Though health-care spending is at a record high in this country, young African-American men see little benefit, according to a Boston Medical Center (BMC) researchers’ Viewpoint commentary published in the current issue of the Journal of the American Medical Association.
Researchers note that black men live about five years less than their white counterparts. And while heart disease and cancer contribute to this decreased life expectancy, homicide also plays a major role. From ages 1 to 14, homicide is either the second- or third-leading cause of death for African-American men, and from ages 15 to 34, it is the leading cause of death. Here’s another sobering fact from the researchers: Black men are safer in prison. Data show black men are half as likely to die if they are in prison than if they aren’t incarcerated, but white men can die at a higher rate if they are jailed.
Public health sector officials long have been calling for more attention to the health plight of young black men, but the medical field has been relatively silent, said corresponding author Stephen Martin, M.D., of the department of family medicine at BMC and the Boston University School of Medicine.
“Boston Medical Center has many programs and partnerships designed to help individuals cope with violence, find meaningful supports, and make improvements toward living a longer, healthier and happier life. A clear example is providing prescriptions for the hospital’s Preventive Food Pantry,” Dr. Martin said. “But largely, we in the medical field are not meeting young African-American men where they are to address their medical needs—cardiovascular disease, diabetes management, HIV, mental health and much more.”
The authors state that improved funding and other support for social and public health programs to address the disparities in health care, particularly as they impact young African-American men, are needed. Effectively addressing social determinants of health—conditions in which people are born, grow, live, work and age—has the greatest impact on health disparities and requires interventions beyond just medical care, Dr. Martin said. The authors also point out that U.S. public health programs and activities receive only three cents of the health-care dollar to support efforts to improve the health and well-being of our most vulnerable populations.
For medical care itself to improve, the authors said there should be more proactive engagement and partnerships, effective lifestyle support such as the YMCA’s Diabetes Prevention Program, creating trusted spaces for men to feel comfortable and safe, and the use of newer technologies, such as texting and virtual care team members to communicate with patients.
“There is still much to be done to meet men on their own terms and provide them with the survival, behavioral and medical care they need,” said study co-author Brian Jack, M.D., chair of the department of family medicine at Boston Medical Center and Boston University School of Medicine. “Traditional medical care generally isn’t built to do this well. But we are learning better approaches and ways to join efforts with others to truly and effectively meet the needs of young African-American men.”
Dr. Martin and his co-authors also stressed the importance of programs such as the National Healthy Start Association, which bases its fatherhood programs on first addressing survival needs to ensure family involvement. Over the years, Healthy Start has created programs that keep fathers involved, helping them have bigger roles in their children’s lives and promote the importance of responsible fatherhood, adding value and strengthening family resilience.
“There are many shadows that young African-American men in this country walk with every day of their lives; shadows that impede their ability to access myriad needed services,” said co-author Kenn Harris, president-elect of the National Healthy Start Association. “We need services that meet them where they are, but this calls for us to understand the communities in which they live. Our male involvement/fatherhood programs build off of the community-driven approaches demonstrated in the federal Healthy Start programs, which have proved to be an effective strategy. As providers begin to move out of their systems to engage community partners, there’s greater potential for the needs of young African-American men to be met.”
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