Adult African American Men Research Articles

Real Men Do…Real Men Don’t: Young Latino and African American Men’s Discourses Regarding Sexual Health Care Utilization

There is growing recognition that men as well as women need sexual health care (SHC) services. Despite this, male friendly sexual health services are not readily available in the United States, and men are underutilizing the services that are available. This situation needs to be rectified to improve sexual health outcomes for men and women. In this study we conducted 10 focus groups with young adult Latino and African American men to examine their perceptions of the factors influencing SHC utilization among the men they know, with an emphasis on how notions of what it means to be a man affects health care seeking. The findings both amplify and complicate the relationship between masculinity and SHC seeking. They suggest new directions for public health efforts to enhance men's SHC utilization.

Understanding African Americans' views of the trustworthiness of physicians.

Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. To better understand what trust and distrust in physicians means to African Americans. Focus-group study, using an open-ended discussion guide. Large public hospital and community organization in Chicago, IL. Convenience sample of African-American adult men and women. Each focus group was systematically coded using grounded theory analysis. The research team then identified themes that commonly arose across the 9 focus groups. Participants indicated that trust is determined by the interpersonal and technical competence of physicians. Contributing factors to distrust in physicians include a lack of interpersonal and technical competence, perceived quest for profit and expectations of racism and experimentation during routine provision of health care. Trust appears to facilitate care-seeking behavior and promotes patient honesty and adherence. Distrust inhibits care-seeking, can result in a change in physician and may lead to nonadherence. Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans.

The utility of fasting glucose for detection of prediabetes

Treatment of prediabetes attenuates progression to type 2 diabetes mellitus. The American Diabetes Association (ADA) previously defined prediabetes as either impaired fasting glucose (IFG) = 6.1 to 6.9 mmol/L (110-125 mg/dL) and/or impaired glucose tolerance (IGT) (2-hour postload glucose of 7.8-11.0 mmol/L [140-199 mg/dL]). For practical reasons, fasting plasma glucose (FPG) is commonly used for diabetes screening. Recently, the ADA lowered the fasting glucose threshold value for IFG from 110 to 100 mg/dL. Our objective was to determine the utility of FPG alone for detecting prediabetes in African Americans. Oral glucose tolerance test (OGTT) data from a cohort of 304 young adult African American men and women were examined. We calculated prediabetes prevalence using the previous ADA criteria and examined the effect of lowering the IFG threshold value for IFG to 100 mg/dL. The prediabetes prevalence in this cohort using the previous ADA criteria was 20.4% (n = 62). Of the 62 cases, 8 had IFG, 45 had IGT, and 9 had IFG together with IGT. Fasting plasma glucose testing alone detected 17 (27.4%) prediabetic cases, whereas a complete OGTT detected 54 (87.1%). Lowering the IFG threshold value to FPG = 100 mg/dL identified 13 of the 45 IGT-only cases. However, this lower IFG threshold increased prediabetes prevalence in the overall cohort from 20.4% to 31.9%. In conclusion, in young adult African Americans, an ethnic group at high risk for developing diabetes, FPG testing alone may be inadequate for diagnosing prediabetes. Until alternative strategies are identified, an OGTT is presently the best method for detecting the prediabetic condition in these high-risk patients.

Independent association of intermuscular adipose tissue with CVD risk factors

The metabolic implications of intermuscular adipose tissue (IMAT, adipose tissue visible by MRI within the boundary of the muscle fascia) have been little studied compared to total body adipose tissue (TAT) and visceral adipose tissue (VAT). Whole body magnetic resonance imaging was used to quantify TAT and its components: subcutaneous adipose tissue (SAT), VAT, and IMAT. Fasting serum measures (n=262) of glucose, cholesterol (Chol), high density lipoprotein (HDL), triglycerides (Trig) protein bound glucose (PBG, n=206), and insulin (n=119), were acquired in healthy adult African American (AA, n=78) and Caucasian (Ca, n=109) women (BMI 26.5±5.7 kg/m2; 44.4±16.4 years) and men (39 AA, 62 Ca; BMI 25.6±3.5 kg/m2; 45.6±17.4 years). General linear models were used to identify independent effects of IMAT after covarying for VAT, SAT, race, sex and 2-way interactions. Correlations of IMAT with VAT and SAT ranged between 0.38 and 0.78. Statistically significant independent associations were observed for IMAT with glucose (p<0.001), PBG (p<0.001), and Chol (p=0.005). The association of IMAT to Chol differed by race (p=0.011). TG, HDL and insulin had no independent association with IMAT. The strong independent associations of IMAT with fasting glucose and PBG suggest that IMAT may be related to glucose metabolism, however, IMAT also shows some association to Chol. This study was supported by NIH AG14715, DK42618; RR00645, DK40414; and a contract from the NIA.

Racial difference in circulating sex hormone–binding globulin levels in prepubertal boys

Racial differences in disease risk (eg, osteoporosis, metabolic cardiovascular syndrome, and prostate cancer) may arise partly on a hormonal basis. While reports of racial differences in gonadal steroid hormone levels in middle-aged men have produced conflicting results, there is evidence that high sex hormone–binding globulin (SHBG) and estradiol levels are more common among young adult African American men than white men. To determine whether this difference relates to pituitary-testicular functioning or to other factors, we conducted a cross-sectional study of 47 healthy prepubertal African American and white boys aged 5 to 9 years at the time of their annual school physical examination. Height, weight, blood pressure, waist and hip circumference, and Tanner staging were determined, and a fasting blood sample was obtained. The African Americans studied were slightly older than the whites (mean ± SD, 82.4 ± 15.0 vs 70.5 ± 10.3 months, P = .003). African Americans were also slightly taller and heavier and had a lower waist-to-hip ratio, but these differences could be explained by the difference in age. Mean SHBG levels were 25% higher ( P = .15) in African Americans than in whites (197 ± 104 vs 157 ± 79 nmol/L), and when adjusted for age, values were 46 nmol/L higher among African Americans. The fifth quintile for SHBG (values > 245 nmol/L) included 1 (4.2%) of 24 whites and 8 (35%) of 23 African Americans studied ( P = .003). There was no significant correlation between age, body mass index, waist circumference, or fasting insulin and SHBG. Total testosterone, the free androgen index, and dehydroepiandrosterone increased with age in both groups, but after adjusting for age, no racial differences were found. Estradiol, estrone, and inhibin B levels, as well as systolic and diastolic blood pressures, were also comparable in both groups. We conclude that high levels of SHBG are more common among African American than in white boys and hypothesize that this difference and its effect on the ratio between bound and free steroid hormones may contribute to racial differences in disease risk in adult men.

Correlation of oral glucose tolerance test-derived estimates of insulin sensitivity with insulin clamp measurements in an African-American cohort

The purpose of this study was to determine which measures obtained from an oral glucose tolerance test (OGTT) are the best estimates of insulin sensitivity measured directly using the euglycemic hyperinsulinemic clamp procedure. Data were examined from a study conducted on 307 young adult African-American men and women. An OGTT with insulin measurements was conducted after a 12-hour overnight fast. The euglycemic hyperinsulinemic clamp was used to measure insulin-stimulated glucose uptake (M) directly. Pearson’s correlation analyses were performed to examine the relationship of OGTT-derived parameters with insulin sensitivity measured using the clamp. There were consistent statistically significant correlations between calculated estimates of insulin sensitivity (fasting insulin/fasting glucose, summed insulin/summed glucose, homeostasis model assessment [HOMA], Quantitative Insulin Sensitivity Check Index [QUICKI]) with insulin sensitivity measured by the insulin clamp ( P < .001). The calculated estimates that correlated most strongly with clamp measured insulin sensitivity were QUICKI and the logarithm of summed insulin during the OGTT. These data indicate that fasting and OGTT-derived plasma insulin and glucose concentrations can be used to estimate insulin sensitivity in young adult African-Americans when it is not feasible to conduct the insulin clamp procedure. Calculated indices that include log transformation of plasma insulin concentration improve the estimation of insulin sensitivity.

The Influence of Ethnicity on Thermoregulation During Immersion in 20 and 27??C Water for 120-Minutes

0900 Temperature homeostasis is maintained, in part due to an increase in heat production and a decrease in heat loss. The effectiveness of these mechanisms is influenced by a number of factors, such as aerobic capacity, body composition, and perhaps, one's ethnicity. Research has provided data to suggest that ethnicity may, in part, be responsible for the disparity between the intrinsic systems of thermoregulation of different populations. PURPOSE: Therefore, the goal of this investigation was to examine the effect of ethnicity on the thermal and metabolic responses of healthy adult Caucasian (CAU) and African American (AA) men during immersion in 20 and 27°C water for 120-minutes. METHODS: Following a baseline period (30-minutes), subjects were moved into a water immersion tank where they remained seated and still for 120-minutes, or until core temperature (Tre) was ≤ 35°C. During each trial, the following data were collected: rectal temperature (Tre), mean skin temperature (Tsk), and oxygen consumption (VO2) [from which heat production values are derived]. RESULTS: Although non-significant with regard to their response in rectal temperature, ANOVA revealed a significant (p < 0.05) difference between the groups for heat production, with the CAU subjects (pooled across temperature), demonstrating higher heat production values compared to their AA counterparts [172 ± 32 vs 124 ± 48 W×m2, respectively]. ANOVA also revealed significant time-by-temperature interactions for mean skin temperature, rectal temperature, and heat production. Each of the responses varied during the 20°C water immersion trial as compared to the 27°C water immersion. CONCLUSION: These data suggest that the AA subjects demonstrated an attenuated metabolic response compared to their CAU counterparts during 120-minutes of water immersion. However, further research is needed employing a larger sample size and over a more protracted exposure time so as to more clearly elucidate differences between CAU vs. AA individuals.

Aerobic Exercise Attenuates an Exaggerated Exercise Blood Pressure Response in Normotensive Young Adult African-American Men

An exaggerated exercise blood pressure response (EEBPR) may be associated with an increased risk of hypertension. We hypothesized that aerobic exercise training can decrease EEBPR and the risk for hypertension by decreasing arterial resistance. We studied the effects of aerobic training on the submaximal exercise blood pressure (BP) of eight normotensive young adult African-American men with an EEBPR. Subjects were trained on a stationary bicycle at an intensity of 70% peak oxygen uptake (VO 2peak ), for 30 min, three times per week, for 8 weeks. BP, heart rate, cardiac output (CO), stroke volume (SV) and total peripheral vascular resistance (TPR) were measured at rest and during submaximal exercise at a work intensity of 50% VO 2peak. Significance of the training effects were evaluated by comparing the pre- and post-training measures ( t -test, p < 0.05). A 15% post-training increase in VO 2peak (34.6 - 1.4 to 40 - 1.4 ml/kg/min) and a 9.5 ml post-training increase in mean resting stroke volume were found. A 16.2 mmHg decrement in mean systolic BP, an 11.5 mmHg decrement in mean diastolic BP, a 120 dyne/s/cm 5 decrement in TPR and a 1.2 l/min increase in CO were detected during the posttraining submaximal exercise tests. These results suggest that reductions in TPR may attenuate the EEBPR of normotensive African-American males following an 8-week training regimen of stationary bicycling at 70% VO 2peak . Aerobic exercise training may, therefore, reduce the risk of hypertension in normotensive African-American males by the mechanism of a reduction in TPR. Because of the limited number of subjects, the results of this study should be interpreted cautiously pending confirmation by a larger controlled trial.

The Adult Life Cycle of Poor African American Fathers

This article is based on the qualitative findings of a 4-year study of 150 adult African American men who are non-custodial fathers. Using social constructionist and ecological frameworks, issues of individual, personality and family development are explored and implications for micro and macro social work practice are discussed.

Assessing the Psychosocial Well-Being of African American Gays:

This paper presents a model for assessing personal, cultural, and social factors influencing the psychosocial well-being of black gay men. Differences are discussed by focusing on three groups-adolescent, adult and older gay African American men. Each of these groups is considered in connection with the developmental tasks of play, work and love. These tasks are explored as a function of age cohort, gender appearances, socioeconomic status, church and religon, and area of residence as they are linked to an individual's participation in the black, gay, and black gay communities. These intersecting domains are addressed within the context of racism as they affect the psychosocial well-being of black gay men.

The relationships of substance abuse to illegal and violent behavior, in a community sample of young adult African American men and women (gender differences).

In a longitudinal study of an African American young adult community sample (N = 380), prospective data on lifetime substance use/abuse from childhood up to age 24 were used as control variables in analyses to predict illegal and violent behavior during the ensuing 2 1/2-year period. Frequent earlier use of drugs predicted subsequent violent behavior for both men and women. Frequency of earlier use of alcohol predicted subsequent violent behavior for men but not for women. A weaker relationship was found between degree of psychopathology and degree of engaging in either illegal or violent behavior than between degree of psychopathology and degree of substance use/abuse. Comorbidity (the combination of earlier use/abuse of drugs with earlier psychopathology) was a stronger predictor, for women than for men, of later illegal and violent behavior.