African American Men's Health Research Articles

African American Men and Mental Health

African American men face challenges that include internalized negative social identities, marginalization, oppression, systemic racism, invisibility syndrome, targets of violence, murder, and erasure. Social workers may place the population at further risk of harm by using methods influenced solely by Eurocentric values. There is a paucity of peer-reviewed journal articles in the social work literature regarding the mental health of African American men. The literature fails to support social workers in acquiring the clinical skills required to provide services to African American men. This article will provide guidance to improve assessment, diagnosis, and clinician engagement with adult African American male clients. Barriers to the care of this population include the stigma of receiving mental health services, avoidance of vulnerability, medical distrust, clinician bias, no knowledge culturally expressed symptomology of mental illness, and an absence of culturally responsive care. Theories that inform the work with African American men in this article are the social determinants of health theory, intersectional theory, and narrative theory.

How Masculinity Impedes African American Men From Seeking Mental Health Treatment.

This study addresses the pronounced mental health disparities faced by African American men, characterized by the heightened severity of mental health conditions and their reluctance to seek mental health treatment. Persistent neglect toward the mental health of African American men perpetuates systemic inequities and heightens the stigma surrounding mental well-being within their communities. This study investigates the interaction of masculinity, distrust in doctors, and parental support on attitudes influencing African American men's reluctance to seek mental health care. A survey administered to 74 African American men revealed a negative correlation between masculinity and attitudes toward seeking mental health treatment. In contrast, no significant correlations were found between distrust in doctors and parental support on attitudes toward seeking mental health treatment. These findings were analyzed using Pearson's correlation, underscoring the urgent need to address masculine norms in mental health discourse among African American men. Implications of the findings and future directions for masculinity in African American men are discussed.

Money Protects White but Not African American Men against Discrimination: Comparison of African American and White Men in the Same Geographic Areas

To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men’s cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men’s physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.

PD40-03 RACIAL DISPARITIES IN MAGNETIC RESONANCE IMAGING-GUIDED BIOPSY FOR THE DIAGNOSIS OF PROSTATE CANCER IN THE UNITED STATES

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV (PD40)1 Apr 2020PD40-03 RACIAL DISPARITIES IN MAGNETIC RESONANCE IMAGING-GUIDED BIOPSY FOR THE DIAGNOSIS OF PROSTATE CANCER IN THE UNITED STATES Arveen Kalapara*, Bradly Watarai, Stephanie Jarosek, and Badrinath Konety Arveen Kalapara*Arveen Kalapara* More articles by this author , Bradly WataraiBradly Watarai More articles by this author , Stephanie JarosekStephanie Jarosek More articles by this author , and Badrinath KonetyBadrinath Konety More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000920.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (MRI) has evolved into an invaluable tool in the diagnostic pathway for localised prostate cancer. Racial disparities exist between Black and White American patients in treatment access and outcomes. However, it remains unclear whether any racial disparities exist in access to pre-biopsy prostate MRI. We aimed to compare rates of men undergoing MRI prior to prostate biopsy by race. METHODS: Retrospective review of a large de-identified commercial health insurance claims database in the United States (OptumLabs®) to identify men who underwent prostate biopsy and MRI between 2010 and 2017. Prostate biopsy was considered the index event and our cohort was restricted to men with continuous enrolment of 12 months prior and 1 month following biopsy. Race was classified as Black, White, Asian or Hispanic. Our primary outcome was utilization of MRI prior to prostate biopsy. We used Chi-square test to compare the proportion of men undergoing MRI in 2010 and 2017, and multivariable logistic regression adjusting for age, race and socioeconomic factors to predict likelihood of receiving MRI. RESULTS: We identified 108,557 patients who underwent prostate biopsy, including 86,997 White, 12,051 Black, 7220 Hispanic and 2289 Asian men. Median age was 64 years (IQR, 58-70). Overall, 134 of 18,584 (0.7%) men underwent MRI prior to biopsy in 2010, compared with 1828 of 11887 (15.4%) in 2017 (p<0.001). 0.68%, 0.70%, 1.02%, 1.65% compared to 15.1%, 10.1%, 23.4%, 21.7% White, Black, Hispanic, Asian men underwent MRI prior to biopsy in 2010 and 2017 respectively. On multivariable logistic regression, Black men were significantly less likely to receive MRI within 6 months prior to prostate biopsy than White men (OR 0.89, 95% CI 0.81-0.99). Hispanic men (OR 1.65, 1.50-1.81) and Asian men (OR 1.68, 1.43-1.97) were significantly more likely to receive MRI than White men. CONCLUSIONS: Among commercially insured men in the United States, Black men are significantly less likely, and Hispanic and Asian men significantly more likely, than White men to receive prostate MRI prior to biopsy. Further studies are required to identify reasons for these trends, and whether these persist in non-commercially insured patients. Source of Funding: Center for Healthy African American Men's Health through Partnerships (NIH U54MD008620) © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e815-e816 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arveen Kalapara* More articles by this author Bradly Watarai More articles by this author Stephanie Jarosek More articles by this author Badrinath Konety More articles by this author Expand All Advertisement PDF downloadLoading ...

Colorectal Cancer Screening in Black Men: Recommendations for Best Practices

Screening for colorectal cancer has been demonstrated to reduce colorectal cancer mortality. Blacks have a higher mortality from this malignancy, particularly men, yet screening rates in this population are often found to be lower than in whites. A modest literature demonstrates effective interventions that can increase screening rates in blacks; however, results are not consistent and ongoing work is required. Most work has not addressed specific barriers to screening in black men. Given the lack of studies on black men only, this study evaluated the state of research in the black population using a PubMed search. The authors provide commentary that proposes increased (1) state and local government support for collaborative programs with healthcare organizations, including patient navigation; (2) augmented community-organizing efforts to generate more attention to the need for colorectal cancer screening in the black community, with a focus on black men; and (3) federal research funding to promote investigation into new interventions and evaluation of existing ones. Specific recommendations for black men include lowering the screening age to 45years, increasing access to health care, the use of patient navigators, and improved reporting and monitoring of colorectal cancer screening rates. SUPPLEMENT INFORMATION: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Preventing Violent Encounters Between Police and Young Black Men: A Comparative Case Study

In the past several years, high profile events have drawn attention to the longstanding problem of violent encounters between police and young black men in the U.S. This paper highlights the results of a 1-year qualitative study to describe (1) perceptions of police-youth violence prevention policies, programs, and practices; and (2) existing infrastructures that can be leveraged to strengthen police-youth violence prevention efforts. Semi-structured interviews were conducted with 48 key stakeholders from four groups (young black men aged 14-24years, parents and educators, police officers, and staff in youth serving organizations) in 2017. Stakeholders were asked to (1) identify any policies, programs, or practices aimed at police-youth violence prevention; (2) evaluate the effectiveness of these efforts and how they might be improved; and (3) envision any new efforts to prevent future violent encounters between police and young black men. Data were collected and analyzed in 2017 using content analysis methods. Key stakeholders demonstrated high awareness of efforts, particularly programs to deter youth violence. However, none of them were able to identify specific efforts to reduce violent encounters between local police and young black men. Responses differed across key stakeholder groups. Young people often stated that police needed to become more involved in the communities they serve; however, police believed they were building relationships with the community. Future violence prevention efforts must incorporate policies, programs, and practices that explicitly address violent encounters between police and young black men. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

A National Study of U.S. Emergency Departments: Racial Disparities in Hospitalizations for Heart Failure

Racial disparities in heart failure hospitalizations are well documented. The majority of heart failure hospitalizations originate from emergency departments, but emergency department hospitalization patterns for heart failure and the factors that influence hospitalization are poorly understood. This gap in knowledge was examined using a nationally representative sample of emergency department visits for heart failure. National Hospital Ambulatory Medicare Care Survey data on 2001-2010 emergency department visits were analyzed in 2015-2017 to examine age-related racial differences in hospitalization patterns for heart failure, using multivariable modified Poisson regression models. More than 12million adult visits for heart failure to U.S. emergency departments occurred from 2001 to 2010, with 23% of visits by blacks. Overall, 71% of visits resulted in hospitalization (57% to floor beds and 14% to intensive care units). Among floor admissions for higher clinical acuity visits, whites were more likely than blacks to be hospitalized. Whites with higher clinical acuity were more likely to be hospitalized than those with lower clinical acuity (71% vs 63%, p=0.005). This expected pattern was not observed in blacks, particularly those aged ≥65years, who were hospitalized in 71% of lower clinical acuity visits, but only 61% of higher acuity visits. Among adults aged ≥65years, there was a significant interaction between clinical acuity Xrace with regard to hospitalization (p=0.037). These results suggest age and racial disparities in hospitalization rates for emergency department patients with heart failure. The reasons for these disparities in hospitalization are unclear. Further studies on emergency department hospitalization decisions, and the impact of emergency department clinical factors, may help clarify this finding. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Universal Screening for HIV and Hepatitis C Infection: A Community-Based Pilot Project

Black men in the Deep South have been disproportionally affected by high HIV and hepatitis C virus infection rates. Conventional clinic-based screening approaches have had limited success in reaching those with undiagnosed HIV or hepatitis C virus infection. The purpose of this study was to evaluate the acceptability, feasibility, and best practices of an integrated HIV and hepatitis C virus community-based health screening approach. The study used a mixed methods approach: focus group discussion, individual interviews, and surveys that assessed perceptions, perspectives, and HIV and hepatitis C virus awareness among six communities across Alabama and Mississippi. Data were collected and analyzed in 2014-2017. Although HIV and hepatitis C virus knowledge was limited among community members surveyed, the results of this study suggest that (1) using an integrated, community-based HIV and hepatitis C virus testing approach is acceptable and feasible; (2) formation of a community advisory board is a key element of successful community mobilization; (3) education and training of community members on disease-specific topics and overcoming stigma are essential; and (4) focus on and inclusion of young community members will be critical for the sustainability of screening efforts. Including and engaging communities at risk for HIV and hepatitis C virus infection in prevention research is a promising strategy to overcome existing barriers of stigma and discrimination. Integration of HIV and hepatitis C virus testing in universal health screening efforts utilizing a Community Health Advisors model encourages unbiased communication with a focus on overall community health. Community health advisors are recognized as important agents in this effort. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Racial and Geographic Disparities in Hepatocellular Carcinoma Outcomes

Hepatocellular carcinoma disproportionately affects minorities. Southern states have high proportions of black populations and prevalence of known risk factors. Further research is needed to understand the role of southern geography in hepatocellular carcinoma disparities. This paper examined racial disparities in hepatocellular carcinoma incidence, demographics, tumor characteristics, receipt of treatment, and all-cause mortality in southern and non-southern cancer registries. Surveillance Epidemiology and End Results data were probed in 2015 to identify 43,868 patients diagnosed with hepatocellular carcinoma from 2000 to 2012 (5,455 in southern registries [Atlanta, Louisiana, and Rural and Greater Georgia]). Southern registries showed steeper increases of age-adjusted hepatocellular carcinoma incidence (from 2.89 to 5.29cases/100,000 people) versus non-southern areas (from 3.58 to 5.54cases/100,000 people). Blacks were over-concentrated in southern registries (32% vs 10%). Compared with whites, blacks were significantly younger at diagnosis, more likely diagnosed with metastasis, and less likely to receive surgical therapies in both registry groups. After adjustment, blacks had a significantly higher risk of all-cause mortality compared with whites in southern (hazard ratio=1.10, p=0.007) and non-southern areas (hazard ratio=1.08, p<0.001). For overall populations, southern registries had higher risk of all-cause mortality versus non-southern registries (hazard ratio=1.13, p<0.001). Age-adjusted incidence rates of hepatocellular carcinoma are plateauing overall, but are still rising in southern areas. Race and geography had independent associations with all-cause mortality excess risk among patients with hepatocellular carcinoma. Further studies are needed to understand the root causes of potential mortality risk excess among overall populations with hepatocellular carcinoma living in the South. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Health System Affiliation and 30-Day Readmission After Heart Attack in Black Men

Black patients who experience acute myocardial infarction and receive care in high minority-serving hospitals have higher readmission rates. This study explores how hospital system affiliation (centralized versus decentralized/independent) impacts 30-day readmissions after acute myocardial infarction in black men. In 2018, the Healthcare Cost and Utilization Project State Inpatient Database (2009-2013) was used to observe 30-day readmission for acute myocardial infarction by race, and data from the American Hospital Association Annual Survey of Hospitals (2009-2013) to determine hospital system affiliation for the states Arizona, California, North Carolina, and Wisconsin. A series of hierarchic logistic regressions were conducted to determine if hospital system affiliation mediates the relationship between race and 30-day readmission. Of 63,743 hospitalizations for acute myocardial infarction among men between 2009 and 2013, black men accounted for 7.1% of hospitalizations and 8.0% of readmissions. In both models, race significantly predicted 30-day readmission (unadjusted OR=1.25, 95% CI=1.14, 1.37, p<0.001; AOR=1.13, 95% CI=1.03, 1.25, p=0.046). After controlling for system type, black men were more likely to be readmitted after acute myocardial infarction than white men in both models (unadjusted OR=1.25, 95% CI=1.14, 1.38, p<0.001; AOR=1.14, 95% CI=1.03, 1.25). There was no difference in odds of being readmitted by race and hospital system type (unadjusted OR=0.88, 95% CI=0.25, 3.07, p=0.84, AOR=1.02, 95% CI=0.21, 5.10, p=0.98). Black men appear to be more likely to be readmitted after acute myocardial infarction. Centralization does not appear to mediate the relationship between race and 30-day readmissions for acute myocardial infarction. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Implementing the Communities That Care Prevention System: Challenges, Solutions, and Opportunities in an Urban Setting

Communities That Care, refined and tested for more than 25years, offers a step-by-step coalition-based approach to promote well-being and prevent risk behaviors among youth. Communities That Care guides coalitions to identify and prioritize underlying risk and protective factors; set specific, measurable community goals; adopt tested, effective prevention programs to target selected factors; and implement chosen programs with fidelity. Communities That Care has been implemented in a variety of communities, but has only recently begun to be systematically evaluated in diverse, urban communities. This paper presents a process evaluation of Communities That Care implementation within a Midwestern ethnically diverse, urban community. In-depth surveys of 25 black male youth aged 8-14years and their caregivers were conducted to determine the degree to which coalition-selected priorities aligned with the experience of black families. Implementation and survey data were collected in 2014-2017 and analyzed in 2017-2018. Roughly 30% of youth reported ever being bullied or bullying someone else on school property; this aligned with the coalition's decision to focus on positive social skills and bullying prevention. Additional data aligned with the coalition's intent to expand its community action plan to encompass other priorities, including family transitions and mobility. For example, roughly one third of caregivers went on welfare and one third of families moved to a new home or apartment in the past year. In communities whose residents have experienced historical and current inequities, an effective community prevention plan may need to address structural as well as social determinants of well-being among youth and their families. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Racial Disparities in Surgical Outcomes Among Males Following Major Urologic Cancer Surgery

Disparities in healthcare outcomes between races have been extensively described; however, studies fail to characterize the contribution of differences in distribution of covariates between groups and the impact of discrimination. This study aims to characterize the degree to which clinicodemographic factors and unmeasured confounders are contributing to any observed disparities between non-Hispanic white and black males on surgical outcomes after major urologic cancer surgery. Non-Hispanic white and black males undergoing radical cystectomy, nephrectomy, or prostatectomy for cancer in the American College of Surgeons National Surgical Quality Improvement Program database from 2007 to 2016 were included in this analysis. The outcome of interest was Clavien III-V complications. Analysis was conducted in 2017 using the Peters-Belson method to compare the disparity in outcomes while adjusting for 13 important demographic and clinical characteristics. Of the 15,693 cases included with complete data, 13.0% (n=2,040) were black. There was a significantly increased rate of unadjusted Clavien III and V complications between white versus black males for radical cystectomy (21.9% vs 10.1%, p=0.005); nephrectomy (6.4% vs 3.9%, p=0.028); and radical prostatectomy (2.3% vs 1.6%, p=0.046). Adjusting for differences in age, BMI, American Society of Anesthesiologists score, functional status, smoking history, and comorbidities including diabetes, chronic obstructive pulmonary disease, heart failure, renal failure, bleeding disorder, steroid use, unintentional weight loss, and hypertension between the groups could not explain the disparity in complications after radical cystectomy; the unexplained discrepancy was an absolute excess of 11.8% (p=0.01) in black males. There was an unexplained excess of complications in black males undergoing radical prostatectomy and nephrectomy but neither reached statistical significance. Black males undergoing radical cystectomy for cancer experienced higher complication rates than white males. Unexplained differences between the black and white males significantly contributed to the disparity in outcomes, which suggests that unmeasured factors, such as the quality of surgical or perioperative care, are playing a considerable role in the observed inequality. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Community Readiness to Adopt the Communities That Care Prevention System in an Urban Setting

This manuscript highlights initial activities from a 5-year project to build a community coalition focused on the promotion of family, school, and community connectedness; academic investment; and social and emotional well-being among black male youth and their families, as well as the prevention and reduction of risk behaviors. Project activities were planned according to the step-by-step coalition-based prevention system, Communities That Care. During Year 1 (2013/2014), semi-structured interviews were conducted with 14 community members (parents, school administrators and teachers, and community leaders and volunteers) to evaluate readiness to adopt Communities That Care. Participants were asked to (1) define community; (2) identify community strengths; (3) recommend methods to strengthen community relationships; (4) envision ideal coalition functions; (5) identify current community resources; (6) recommend prevention targets and methods; (7) identify potential barriers to coalition participation; and (8) assess overall community readiness to adopt Communities That Care. Analyses were conducted in Year 3 (2015/2016). Participants expressed eagerness and readiness to adopt Communities That Care. They identified community strengths and local resources that could contribute to coalition success, as well as potential barriers to participation and group cohesion that if left unaddressed could diminish coalition impact. Participants believed that links between multiple environments (home, school, community) should be strengthened in order to promote the well-being of youth. They envisioned the Communities That Care coalition as a task force of community members with varying talents invested in youth across their entire life course. Community members' insights may be used to guide implementation of Communities That Care by this coalition and others. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Attitudes Toward Genomic Testing and Prostate Cancer Research Among Black Men

Black men are diagnosed with prostate cancer at nearly twice the rate of white men and are underrepresented in prostate cancer research, including validation studies of new clinical tools (e.g., genomic testing). Because healthcare system mistrust has contributed to these disparities for centuries, black men may be less inclined to pursue novel testing, and identification of facilitators to their participation in prostate cancer research studies remains warranted. A community-engaged approach involving a partnership with a community organization was used to conduct seven focus groups in Minnesota, Alabama, and California to explore black men's attitudes toward prostate cancer research participation and genomic testing for prostate cancer. Data were collected and analyzed from April 2015 to April 2017. Identified genomic testing barriers included a lack of terminology understanding, healthcare system mistrust, reluctance to seek medical care, and unfavorable attitudes toward research. Facilitators included family history, value of prevention, and the desire for health education. Lack of prostate cancer knowledge, prostate-specific antigen testing confusion, healthcare system distrust, and misuse of personal health information were barriers to research study participation. Some black men were motivated to participate in research if it was seen as constructive and transparent. Disparities for black men can both motivate and disincentivize participation depending upon a positive or negative view of research. Confusion over prostate cancer clinical care has fueled some mistrust among black men affecting both clinical care and research participation. With increased education, health literacy, and assurances of research integrity and transparency, black men may be more willing to participate in prostate cancer testing and research. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Designing Faith-Based Blood Pressure Interventions to Reach Young Black Men

This community-based participatory research pilot study explored multilevel perceptions and strategies for developing future faith-based organization blood pressure interventions for young black men. Community partners recruited the sample through two, southeastern U.S. urban churches as potential intervention hubs; academic partners conducted phone interviews with church leader key informants, and three focus groups with black men aged 18-50 years. Qualitative content analysis helped generate themes from: key informant questions assessing organizational assets and capacities, and factors influencing participation; and focus group questions assessing lifestyle and self-management behaviors. Questions assessing themes on blood pressure intervention strategies were asked. Data were collected in 2016 and analyzed in 2016-2017. The sample included 21 key informants and 19 young black men. Key informants' leadership experience averaged 16.6 (SD=12.1) years and 28.6% were male. Focus group participants were primarily single (55.6%), college educated (61.1%), and employed (77.8%). Mean blood pressure was 131.1 (SD=15.3)/79.5 (SD=11.2) mmHg, 33.3% self-reported having hypertension, 88.9% report a family history of hypertension, and 88.9% see a provider annually. For key informants, young black men lack understanding of hypertension despite available resources, and pastors are important role models and advocates. For focus group participants, hidden sodium and stressful, busy schedules impact lifestyle behaviors; and church support for busy schedules are important. Common strategies included incentive-laden, activity-integrated programs, and male social context (testimonials, peer mentoring, engagement outside of the church). Findings and lessons learned will help design future community-based participatory research, faith-based organization-led blood pressure interventions relevant to young black men. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Parents Speak: A Needs Assessment for Community Programming for Black Male Youth

Although adolescence can be a difficult developmental period for all children, negative environmental forces make this period particularly risky for many inner-city black males. As part of the Center for Healthy African American Men through Partnerships, this project is utilizing community-based participatory concepts to design and implement programs to address risk-taking behaviors among middle school black males. In 2014, parents of black males between the ages of 11 and 14years were recruited from an urban middle school to participate in focus group discussions. Letters were provided to the school to be mailed to parents inviting them to participate in discussion groups. Four focus groups were conducted. Data analyses were conducted fall 2014. Twenty-one parents participated. The major issue affecting the well-being and future success of young black males reported by parents was the lack of social support. Other areas of concern included negative peer pressure, bullying, violence, and lack of opportunities. Across groups, parents identified the lack of male parental presence in households and the subsequent perceived need by the young males to assume leadership roles, anger among the young males, and the lack of licensed counselors to address mental health issues as barriers to success and well-being. Parents emphasized the needs of the individual, family, and community for social support, positive role models, self-esteem, and respect. The present data can inform prevention programs designed to reduce disparities, such as educational underachievement, exposure to violence, and premature mortality experienced by black males. This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Perceptions of emotional and physical wellness among African American men as predictors of perceived overall health

ABSTRACT African American are at risk for adverse emotional health. However, due to the intersection of their racial and gender identities which heightens their masculinity, emotional wellness is not always considered a priority by and for these men. This study aimed to examine African American men's emotional and physical health in relation to their overall health. An exploratory cross-sectional study was conducted to examine self-reported responses regarding emotional and physical health as predictors of overall wellness among a convenience sample of 115 African American men. The Wellness Self-Perception Questionnaire (WSPQ), a 15-item scale, was used to assess emotional and physical wellness. Overall health was assessed by a single item. Of the 115 study participants, the majority reported a positive perception of their overall health. Linear regression analyses revealed that both reported emotional wellness and physical wellness predicted better overall wellness, even when controlling for men's education and income. A review of the literature indicates this is the first study to assess emotional and physical wellness as predictors of overall health for African American men. Since African American men tend to utilize physical health services even for mental health concerns, implications for physicians are also discussed.

The Association Between Happiness and Self-Rated Physical Health of African American Men: A Population-Based Cross-Sectional Study.

Happiness and self-rated physical health are included in national surveys to assess health perceptions and subjective well-being among individuals. Studies have reported that happiness impacts physical health; however, little is known about the association between happiness and self-rated physical health among African American men (AAM). The objective of this study is to examine this relationship.Participants were 1,263 AAM aged 18+ years from the National Survey of American Life who rated their happiness and physical health. Interviews were conducted between 2001 and 2003. Self-rated physical health was defined as how individuals rated their own physical health and happiness as how individuals perceived their subjective well-being. Three multivariate logistic regression models were used to examine the relationships between happiness and self-rated physical health.It was observed that AAM who were happy were more likely to be married, to be employed, and earn more than $30,000 annually compared to AAM who were not happy. AAM who were happy were less likely to rate their physical health as fair/poor relative to AAM who were not happy. When controlling for demographic and socioeconomic factors, AAM who reported being happy had lower odds of rating their physical health as fair/poor compared to AAM who reported not being happy.Findings suggest that AAM who are happy report better physical health than those who report not being happy. Public health promotion strategies focusing on AAM should consider happiness as a promising influence that may positively impact physical health.

Association between discrimination and obesity in African-American men

ABSTRACTThe objective of this study was to examine the association between discrimination and obesity among a U.S. nationally representative sample of African-American men. Data from the 2001–2003 National Survey of American Life (NSAL) were used to collect measures of everyday and major discrimination, and body mass index (BMI) taken from self-reports. Poisson regression with robust standard errors was applied to estimate the prevalence ratios of everyday and major discrimination as it relates to obesity (BMI ≥ 30 kg/m2), controlling for potential confounders. In the model that included both everyday and major discrimination, men who experienced any major discrimination had a higher likelihood of obesity (prevalence ratio [PR] = 1.33, 95% confidence interval [CI], 1.06, 1.66) than those who did not experience any major discrimination, controlling for age, marital status, income, education, major stressors, two or more chronic conditions, and physical activity. Exposure to any major discrimination was found to be associated with obesity in African-American men. Future studies among this population are needed to examine whether the observed changes in self-reports of major discrimination are associated with obesity, measured by BMI, over time. The health of African-American men must be a priority in reducing excess disparities in disease, disability, and death.

Risk and Protective Factors for Depressive Symptoms Among African American Men: An Application of the Stress Process Model.

This study employs the stress process model (SPM) to identify risk/protective factors for mental health among adult African American men. Using a community-based sample of Miami, FL residents linked to neighborhood Census data, this study identifies risk/protective factors for depressive symptomatology using a sample of 248 adult African American men. The stress process variables independently associated with depressive symptoms were family support, mastery, self-esteem, chronic stressors, and daily discrimination. While mastery and self-esteem mediated the relationship between neighborhood income and depressive symptoms, perceived family support served as a buffer for stress exposure. Collectively, the SPM explains nearly half of the variability in depressive symptoms among African American men. The SPM is a useful conceptual framework for identifying psychosocial risk/protective factors and directing health initiatives and policies aimed at improving the psychological health of African American men.