Black Men Face Research Articles

The Consequences of Misdiagnosing Race-Based Trauma Response in Black Men: A Critical Examination

ABSTRACT Mental illness is a significant public health concern prevalent in America. Over one in five U.S. adults are affected, yet less than half receive treatment. Among African Americans, only one in three seek treatment with statically lower rates among Black males. Therefore, an accurate diagnosis is crucial for appropriate treatment, while misdiagnosis leads to stigma, discrimination, and untreated illness. This paper examines the implications of misdiagnosing trauma responses in Black men, highlighting systemic biases that impede suitable care and perpetuate negative narratives. The authors propose a conceptual framework incorporating historical trauma, discrimination, and traumatic stress reactions, emphasizing the need for cultural competence and humility. This framework involves public narratives that influence perceptions and judgments, reviewing research evidence, advocating for competent trauma assessments, community empowerment, and future research directions. This paper underscores the importance of understanding and addressing the unique challenges Black men face in mental health diagnosis and treatment.

Evidence-based Prostate Cancer Screening Interventions for Black Men: A Systematic Review.

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used to assess the quality of the evidence presented. Of the 206 full-text articles assessed, three were included in this review. Educational interventions about prostate cancer knowledge with shared and informed decision-making (IDM) features, as well as counseling, treatment options, and healthcare navigation information, may increase prostate cancer screening participation among Black men. Additionally, health partner educational interventions may not improve IDM related to screening participation. The quality of the evidence presented in each article was valid and potentially impactful to the community. Black men face various social determinants of health barriers related to racism, discrimination, cost of health services, time away from work, and lack of trust in the healthcare system when making health-related decisions, including prostate cancer screening participation. A multifactorial intervention approach is required to address these inequities faced by Black men especially as prostate cancer is curable when diagnosed at an earlier stage.

Intersectionality approach to mental health for Black men in student affairs

AbstractNavigating higher education can be a challenging experience for Black men. Among these, Black men often face unique mental health challenges stemming from systemic racism, cultural expectations, and societal pressures. Addressing their specific needs requires a comprehensive approach. However, supporting Black men's mental health in higher education involves a multi‐faceted approach. By actively recognizing their challenges and ensuring resources cater to their specific needs, we can create an environment where all Black men can thrive in student affairs services. In this article, we used Chapman‐Hilliard and Adams‐Bass's theoretical framework of Black Liberation Psychology to guide our analysis of the mental health challenges that Black men face in student affairs.

Abstract 2147: Genetic ancestry associations with prostate adenocarcinoma mutational profiles: New Insights from a diverse 5,959-patient real-world cohort

Abstract In prostate cancer, Black men face higher incidence rates, more advanced diagnoses and worse outcomes than White men. These disparities partially stem from environmental, socioeconomic, and healthcare access factors. Recent data highlight racial differences in prostate cancer molecular profiles, with tumors from Black men showing increased SPOP and decreased PIK3CA mutations and amplified androgen receptor signaling and inflammatory pathway activations. Thus, somatic mutation patterns may also contribute to these disparities. We sought to identify associations of mutational profiles in prostate adenocarcinoma (PRAD) with genetic ancestry instead of race and ethnicity categories, analyzing a de-identified cohort of 5,959 patients who underwent the Tempus xT 648-gene NGS tumor profiling test. We used 654 ancestry-informative markers to estimate genetic ancestry by calculating similarity to reference populations for five regions: Africa (AFR), Americas (AMR), East Asia (EAS), Europe (EUR), and South Asia (SAS). Associations between genetic ancestry proportions and somatic variants were assessed for 67 PRAD-related genes using logistic regression models. Analyses included copy number alterations (CNAs), oncogenic gene fusions, small splice and non-synonymous mutations (NS), OncoKB L1/2 & R1, and small missense driver somatic mutations predicted with boostDM. Likelihood ratio tests were employed to compare models with and without ancestry terms. The Benjamini-Hochberg method was utilized to adjust p-values and control the FDR at 5%. We confirmed reported associations in PRAD between AFR ancestry and SPOP NS mutations (OR=1.03 per doubling of AFR ancestry proportion, p=0.03) and decreased AFR with PIK3CA OncoKB and driver mutations (OR=0.94, p=0.02), PTEN CNAs (OR=0.95, p=0.0001), and TMPRSS2-ERG fusions (OR=0.95, p<0.0001). However, we also observed negative associations between AFR and AR CNAs (OR=0.95, p=0.004), EAS and PTEN CNAs (OR=0.96, p=0.01), and EAS and TMPRSS2-ERG fusions (OR=0.97, p=0.02). Additionally, a negative association was found between EAS and TP53 driver NS mutations (OR=0.96, p=0.04), while positive associations with driver mutations in FOXA1 (OR=1.06, p=0.03) and NS mutations in the PI3K/AKT/mTOR pathway genes (OR=1.04, p=0.01) were noted. Lastly, we identified novel positive associations between AMR and driver mutations in PIK3C3A (OR=1.12, p=0.0003) as well as small NS mutations or CNAs in the PI3K/AKT/mTOR pathway genes (OR=1.03, p=0.04). By analyzing a large, diverse real-world cohort and leveraging NGS-inferred genetic ancestry, our study confirms known associations between somatic alterations in PRAD cancer genes and race and ethnicity, while unveiling novel associations in understudied populations of potential significance for understanding disparities in disease outcomes. Citation Format: Brooke Rhead, Yannick Pouliot, Francisco M. De La Vega, David W. Craig, John Carpten. Genetic ancestry associations with prostate adenocarcinoma mutational profiles: New Insights from a diverse 5,959-patient real-world cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2147.

Police Violence Experienced by Black Gay and Bisexual Men: The Effects on HIV Care Engagement and Medication Adherence.

Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms.

Societal factors impacting young Black men in South Africa

PurposeThis study employs the social ecology model to comprehensively explore the complex challenges young Black men face in South Africa and aims to highlight the importance of collaboration in addressing these multifaceted issues.Design/methodology/approachA multidisciplinary approach combines insights from sociology, education and the health literature with regard to government reports and academic data, and provides a holistic analysis of challenges faced by young Black men. Furthermore, it emphasises formal and informal learning, social and environmental influences and health disparities.FindingsYoung Black men in South Africa encounter complex challenges throughout their developmental journey, including limited family support, educational barriers, financial constraints, societal expectations and health disparities. Therefore, collaboration among stakeholders is essential for creating an equitable and inclusive environment that supports their development.Originality/valueThis research provides a comprehensive understanding of the challenges faced by young Black men in South Africa by emphasising the interconnectedness of informal education, economic empowerment and healthcare. Future research should focus on longitudinal studies, cultural influences and international comparisons, informing evidence-based interventions for a more equitable society.

Incarceration's lingering health effects on Black men: impacts persist into retirement

<abstract><sec> <title>Background</title> <p>The unique challenges Black men face within the criminal justice system underscore structural and systemic factors driving widespread inequalities. The long-term effects of these challenges on economic, health, and social outcomes as individuals transition to retirement remain poorly understood, highlighting a critical gap in our knowledge of life trajectories long after justice system involvement.</p> </sec><sec> <title>Objectives</title> <p>This study investigated the enduring health impacts of incarceration on Black men, particularly focusing on the transition into retirement. It aimed to explore the influence of race and gender on experiences of incarceration before age 50, and how such experiences affected self-rated health during the retirement transition.</p> </sec><sec> <title>Methods</title> <p>Utilizing data from the Health and Retirement Study, which followed individuals aged 50–59 for up to thirty years, this research examined the interplay of race, gender, incarceration history, and self-rated health during the retirement transition. Logistic regression and path modeling were employed for data analysis.</p> </sec><sec> <title>Results</title> <p>Logistic regression results indicated that being Black, male, and having lower educational attainment significantly increased the likelihood of experiencing incarceration before the age of 50 (p < 0.05). This suggests that Black men with lower levels of education are at the greatest risk of incarceration. The path model revealed a correlation between incarceration experiences before age 50 and poorer self-rated health at the time of retirement.</p> </sec><sec> <title>Conclusion</title> <p>The findings highlighted the disproportionately high risk of incarceration among Black men, especially those with lower educational attainment, and its persistent negative impacts on health decades later, including during the transition into retirement. Addressing structural racism and the mass incarceration of Black men is crucial for achieving racial health equity as individuals retire.</p> </sec></abstract>

Adding a Coefficient for Race to the 4Kscore Improves Calibration for Black Men.

Black men face a higher incidence of high-risk prostate cancer (PCa) compared with non-Black men. While the 4Kscore is a widely utilized commercial test for PCa risk assessment, it does not currently account for racial differences. The aim of this study is to describe and validate a prespecified race coefficient for the 4Kscore with the goal of improving the accuracy of this test for Black men. Using data from 85 Black men from the initial US prospective validation study, a race coefficient of 0.6 on the log-odds scale was prespecified. We calculated discrimination, calibration, and clinical utility of the 4Kscore with and without this coefficient for Black race in our primary analysis cohort of 205 Black men undergoing biopsy for PCa in a Veterans Affairs (VA) institution. We performed a sensitivity analysis using a combined cohort from the US prospective validation and the VA studies. The mean probability of high-grade PCa from the 4Kscore in the primary cohort increased from 25% to 37% with race coefficient addition. Incorporating the race coefficient improved 4Kscore's calibration in Black men, with consequent improvements in clinical utility based on decision curve analysis. Model discrimination was maintained (AUC 0.825 vs 0.828, P = .14) in the combined cohort of Black and non-Black men from the US prospective and VA studies and the calibration remained largely unchanged. Incorporating a prespecified coefficient for Black race improved calibration and clinical utility of the 4Kscore among Black men and should be added to the 4Kscore.

Looking more criminal: It's not so black and white.

Prior research regarding the influence of face structure on character judgments and first impressions reveals that bias for certain face-types is ubiquitous, but these studies primarily used decontextualized White faces for stimuli. Given the disadvantages Black men face in the legal system, this study aimed to investigate whether the criminal face-type presented in the context of crime influenced different legal system-type judgments as a function of perpetrator race. In a mixed-model design, participants saw Black and White computer-generated faces that varied in criminality presented with either violent or nonviolent crime scenarios. At test, participants attempted to identify the original perpetrator from a photo array, along with providing penalty severity judgments for the crime committed. Results indicate that when crimes were violent, participants meted harsher penalties overall to Black faces or to high-criminality faces identified as the perpetrator. Furthermore, for violent crimes, participants were more likely to select a face from the photo array that was higher/equally as high in criminality rating relative to the actual perpetrator when memory failed or when the perpetrator was Black. Overall, the findings suggest that when people are making judgments that could influence another's livelihood, they may rely heavily on facial cues to criminality and the nature of the crime; and this is especially the case for Black faces presented in the context of violent crime. The pattern of results provides further support for the pervasive stereotype of Black men as criminal, even in our racially diverse sample wherein 36% identified as Black.

A Technology-Enhanced Intervention for Violence and Substance Use Prevention Among Young Black Men: Protocol for Adaptation and Pilot Testing.

Black boys and men from disinvested communities are disproportionately survivors and perpetrators of youth violence. Those presenting to emergency departments with firearm-related injuries also report recent substance use. However, young Black men face several critical individual and systemic barriers to accessing trauma-focused prevention programs. These barriers contribute to service avoidance, the exacerbation of violence recidivism, substance use relapse, and a revolving-door approach to prevention. In addition, young Black men are known to be digital natives. Therefore, technology-enhanced interventions offer a pragmatic and promising opportunity to mitigate these barriers, provide vital life skills for self-led behavior change, and boost service engagement with vital community resources. The study aims to systematically adapt and pilot-test Boosting Violence-Related Outcomes Using Technology for Empowerment, Risk Reduction, and Life Skills Preparation in Youth Based on Acceptance and Commitment Therapy (BrotherlyACT), a culturally congruent, trauma-focused digital psychoeducational and service-engagement tool tailored to young Black men aged 15-24 years. BrotherlyACT will incorporate microlearning modules, interactive safety planning tools for risk assessment, goal-setting, mindfulness practice, and a service-engagement conversational agent or chatbot to connect young Black men to relevant services. The development of BrotherlyACT will occur in 3 phases. In phase 1, we will qualitatively investigate barriers and facilitators influencing young Black men's willingness to use violence and substance use prevention services with 15-30 young Black men (aged 15-24 years) who report perpetrating violence and substance use in the past year and 10 service providers (aged >18 years; any gender; including health care providers, street outreach workers, social workers, violence interrupters, community advocates, and school staff). Both groups will be recruited from community and pediatric emergency settings. In phase 2, a steering group of topic experts (n=3-5) and a youth and community advisory board comprising young Black men (n=8-12) and service providers (n=5-10) will be involved in participatory design, alpha testing, and beta testing sessions to develop, refine, and adapt BrotherlyACT based on an existing skills-based program (Achieving Change Through Values-Based Behavior). We will use user-centered design principles and the Assessment, Decision, Administration, Production, Topical, Experts, Integration, Training, and Testing framework to guide this adaptation process (phase 2). In phase 3, a total of 60 young Black men will pilot-test the adapted BrotherlyACT over 10 weeks in a single-group, pretest-posttest design to determine its feasibility and implementation outcomes. Phase 1 data collection began in September 2021. Phases 2 and 3 are scheduled to start in June 2023 and end in September 2024. The development and testing of BrotherlyACT is a crucial first step in expanding an evidence-based psychoeducational and service-mediating intervention for young Black men involved in violence. This colocation of services shifts the current prevention strategy from telling them why to change to teaching them how. PRR1-10.2196/43842.

"But I Live Here Too": Social-structural stressors, racial discrimination, and resiliency among urban dwelling black emerging adult men.

For many Black emerging adult men in the United States, social-structural stressors rooted in racial discrimination are daily experiences that place them at greater risk for poor health. Emerging adulthood is a critical life course period marked by greater experimentation with health risk behaviors. Although Black men's health vulnerabilities during this period are connected to their social-structural environments, investigations of these factors among noncollege sampled Black men remain limited. We conduced thirty semi-structured in-depth interviews to examine associations between social-structural challenges and social-structural resources for resiliency. Interviews were audio-recorded, transcribed verbatim, and coded using Dedoose web-based qualitative software. Through open coding, emergent concepts were connected across interviews and major themes were identified. We found three core social-structural stressors: (1) Racial profiling, (2) neighborhood violence, and (3) lack of economic opportunities, and three resilience factors: (1) Positive social networks, (2) community-based resources, and (3) safe environments that foster a sense of community. Collectively, these findings provide insight into developing structural- and community-level interventions tailored to bolster resiliency across multiple levels and counteract the social-structural challenges that young Black men face.

Black Men's Intimate Partner Violence Victimization, Help-Seeking, and Barriers to Help-Seeking.

Guided by hegemonic masculinity and intersectionality theories, this descriptive, exploratory study examined Black men's intimate partner violence (IPV) victimization experiences, subsequent help-seeking decisions, and barriers to help-seeking. To begin exploring Black men's experiences, two research questions guided this study: (a) What are Black men's experiences of IPV-related help-seeking? (b) What barriers do Black men face when seeking IPV-related help and support? A total of 54 Black men participated in an online survey on their IPV experiences via the crowdsourcing platform Prolific. Overall, the men who participated in this study experienced relatively low levels of minor and severe physical and sexual violence victimization, as well as lower levels of coercive controlling violence in comparison to nationally representative data, suggesting this sample comprises men who experience situational couple versus coercive controlling violence. All but one participant utilized at least one help-seeking strategy. Informal strategies were most commonly utilized, whereas legal strategies were least commonly utilized. The degree to which participants perceived each strategy as helpful was quite variable, such that staying with friends or family was the most helpful strategy yet 47.8% found it unhelpful. The most common help-seeking barriers (e.g., wanting to solve the problem on their own) overlap with hegemonic masculinity and Black men's experiences with formal and legal systems, relating less to the internalized and anticipated stigma subscales created for women. Broadly, this study helps illustrate the need for researchers to focus on developing measures and interventions tailored to Black men and their experiences.

Black men in white coats - Barriers black men face in medicine, implications to decreased representation, and potential interventions at the uniformed services university of the health sciences

The number of black male applicants to US medical schools has remained stagnant over the last 30 years. The etiology behind the lack of applicants is multifaceted and involves greater systemic barriers, specifically, educational and social barriers. The lack of representation of black males in medicine also has downstream implications for the health of the African American/black community. African Americans exhibit some of the lowest levels of trust in the healthcare system, have less access to care than their non-minority peers, and have, comparatively, poorer healthcare outcomes than other populations in the US. Research has demonstrated that patient-provider race concordance improves communication, outcomes, culturally competent care, and satisfaction with care. The greater the gap between these two populations, the harder it becomes to improve healthcare outcomes, maintain a medically ready fighting force in the US military, and improve trust in the healthcare system. This article provides an analysis of the multifactorial barriers black male applicants face applying, matriculating, and graduating medical school and how decreased representation may affect healthcare delivery. Furthermore, this review explores next steps and potential implementations at the Uniformed Services University of the Health Sciences to address the above deficiencies.

Does Perceived Racism Affect Prostate Cancer Screening Rates and Patient-Provider Shared Discussions Among Black and White Men?

While Black men face a significant cancer risk burden in the United States, confronting complex historical and social issues such as racism and discrimination undermines care. This study explored associations between perceived racism, prostate screening rates, and shared medical discussions. We performed data analysis of merged Behavioral Risk Factor Surveillance System (BRFSS) survey data. Data were limited to Black and White men. We used propensity score analysis to assess the race-associated effects on outcomes. Black men were less likely than White men to receive discussions of both prostate-specific antigen (PSA) screening advantages χ2(4.54), p < .05 and disadvantages χ2(41.62), p < .001. The effects of perceived racism and its interaction with race were statistically non-significant for all PSA outcomes. Compared with their White counterparts, Black men were significantly less likely to be advised of potential PSA screening advantages and harms. This inequity in health care delivery has implications concerning disease prevention and informed decision-making.

A Dynamic Framework for Earnings Inequality between Black and White Men

Abstract The present study conceptualizes earnings inequality between black and white men as a three-stage dynamic process: the pre-market human capital acquisition, the labor-market entry, and the longitudinal career progression. Based on the Panel Study of Income Dynamics (PSID), this framework is put to an empirical test that leads to two major conclusions. First, overall patterns of black-white earnings inequality are shaped primarily at labor-market entry as opposed to developing within the labor market. Second, the longitudinal progression of earnings inequality exhibits distinctive trajectories across different pre-market groups. Less-educated black men face a wider earnings gap at labor-market entry, but the gap stays relatively stable over time. Highly educated black men face a narrower earnings gap at labor-market entry, but the gap widens over time. I attribute these patterns to the temporal-specific interplays between race and a series of labor-market mechanisms.

How pharmacy can start to solve the inequity puzzle

How pharmacy can start to solve the inequity puzzle

Papa

In this personal narrative, the author details her grandfather’s and father’s experiences of police brutality in Los Angeles, a pattern that continues from one generation to another. She shows the long legacy of violence and racism that Black men face at the hands of the Los Angeles Police Department – from her grandfather Roy Wyche, who was beaten so badly in 1974 that he sustained permanent brain damage, to her father who suffered severe injuries after being wrongly suspected of a crime in 1983. These stories, she argues, are common occurrences that are part of a long history of injustice and systemic racism that Black people continue to face in the present day.

Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men’s Experiences in a Northeastern City

While a great deal of research captures the lived experiences of Black men as they navigate through the criminal legal system and onto reentry, very little research is grounded in how those processes are directly connected to their health. Although some research argues that mass incarceration is a determinant of poor health, there is a lack of qualitative analyses from the perspective of Black men. Black men face distinct pathways that lead them into the criminal legal system, and these same pathways await them upon reentry. This study aims to examine the health implications associated with incarceration and reentry of Black men. While adopting a phenomenological approach alongside interviews, our findings show both race- and gender-specific outcomes for the men in our sample. For example, health and wellness appears to be a significant theme that governs their (in)ability to matriculate society. Moreover, their contact with the criminal legal system appears to exacerbate health concerns and hindrances toward reentry. Other themes include mental health and the role of masculinity. We conclude with implications on policy and future research.

Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men's Experiences in a Northeastern City.

While a great deal of research captures the lived experiences of Black men as they navigate through the criminal legal system and onto reentry, very little research is grounded in how those processes are directly connected to their health. Although some research argues that mass incarceration is a determinant of poor health, there is a lack of qualitative analyses from the perspective of Black men. Black men face distinct pathways that lead them into the criminal legal system, and these same pathways await them upon reentry. This study aims to examine the health implications associated with incarceration and reentry of Black men. While adopting a phenomenological approach alongside interviews, our findings show both race- and gender-specific outcomes for the men in our sample. For example, health and wellness appears to be a significant theme that governs their (in)ability to matriculate society. Moreover, their contact with the criminal legal system appears to exacerbate health concerns and hindrances toward reentry. Other themes include mental health and the role of masculinity. We conclude with implications on policy and future research.

Laboratory eligibility criteria as potential barriers to participation by black men in prostate cancer clinical trials.

73 Background: Eligibility criteria may disproportionately affect black patients and contribute to their underrepresentation in clinical trials. We studied this potential barrier by examining clinical trials in prostate cancer, a disease in which black men face higher incidence and mortality. Specifically, we investigated the use of serum creatinine (sCr) alone instead of race-adjusted measurements for renal function, and the use of an absolute neutrophil count (ANC) threshold that could exclude men with benign ethnic neutropenia, which afflicts 6.7-8% of black patients and could lead to the exclusion of patients despite having healthy immune systems. Methods: We identified 401 interventional prostate cancer clinical trials with an overall survival endpoint. The list of trials was collected on January 16, 2017 from clinicaltrials.gov using the following criteria – study type: interventional studies; conditions: prostate cancer; interventions: drug; outcome measures: overall survival. Characteristics gathered from each trial included sponsor type, phase, accrual goal, start year, and toxicity. Results: Overall, 47.9% (192) of these trials used either sCr alone and/or required participants to have ANC ≥1.5×109 cells/L. Specifically, 25.2% (101) of the trials used sCr alone to determine eligibility, and 41.4% (166) of the trials required patients to have an ANC ≥1.5×109 cells/L. Conclusions: Of clinical trials in prostate cancer, 47.9% used criteria that disproportionately excluded black patients. The reevaluation of these two eligibility criteria could improve minority trial enrollment. First, lowering the ANC cutoff for patients with benign ethnic neutropenia would increase the number of eligible black participants, as 89% of these patients have an ANC ≥1.0×109 cells/L. Second, using race-adjusted equations for renal function would take into account racial differences in creatinine. While adopting race-based differences in trial criteria may add slight logistical challenges when ensuring patients meet trial eligibility, these adjustments would prevent healthy patients from being excluded solely because of benign laboratory differences caused by their race.