.2.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams David R. The health of men: structured inequalities and opportunities. Am J Public Health. 2003 May;93(5):724–731. doi: 10.2105/ajph.93.5.724. [DOI] [PMC free article] [PubMed] [Google Scholar]