Abstract
African American men continue to experience a plethora of health challenges that without question warrant an entire volume dedicated to discussing not only their causes but also solutions. To date, there are a few books that exclusively focus on the health of African American men. Treadwell, Xanthos, and Holden’s recently released book (October, 2012), Social Determinants of Health Among African American Men, offers a comprehensive overview of the health status of African American men in the United States. A rich, scholarly, and current work, the book offers 17 chapters written by researchers, scholars, health professionals, and health practitioners from diverse fields of disciplines. Chapters in this book address a number of timely health issues that include the epidemiological burden of chronic conditions, contextual factors shaping health, and a range of solutions postulated to improve health outcomes among African American men. Each chapter follows a similar format that includes learning objectives, context specific to topic areas being addressed within each chapter, summary section, key terms, and discussion questions. Use of this format across each chapter makes the book a valuable resource in academic settings at both the undergraduate and graduate levels.
The book is divided into four parts: “Social Determinants of Health Status,” “Social Determinants of Health Behavior,” “Social Determinants of Health Care,” and “Addressing Social Determinants of Health Inequities.” Chapters across these four parts ranged from implications of racism on cancer risks, morbidity, and mortality; psychosocial and mental health; the impact of incarceration on health; sexual identify and health; medical mistrust among Black men; linkages between physical and social environments and health; and the role of public policy as a strategy for addressing health inequities. Clearly, having all 17 chapters in one volume elevates the importance of exploring health issues among African American men. Review across these 17 chapters reveal there is a heavy emphasis on the impact of incarceration on the health status of men. Several chapters address the impact of incarceration, racism, and discrimination on psychosocial and physical health of African American men.
Most chapters in this volume are impressive, but a few chapters are worth highlighting in this book review. Hammond and Siddiqi do an excellent job discussing the underpinnings of medical mistrust among African American men. This is done by offering a theoretical framework informed by previous frameworks and data collected from a cross-sectional investigation of African American men recruited between 2003 and 2009 in Michigan, Georgia, California, and North Carolina. Hammond and Siddiqi’s work acknowledges that perceived racism in health care is an important determinant of African American men’s trust in medical organizations and their willingness to utilize health care services. Although the study design limits Hammond and Siddiqi from making casual inferences, the use of data to advance the development of the chapter’s conceptual model (framework) was thoughtfully done. In another chapter, Blackwell addresses how characteristics of the neighborhood environment affect the health of African American men. In this chapter, Blackwell explains how neighborhood conditions such as limited employment opportunities, poor access to quality health care, poor housing options and conditions, and poor educational systems make the case for why interventions beyond the health sector are needed to address health disparities among this population.
In my opinion, some of the most exciting work in this book can be found in Part Four: Addressing Social Determinants of Health Inequities. Chapters 13 through 17 more directly focus on presenting solutions to a variety of factors that negatively affect the health of African American men. For example, Chapter 14, written by Whitley and Drisko, describes efforts by the Denver Men’s Health Initiative (DMHI) to increase access to affordable patient-centered care through the use of patient navigators. This chapter provides information on the DMHI’s marketing efforts, environmental determinants faced by African American men in Denver, stories from men receiving care from DMHI, and health care utilization rates among African American men receiving health care services at DMHI. This chapter also discusses how the DMHI has achieved a return on its investment, thus positioning the initiative to leverage funds to continue providing outreach, education, and health care services to African American men in Denver. Perez in Chapter 16 discusses how criminal justice and other public policies are needed to improve health and social outcomes among low-income African American men, as well as the communities they live in. As previously mentioned, many of the chapters appearing in this book address the impact of being incarcerated on the health and well-being of African Americans. Perez takes this discussion one step further by discussing the need for policies to remove barrier to work and education, thus taking steps toward eliminating the cycle of “cradle-to-prison” trajectory.
The book, although comprehensive, does not address in depth the historical burden of prostate cancer among African American men. The book does provide information on cancer risk regarding prostate cancer, but more could be offered. Although there certainly has been a plethora of journal publications and books written on this topic, the historical and long-standing burden of prostate warrants a chapter of its own in any book focusing on the health of African American men. An exclusive chapter focusing on clinical and public health solutions to address prostate cancer among African American men would add tremendous value to the second edition of the book. This can be said about other leading causes of death not addressed in great detail in the book. For example, diabetes, heart disease, and strokes—all exacting a tremendous burden on African American men—are worthy of deeper discussion in the book.
There was clearly recognition of the role that social support plays in mediating negative health outcomes. Perhaps the next edition of the book could feature a chapter discussing the importance of various forms of social support among men. This chapter could present strategies on creating social support systems that take into account social norms, views, and life experiences of African American men. Finally, repeatedly, across chapters, authors mention how lack of education and poverty affect African American men’s abilities to have viable–sustainable employment options. As such, this has implications for African American men as it relates to their living environments, insurance coverage, access to health care, emotional health, and overall quality of life. Therefore, the inclusion of a chapter focusing on policies that promote safe and healthy learning environments for African American children (especially African American boys) in the next edition would be of great value. Specifically, a future chapter that identifies effective use of policies to reduce school dropout rates among young Black boys would be an important contribution to the field of public policy, public health, and education.
As Freudenberg and Ruglis (2007) suggest in their article, “Reframing School Dropout as a Public Health Intervention,” “Good education predicts good health, and disparities in health and in education achievement are closely linked.” More important, early effort to prevent poor academic performance and completion of school should be a national priority. Independent of the fact that this book focuses on adult African American men, a chapter examining why school dropout rates negatively contribute to adverse social, economic, and health conditions among African American boys and men across multiple life stages is needed.
In summary, this book largely addresses factors that go beyond individual risk factors to address societal influences on the health status of African American men. This is a common theme across all chapters. As such, this book is well positioned to serve as an important resource to scholars in a variety of settings. As previously mentioned, given its consistent format across chapters, it can serve as the primary textbook for a men’s health course focusing on African American men’s health at the undergraduate or graduate level. Treadwell, Xanthos, and Holden should be commended for offering readers a highly referenced and timely book written by scholars from a variety of disciplines.