Abstract
ABSTRACTPurpose: There is a dearth of effective, evidence-based programs to reduce chronic disease in low-income African-American men. We report on the results of formative research in the National Institutes of Health (NIH)-funded MOCHA Moving Forward project on factors identified by the participants to drive health disparities.Methods: Based on individual interviews with 42 middle-aged (40–65 years), low-income African-American men, three themes emerged.Results: First, the results indicate a hierarchy in the perceived relative influence of different factors, with poverty and unemployment perceived to have the most powerful affects. Second, results show that factors in different domains do not operate as discrete independent influences, but rather, interact synergistically. Finally, the findings show how perceived social structural constraints have produced deep cynicism about the future, with notably divergent reactions, producing a sense that there is almost nothing an individual can do, or paradoxically, a greater the sense of personal responsibility.Conclusion: The implications of addressing the cascade of social determinants to reduce chronic disease in African-American men are discussed.
Highlights
The first official national call to reduce health disparities in the USA was issued in the 1990 Surgeon General’s Report, Healthy People 2000, and reiterated in Healthy People 2010 and Healthy People 2020
Despite the high priority placed on this national goal, progress over the last 30 years has been slow, and to the extent that progress is being made, health disparities are becoming further concentrated in poorer populations with lower levels of education. (Ding, Do, Schmidt, & Bauman, 2015; National Center for Health Statistics, 2017; Taylor, Dal Grande, Wu, Shi, & Campostrini, 2014) re-doubled efforts to develop innovative programs tailored to the needs of historically underserved populations are critical
The Men of Color Health Awareness (MOCHA) program is a grassroots, community-driven movement to improve the health of low-income African-American men who bear a disproportionate share of the burden of health inequities
Summary
The first official national call to reduce health disparities in the USA was issued in the 1990 Surgeon General’s Report, Healthy People 2000, and reiterated in Healthy People 2010 and Healthy People 2020. The Men of Color Health Awareness (MOCHA) program is a grassroots, community-driven movement to improve the health of low-income African-American men who bear a disproportionate share of the burden of health inequities. The first 18 months of the MOCHA Moving Forward study have focused on conducting formative research to identify the most salient risk factors influencing African-American men’s health. The key research question driving the analysis presented here was “Which factors do low-income, middle-aged African-American men perceive to have the greatest impact on driving health disparities?” The formative research seeks to identify key mediating variables so that they can be operationalized and empirically measured in the experimental research phase and/or incorporated into future versions of the MOCHA model. This paper reports on initial findings of the formative research
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