Men, especially African American men, have poorer health than women. To identify concerns and experiences that may contribute to this disparity, participatory action research methods were used to conduct six focus groups with fifty-nine participants in a North Carolina city. Aspects of male gender socialization were identified as major barriers to health. This socialization influences many behaviors in which men engage, such as unhealthy diet, limited exercise, unsafe sex, and substance abuse. Focus group participants with fewer educational and financial resources discussed drug-infested communities, economic barriers, crime, lack of affordable health insurance, and perceived discrimination in health care encounters. Participants with more formal education and more financial resources expressed concerns about managed care and chronic diseases. These results demonstrate the importance of male gender socialization in the health of African American men. In addition, economic class must be taken into account when addressing the health of African American men.
Antai-Otong, D.2002. Culturally sensitive treatment of African Americans with substancerelated disorders. Journal of Psychosocial Nursing and Mental Health Services40:14-21.
2.
Arnstein, S. R.1969. A ladder of citizen participation. Journal of the American Planning Association35 (4): 216-224.
3.
Baranowski, T., C. Perry, and G. Parcel. 1997. How individuals, environments, and health behavior interact. In Health behavior and health education, edited by K. Glanz, K. M. Lewis, and B. K. Rimer, 153-178). San Francisco: Jossey-Bass.
4.
Brooks, Gary, and Glen Good, eds. 2001. The new handbook of psychotherapy and counseling with men: A comprehensive guide to settings, problems and treatment approaches. San Francisco: Jossey-Bass/Pfeiffer.
5.
Brunswick, A. F, A. Aidala, J. Dobkin, J. Howard, S. P. Titus, and J. Banaszak-Holl. 1993. HIV-1 seroprevalence and risk behaviors in an urban African-American community cohort. American Journal of Public Health83:1390-1394.
6.
Burstin, H. R, S. R. Lipsitz, and T. A. Brenna. 1992. Socioeconomic status and risk for substandard medical care. Journal of the American Medical Association268:2383-2387.
7.
Centers for Disease Control and Prevention. 2000. HIV/AIDS Surveillance Report 12. http://www.cdc.gov/hiv/stats/hasr1202.htm.
8.
Clark, R., N. Anderson, V. Clark, and D. Williams. 1999. Racism as a stressor for African Americans a biopsychosocial model. American Psychologist54:805-816.
9.
Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. 2002. Unequal treatment: Confronting racial and ethnic disparities in health care. Board on Health Sciences Policy, Institute of Medicine. Washington, DC: National Academy Press.
10.
Cooley, M. E., and K. Jennings-Dozier. 1998. Cultural assessment of black American men treated for prostate cancer: Clinical case studies. Oncology Nursing Forum25:1729-1736.
11.
Courtenay, W.2000. Constructions of masculinity and their influence on men's well-being: A theory of gender and health. Social Science and Medicine50:1385-1401.
12.
Crawford, E. D., C. L. Bennett, N. N. Stone, S. J. Knight, E. DeAntoni, L. Sharp, M. B. Garnick, and H. A. Porterfield. 1997. Comparison of perspectives on prostate cancer: Analyses of survey data. Urology50:366-372.
13.
Dancy, B.1994. African American men: The ideal AIDS program. Journal of The Blace Nurses Association7:60-67.
14.
Eckert, J., and R. Rubinstein. 1999. Older men's health sociocultural and ecological perspectives. Medical Clinics of North America83:1151-1172.
15.
Erol, E., C. Hamond, J. Wasson, B. Berlin, M. Ely, V. Laudone, A. Tarantino, and P. Alertsen. 1998. Assessment of the feasibility and impact of shared decision making in prostate cancer. Urology51:63-66.
16.
George, M. A., L. W. Green, and M. Daniel. 1996. Evolution and implications of PAR for public health. Journal of Promotion and Education3:6-10.
17.
Helgeson, V. S.1995. Masculinity, men's roles, and coronary heart disease. In Men's health and illness: Gender, power and the body, edited by D. Sabo and D. F. Gordon, 68-104. Thousand Oaks, CA: Sage.
18.
Hong, L.2000. Toward a transformed approach to prevention: Breaking the link between masculinity and violence. Journal of American College Health48:269-279.
19.
Israel, B., A. Schulz, E. Parker, and A. Becker. 1998. Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health19:173-202.
20.
James, S.1994. John Henryism and the health of African Americans. Culture, Medicne and Psychiatry18:163-182.
21.
Jones, C.2000. Levels of racism: A theoretic framework and a gardener's tale. American Journal of Public Health90:1212-1215.
22.
Kaiser Commission on Uninsured Basics. 2001. The uninsured: A primer, key facts about Americans without health insurance. Kaiser Family Foundation. http://www.kff.org.
23.
Kim, M., and M. Hill. 2000. Development and testing of the Hill-Bone compliance to high blood pressure therapy scale. Progress in Cardiovascular Nursing15:90-96.
24.
LaVeist, T., J. M. Wallace, and D. L. Howard. 1995. The color line and the health of African Americans. Humboldt Journal of Social Relations21:119-136.
25.
Lemle, R., and M. D. Mishkind. 1989. Alcohol and masculinity. Journal of Substance Abuse Treatment6:213-222.
26.
Lillie-Blanton, M., M. Brodie, D. Rowland, D. Altman, and M. McIntosh. 2000. Race, ethnicity, and the health care system: Public perceptions and experiences. Medical Care Research and Review57B9J (suppl. 1): 218-235.
27.
Ludescher, G., R. Nishiwaki, D. Lewis, E. Brown, D. Glacken, and E. Jenkins. 1993. Black male college students and hypertension: A qualitative investigation. Health Education Research8:271-282.
28.
Margolis, L. H., A. Richmond, T. Brown, and S. Jackson. 2003. Working with African American worksites to implement an on-site cardiovascular health program. Journal of Health Care for the Poor and Underserved14:331-340.
29.
Moynihan, C.1998. Theories in health care and research: Theories of masculinity. British Medical Journal317:1072-1075.
30.
National Center for Health Statistics (NCHS). 2000. National vital statistics report, no. 48. http://www.cdc.gov/nchs/about/major/dvs/mortdata.htm.
31.
Nicholas, D.2000. Men, masculinity, and cancer: Risk-factor behaviors, early detection, and psychosocial adaptation. Journal of American College Health49:27-33.
32.
Rose, L., M. Kim, C. Dennison, and M. Hill. 2000. The contexts of adherence for African Americans with high blood pressure. Journal of Advanced Nursing32:587-594.
33.
Rosenthal, E. L.1998. The National Community Health Advisor Study. Policy Research Project Report, June. Tucson: University of Arizona.
34.
Sandman, D., E. Simantov, and C. An.2000. Out of touch: American men and the health care system. New York: Commonweatlh Fund.
35.
Shea, S., D. Misra, M. H. Ehrlich, L. Field, and C. K. Francis. 1992. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. New England Journal of Medicine327:776-781.
36.
Sherman, D. W., and C. Q. Kirton. 1998. Hazardous terrain and over the edge: The survival of HIV-positive heterosexual, minority men. JANAC9:23-34.
37.
Staples, R.1995. Health among African American males. In Men's health and illness: Gender, power and the body, edited by D. Sabo and D. F. Gordon, 121-138. Thousand Oaks, CA: Sage.
38.
U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease Control and Community Intervention (USDHHS). 1994. Community health advisors: Models, research and practice selected annotations—United States. 2 vols. Atlanta, GA: Centers for Disease Control and Prevention.
39.
Van Ryn, M., and J. Burke. 2000. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Social Science & Medicine50:813-828.
40.
Waldron, I.1976. Why do women live longer than men?Social Science and Medicine10 (7-suppl.-8): 349-362.
41.
Weissman, J., and A. M. Epstein. 1989. Case mix and resource utilization by uninsured hospital patients in the Boston metropolitan area. Journal of the American Medical Association261:3572-3576.
42.
Williams, D.1994. Racism and health: A research agenda. Ethnicity & Disease6:1-6.
43.
Williams, D.1999. Race, socioeconomic status, and health: The added effects of race and discrimination. Annals of the New York Academy of Sciences896:173-188.
44.
Williams, D. R., and R. Williams-Morris. 2000. Racism and mental health: The African American experience. Ethnicity & Health5:243-268.
45.
Williams, D., R. Lavizzo-Mourey, and R. Warren. 1994. The concept of race and health status in America. Public Health Reports109:26-41.
46.
Wolfe, W.2003. Overlooked role of African-American males’hypermasculinity in the epidemic of unintended pregnancies and HIV/AIDS cases with young African American women. Journal of the National Medical Association95:846-852.
47.
World Health Organization. 2003. Social determinants of health, 2nd ed., edited by Richard Wilkinson and Michael Marmot. http://www.who.dk/document/E59555.pdf (accessed July 23, 2004).
