By Jamie Mitchell, M.S.W, Ph.D.*
For at least the past 100 years, African American men have had the shortest lifespan of all racial ethnic groups in the United States, with a life expectancy that rivals men in some third world countries (Gadson, 2006). With an average life expectancy of six years less than white men and 11 years less than white women (Casares et al, 2006), some prominent researchers estimate that nearly two thirds of all teenage African American boys will not live to see their 65th birthday (Geronimus & Thompson, 2004). So what exactly is killing African American men prematurely? One possible answer is that avoidable illnesses such as common types of cancer and chronic disease seem to be claiming the majority of African American male lives in middle adulthood and beyond. For example, for all types of cancer combined, African American men are 37% more likely to die than their White male counterparts (Jemal et al, 2008), and the rate of death among African American men for prostate, colon and lung cancer is higher than any other group in the United States (Toles, 2008). African American men are also more likely to be hypertensive, less likely to have health insurance (Virnig et al, 2009), and are disproportionately affected by coronary heart disease, stroke, and diabetes (Casares et al, 2006).
The discussion around the overrepresentation of health disparities among African American men has centered on two issues; the social determinants of poor health that create and influence health risks at a societal level, and the underutilization of preventive health behaviors which are proven to reduce disease risk at the individual level. It is well known that social determinants of the health such as healthcare access (Casares et al, 2006) and racial discrimination in employment, housing, and other sectors significantly affect the ability of African American men to make health-related decisions. However, it is equally acknowledged that even given minimal resources, African American men can make changes to their diet, physical activity, risky health behaviors such as smoking, and monitoring of health conditions which can reverse the progression of chronic disease or reduce the likelihood of it developing initially. Our charge as clinicians, researchers, policy makers, and health advocates is to assist African American men on both fronts; to work toward evolving societal conditions so that every individual has sufficient resources to prevent disease and live healthfully; while empowering African American men to make the individual lifestyle changes using what resources are available to reduce their own risk of disease and ultimately, of death.
* Dr. Jamie Mitchell is an Assistant Professor at the School of Social Work at Wayne State University in Detroit, Michigan
Casares, C., Ro, M., Thomas, S., Braithwaite, K., & Treadwell, H.M. (2006). Prevention and men of color in the U.S. – findings from the national healthcare disparities report. Challenge-A Journal of Research on African American Men, 12 (2), 1-14.
Gadson, S. (2006). The third world health status of Black American males. Journal of the National Medical Association, 98 (4), 488-491.
Geronimus, A., & Thompson, J. (2004). To Denigrate, ignore or disrupt: Racial inequality in health and the impact of a policy-induced breakdown of African American communities. Du Bois Review: Social Science Research on Race, 1, (2), 247-279.
Jemal, A., Siegal, R., Ward, E., Hao, Y., Xu, J., Murray, T., & Thun, M. (2008). Cancer statistics, 2008. CA: A Cancer Journal for Clinicians (American Cancer Society), 58 (2), 71-96.
Toles, C. (2008). Black men are dying from prostate cancer. The Association of Black Nursing Faculty, 19 (3), 92-95.
Virnig, B.A., Baxter, N.N., Haberman, E., Feldman, R., & Bradely, C. (2009). A matter of race: Early versus late-stage cancer diagnosis. Health Affairs, 28 (1), 160-168.