Since the publication of the 10-volume Secretary’s Task Force on Black and Minority Health (HHS, 1985), it has been painfully obvious that collectively, African-American men experience very poor health outcomes. Historically, life expectancy of African-American men has consistently lagged behind that of Whites and most other racial and ethnic groups of men (Arias, 2006). Leading cause of death among African-American men include heart disease, cancer, stroke, diabetes, unintentional injuries, kidney diseases, chronic lower respiratory disease, and homicide (CDC, 2013). Unfortunately, to date, more complete explanations offered to identify why African-American men continue to experience poorer health outcomes have been limited (Jack and Toston, 2010).
Part of the challenge has been that African-American men’s health typically been examined through a focus on racial and ethnic health disparities. While useful for identifying factors associated with race and ethnicity that affect health outcomes, a focus on racial and ethnic health disparities in men’s health has tended to miss the critical role that gender plays in African-American men’s lives and health (Griffith, Metzl, & Gunter, 2011). A second challenge of how we have studied African-American men’s health is that we have tended to use a comparative framework to examine how African-American men differ from other groups of men or African-American women (Bediako & Griffith, 2007). While this is useful for identifying health issues that require additional attention, comparative approaches tend to obscure unique physical environment, economic circumstances, social norms and cultural practices that affect patterns of health outcomes for African-American men. Focusing exclusively on African-American men facilitates identifying and examining the unique pathways and mechanisms that may be responsible for the consistently poor health of African-American men, and helps to identify cultural strengths that could be the foundation of interventions to improve the health of this population (Bediako & Griffith, 2007; Griffith, Metzl, & Gunter, 2011; Griffith, 2012).
Co-guest editors of this American Journal of Men’s Health supplement sought to publish a collection of peer-reviewed manuscripts that would expand the discourse in the field of African-American men’s health beyond narrowly focusing on characteristics of the individual. Instead this supplement aims to examine how context (social and physical environment), politics, access to health care and more—collectively influence quality and length of life among African-American men. Given the supplement’s focus on context, contributing authors identify multiple pathways that explain the conditions that influence health. In addition, authors in this supplement offer and solutions to addressing and eliminating health disparities and inequities between racial and ethnic groups of men and among African-American men. This supplement consists of seven articles—each are briefly described.
Thorpe and co-authors, in their article, “Health Behaviors of African-American Men: Implications for Research and Practice” analyzed and present data from the Third National Health and Nutrition Examination Survey (1988–1994) and the NHANES III Linked Mortality Public-Use File. This paper focuses on the association between health behaviors and all-cause mortality. Researchers found that being a current smoker and being physically inactive was associated with increased risk of mortality. Authors offer recommendations on ways to develop age-appropriate interventions focusing on smoking cessation and increasing physical activity among African-American men.
Griffith, Ellis and Allen conduct a qualitative study utilizing an intersectional approach to examine sources of stress among African-American men. In his article, “An Intersectional Approach to Social Determinants of Stress for African-American Men: Men’s and Women’s Perspectives”, Griffith finds that the type and intensity of the men’s racial experiences were greatly affected by the fact that they were both African American and male. To understand the stressors that affected African-American men’s quality of life, it was critical to consider how race, ethnicity, age, marital status and other factors combined to serve as stressors. Griffith and colleagues found that health was rarely mentioned by the men as a source of stress, but key women in men’s lives recognized that declines in men’s physical functioning, pain and mobility were key sources of stress for African-American men. Griffith’s research elevates the need for more research to consider the perspective of women in men’s lives to help men recognize stressors and health issues and bring these factors to the attention of the men and health professionals.
Lisa Bowleg’s presents findings from a qualitative research study entitled, “The Skill is Using Your Big Head Over Your Little Head”: What Black Heterosexual Men Say They Know, Want, and Need to Prevent HIV”. Bowleg conducted four focus groups with 28 African-American men, ages 19 to 51, to examine whether study participants prioritize HIV/AIDS in their lives, and to identify HIV prevention needs. Bowleg reports that HIV was not a “top life priority” among this sample of African-American men. However, men did report prioritizing the importance of educating their own children about HIV prevention. African-American men in this study also reported protecting their main partners from HIV should they have sexual encounters with other partners. Bowleg offer suggestions on ways to increase the delivery of effective educational opportunities to heterosexual African-American men.
Unfortunately, there is not a body of scholarly books focusing exclusively on the health of African-American men in the United States. Jack provides a review of a recently published book, “Social Determinants of Health among African-American Men” edited by Treadwell, Xanthos, and Holden (Jossey-Bass, 2012). Jack’s book review indicates that this book moves beyond discussing individual risk factors to offering a boarder discussion of how the physical and social environments greatly influence health outcomes among African-American men. Jack provides insights into the books strengths and identifies what audiences would benefit from the books content.
Watkins, Abelson, and Jefferson’s work, “’Their Depression is Something Different… It Would Have to Be:’ Findings from A Qualitative Study of Black Women’s Perceptions of Depression in Black Men” provides insight into the social support role of Black women in the lives of Black men. Researchers report identifying four themes ranging from Black men’s depression is a cultured and gendered phenomenon to the importance of identifying ways to reach/provide black men with resources around depression. This article does an excellent job of discussing why depression is viewed as a topic not often discussed in the Black community, highlights the important perspective Black women have on African-American men’s health and offers suggestions on how to address barrier to Black men acknowledging depression, seeking help and support and maintaining treatment.
This supplement offers another article addressing mental health among African-American men. Johnson-Lawrence, Griffith, and Watkins examined how mood/anxiety disorders and chronic physical health conditions varied by age, race, and ethnical background among African-American, Caribbean Black, and non-Hispanic White men. Researchers used data from the National Survey of American Life dataset – a nationally representative sample of African Americans and Caribbean Blacks - to conduct the study. Johnson-Lawrence and peers’ work, “The Effects of Race, Ethnicity and Mood/Anxiety Disorders on the Chronic Physical Health Conditions of Men from A National Sample” findings validated the need for continued research to identify predictors of chronic physical health. Specifically, this study reported that among men 45 years old and older with mood/anxiety disorders, African American men had greater odds of chronic physical health conditions than White men. Researchers recommend more studies are needed to identify pathways that help explain how underlying variations between mental health and chronic physical health conditions occur across life stages of African-American men.
The supplement ends with an important commentary entitled, “Structural Health, and the Politics of African American Masculinity”. Metzl provides a compelling discussion on how structures and institutions that “… enable, and occasionally block attempts to achieve happiness and longevity” among African-American men. Metzl offers suggestions on how to increase awareness of the many barriers to African-American health. Metzl’s suggestions include acknowledging the role of the environment; employing strategies to address unequal treatment in health care settings; utilizing economic, political, and social justice interventions; and disseminate tailored health messages to better reach and education African-American men about their health.
This supplement, focusing on the health and well-being of African-American men, offers emerging approaches that can facilitate better understanding of ways how African-Americans men view various dimensions of their health. This supplement also provides readers with access to innovative theoretical frameworks to identify complex pathways shaped by the interaction of biology, family, general roles and norms, health care systems, and physical and social environments that may be useful to inform future research and interventions. The supplement’s focus on African-American men is particularly useful to examine why US cultural norms regarding manhood and masculinity do not have the same meaning and influence within and across African-American men’s lives or health outcomes (Griffith, Metzl, & Gunter, 2011). As researchers committed to advancing our understanding of health concerns among African-Americans, we hope this supplement serves as a valuable resource to researchers, practitioners, clinicians, and students from wide range of disciplines, settings, and professions. We encourage you to share this editorial and the contents of this supplement with those you believe would find timely publication of interest.
Contributor Information
Leonard Jack, Jr., Xavier University of Louisiana
Derek M. Griffith, Vanderbilt University
References
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