Abstract
Since the publication of the 10-volume Secretary’s Task Force on Black and Minority Health (U.S. Department of Health and Human Services, 1986), it has been painfully obvious that collectively, African American men experience very poor health outcomes. Historically, life expectancy of African American men has consistently lagged behind that of Whites and most other racial and ethnic groups of men (Arias, 2006). Leading causes of death among African American men include heart disease, cancer, stroke, diabetes, unintentional injuries, kidney diseases, chronic lower respiratory disease, and homicide (Centers for Disease Control and Prevention, 2013). Unfortunately, to date, more complete explanations offered to identify why African American men continue to experience poorer health outcomes have been limited (Jack, Tyson, Jack, & Sims, 2010).
Part of the challenge has been that African American men’s health has typically been studied through the lens of racial and ethnic health disparities. While useful for identifying factors associated with race and ethnicity that affect health outcomes, a focus on racial and ethnic health disparities in men’s health has tended to miss the critical role that gender plays in African American men’s lives and health (Griffith, Metzl, & Gunter, 2011). A second challenge of how we have studied African American men’s health is that we have tended to use a comparative framework to examine how African American men differ from other groups of men or African American women (Bediako & Griffith, 2007). While this is useful for identifying some health issues that require additional attention, comparative approaches tend to obscure unique physical environment, economic circumstances, social norms, and cultural practices that affect patterns of health outcomes for African American men. Focusing exclusively on African American men facilitates identifying and examining the unique pathways and mechanisms that may be responsible for the consistently poor health of African American men and helps identify cultural strengths that could be the foundation of interventions to improve the health of this population (Bediako & Griffith, 2007; Griffith, 2012; Griffith et al., 2011).
The co–guest editors of this American Journal of Men’s Health supplement sought to publish a collection of peer-reviewed articles that would expand the discourse in the field of African American men’s health beyond narrowly focusing on characteristics of the individual. Thus, this supplement aims to examine how context (social and physical environment), politics, access to health care, and more collectively influence the quality and length of life among African American men. Given the supplement’s focus on context, contributing authors identify multiple pathways that explain the conditions that influence health. In addition, authors in this supplement offer solutions to addressing and eliminating health disparities and inequities between racial and ethnic groups of men and among African American men. This supplement consists of seven articles—each is briefly described.
Thorpe and coauthors, in their article “Health Behaviors of African American Men: Implications for Research and Practice,” analyze and present data from the Third National Health and Nutrition Examination Survey (1988-1994) and the NHANES III Linked Mortality Public-Use File. This article focuses on the association between health behaviors and all-cause mortality. The researchers found that being a current smoker and being physically inactive was associated with increased risk of mortality. The authors offer recommendations on ways to develop age-appropriate interventions focusing on smoking cessation and increasing physical activity among African American men.
Griffith, Ellis, and Allen conduct a qualitative study using an intersectional approach to examine sources of stress among African American men. In their article, “An Intersectional Approach to Social Determinants of Stress for African American Men: Men’s and Women’s Perspectives,” Griffith and colleagues find that the type and intensity of the men’s racial experiences were greatly affected by the fact that they were both African American and male. To understand the stressors that affected African American men’s quality of life, it was critical to consider how race, ethnicity, age, marital status, and other factors combined to serve as stressors. Griffith and colleagues found that health was rarely mentioned by the men as a source of stress, but key women in men’s lives recognized that declines in men’s physical functioning, pain, and mobility were key sources of stress for African American men. This research elevates the need for more research to consider the perspective of women in the lives of African American men. Research from this perspective will lead to the development of men’s health promotion strategies that can help African American men recognize stressors and health issues. In addition, employing evidenced-based health promotion strategies would also assist African American, if and when necessary, to discuss health in general with their health professionals.
Lisa Bowleg presents findings from a qualitative research study in the article titled, “The Skill Is Using Your Big Head Over Your Little Head”: What Black Heterosexual Men Say They Know, Want, and Need to Prevent HIV.” Bowleg conducted four focus groups with 28 African American men, ages 19 to 51, to examine whether study participants prioritize HIV/AIDS in their lives and to identify HIV prevention needs. Bowleg reports that HIV was not a “top life priority” among this sample of African American men. However, men did report prioritizing the importance of educating their own children about HIV prevention. African American men in this study also reported protecting their main partners from HIV should they have sexual encounters with other partners. Bowleg offer suggestions on ways to increase the delivery of effective educational opportunities to heterosexual African American men.
Unfortunately, there is not a body of scholarly books focusing exclusively on the health of African American men in the United States. Jack provides a review of a recently published book, Social Determinants of Health Among African-American Men, edited by Treadwell, Xanthos, and Holden (Jossey-Bass, 2012). Jack’s book review indicates that this book moves beyond discussing individual risk factors to offering a broader discussion of how the physical and social environments greatly influence health outcomes among African American men. Jack provides insights into the book’s strengths and identifies what audiences would benefit from the book’s content.
Watkins, Abelson, and Jefferson’s work, “‘Their Depression Is Something Different . . . It Would Have to Be’: Findings From a Qualitative Study of Black Women’s Perceptions of Depression in Black Men,” provides insight into the social support role of Black women in the lives of Black men. The researchers report identifying four themes ranging from Black men’s depression as a cultured and gendered phenomenon to the importance of identifying ways to reach/provide Black men with resources around depression. This article does an excellent job of discussing why depression is viewed as a topic not often discussed in the Black community. The article highlights the important perspective Black women have on African American men’s health and offers suggestions on how to address barrier to Black men acknowledging depression, seeking help and support, and maintaining treatment.
This supplement offers another article addressing mental health among African American men. Johnson-Lawrence, Griffith, and Watkins examined how mood/anxiety disorders and chronic physical health conditions varied by age, race, and ethnical background among African American, Caribbean Black, and non-Hispanic White men. The researchers used data from the National Survey of American Life data set—a nationally representative sample of African Americans and Caribbean Blacks—to conduct the study. Johnson-Lawrence and colleagues’ work, “The Effects of Race, Ethnicity, and Mood/Anxiety Disorders on the Chronic Physical Health Conditions of Men From a National Sample,” reported findings that validated the need for continued research to identify predictors of chronic physical health. Specifically, this study reported that among men 45 years and older with mood/anxiety disorders, African American men had greater odds of chronic physical health conditions than White men. The researchers recommend more studies are needed to identify pathways that help explain how underlying variations between mental health and chronic physical health conditions occur across life stages of African American men.
The supplement ends with an important commentary titled, “Structural Health, and the Politics of African American Masculinity.” Metzl provides a compelling discussion on how structures and institutions “. . . enable, and occasionally block attempts to achieve happiness and longevity” among African American men. Metzl offers suggestions on how to increase awareness of the many barriers to African American health. Metzl’s suggestions include acknowledging the role of the environment; employing strategies to address unequal treatment in health care settings; using economic, political, and social justice interventions; and disseminating tailored health messages to better reach and educate African American men about their health.
This supplement, focusing on the health and well-being of African American men, offers emerging approaches that can facilitate better understanding of how African Americans men view various dimensions of their health. This supplement also provides readers with access to innovative theoretical frameworks to identify complex pathways shaped by the interaction of biology, family, gender roles and norms, health care systems, and physical and social environments that may be useful to inform future research and interventions. The supplement’s focus on African American men is particularly useful to examine why U.S. cultural norms regarding manhood and masculinity do not have the same meaning and influence within and across African American men’s lives or health outcomes (Griffith et al., 2011). As researchers committed to advancing our understanding of health concerns among African Americans, we hope this supplement serves as a valuable resource to researchers, practitioners, clinicians, and students from a wide range of disciplines, settings, and professions. We encourage you to share this editorial and the contents of this supplement with those you believe would find this a timely publication of interest.