"If you do nothing about stress, the next thing you know, you're shattered": Perspectives on African American men's stress, coping and health from African American men and key women in their lives

Strategies for Coping with Minority Stress among Queer Young Adults: Usage Frequency, Associations with Demographics, and Mental Health

Queer young adults report significantly higher levels of anxiety and depression than their heterosexual counterparts, which is linked to sexual minority stress. Therefore, it is important to understand the coping strategies employed by this population to navigate minority stress and how coping strategies may impact mental health outcomes. Drawing from a U.S. national diverse sample of 387 queer young adults (ages 18-39 years), we analyzed descriptive results of 11 behavioral strategies to cope with minority stress and used ordered logistic and linear regression to examine the following objectives: the frequency of the use of each coping strategy, and the associations between each strategy and demographic characteristics as well as depression and anxiety. Results revealed that avoidance and talking with friends were the most frequently utilized coping strategies, while prayer/religious activities and counseling/psychotherapy/support groups were infrequently used. We examined utilization preferences of coping strategies across demographic factors (e.g., assigned sex at birth and sexual orientation). The use of counseling/psychotherapy/support group was positively associated with mental health symptoms, while exercise and mindfulness/mediation were associated with lower mental health symptoms. Our findings provide insights for mental health researchers and professionals in selecting appropriate coping strategies for queer young adults in prevention and intervention efforts.

An exploration of neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older black adults

OBJECTIVES

While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older Black adults.

METHODS

Data were from 3,191 Black adults ages 51+ in the 2008-2016 waves of the Health and Retirement Study to examine associations among neighborhood characteristics, psychosocial resilience (sense of purpose, mastery, and social support), and cognitive functioning among Black adults. Multilevel linear regression models assessed direct effects of neighborhood characteristics and psychosocial resources on cognitive functioning. We then tested whether psychosocial resources moderated the association between neighborhood characteristics and cognitive functioning.

RESULTS

Mean levels of cognitive functioning, sense of purpose, social support, and mastery were significantly related to neighborhood disorder and discohesion. Regression results showed that levels of neighborhood disorder and high discohesion were significantly associated with cognitive functioning. Sense of purpose was positively associated with cognitive functioning, net of neighborhood characteristics. However, only social support moderated the association between neighborhood discohesion and cognition.

CONCLUSIONS

These findings demonstrate the importance of examining psychosocial and contextual risk and resilience resources among midlife and older Black adults. This work may inform the development of cognitive behavioral interventions aimed at increasing sense of purpose to promote and enhance cognitive resiliency among Black adults. Altogether, this work may have implications for policy aimed at advancing cognitive health equity.

Shop Talk: A Qualitative Study to Understand Peer Health-related Communication Among Black Men at the Barbershop

BACKGROUND

While successful health promotion efforts among Black men have been implemented at barbershops, the focus has largely been on outcomes as opposed to the processes by which outcomes are produced. An understanding of processes can be leveraged in the design and implementation of future efforts to improve the health of Black men.

PURPOSE

The objectives of the present study were to: (i) understand peer-derived sources of health-related support at the barbershop and (ii) understand the role of the barbershop in promoting health among Black men.

METHODS

Seven focus groups were conducted at barbershops used predominately by Black men. Each focus group lasted between 45 and 60 min. Using a thematic approach, each focus group was independently coded by two coders using a codebook derived from an inductive and deductive approach. The results were confirmed with members of the community advisory board.

RESULTS

Three themes emerged: (i) dynamic and candid exchange of health-related support at the barbershop; (ii) tailored forms of health-related and judgment-free communication that provide encouragement and increase motivation; and (iii) characteristics of a supportive environment at the barbershop that facilitate health-related communication.

CONCLUSIONS

The findings of the present study offer a potential pathway for public health efforts seeking to improve health among Black men. Those interested in designing and implementing these efforts can create tailored programs for Black men by recognizing and leveraging the unique dynamics of health-related conversations at the barbershop.

Gender health equity: The case for including men's health

United States' federal policy and infrastructure fail to explicitly consider the health of men, particularly the poor health of marginalized men. This inattention to men's health hinders the nation's ability to improve population health, to achieve gender health equity, and to achieve health equity more broadly. Expanding efforts to consider gender in federal policy and infrastructure to include men, naming men as a population whose poor health warrants policy attention, creating offices of men's health in federal agencies, and utilizing an intersectional lens to develop and analyze policies that affect health would likely yield critical improvements in population health and health equity in the United States. Using data from the Centers for Disease Control and Prevention, I illustrate the persistence of sex differences in mortality and leading causes of death, and how these patterns mask gender gaps in health that are driven largely by marginalized men. Given the common practice of presenting data by sex and race separately, it is difficult to recognize when the health of specific groups of men warrants attention. I utilize the case of Black men to illustrate the importance of an intersectional approach, and why men's health is critical to achieving gender and racial equity in health. While a gender mainstreaming approach has enhanced the nation's ability to consider and address the health of women and girls, it has not expanded to be inclusive of boys and men. Consequently, I argue that if our goal is to achieve health equity, it is critical to employ an intersectional approach that simultaneously considers the full range of factors that influence individual and population health and well-being. An intersectional approach would facilitate efforts to simultaneously explore strategies to achieve racial, ethnic, and gender health equity, which are driven by structural determinants beyond sex and gender related factors.

"We need a little strength as well": Examining the social context of informal caregivers for Black women with breast cancer

BACKGROUND

Informal caregivers (e.g., partners, other family members, friends) often provide social support to Black women with breast cancer, and caregivers find both benefits and challenges in their caregiving role.

METHODS

In this qualitative study, twenty-four caregivers for Black women with breast cancer participated in focus groups and interviews. Participants responded to a brief close-ended questionnaire as well as semi-structured questions about their experiences as cancer caregivers. Demographic information was collected, and relationship satisfaction was measured by the Relationship Assessment Scale-General scale (RAS-G). Focus groups and interviews were recorded, transcribed verbatim, and coded by two independent coders. Using an iterative, discussion-based process, the study team developed and refined themes.

RESULTS

All caregivers described themselves as Black/African American, and the majority identified as female (79%). The mean RAS-G score was 4.5 (SD = 0.5), indicating high levels of relationship satisfaction. Qualitative themes included using a range of strategies to provide emotional support; shifting between roles; needing time and space; and trying to stay strong. Several female caregivers described how the cumulative experiences of providing care for multiple family members and friends could be draining, as could their own experiences in the patient role.

CONCLUSIONS

These findings show a complex, multilayered social context that affects both the patient-caregiver relationship and the health and wellbeing of caregivers. Clinicians providing treatment and support for Black women with breast cancer should be mindful of how the health context of the family may affect patient and caregiver outcomes.

Lessons Learned From a Community-Based Men's Health Fair

INTRODUCTION

Strategies are needed to promote the uptake of preventive health services among Black, Hispanic, and rural men because these men underutilize health services. Previous research indicates that men prefer community-based health promotion programming, such as health fairs; however, specific guidance on how to tailor health fairs for Black, Hispanic, and rural men are lacking. The present seeks to study provides that guidance.

METHODS

A multisectoral team developed, implemented, and evaluated a men's health fair in a county of South Carolina with a sizeable Black, Hispanic, and rural-dwelling population. Although the health fair was open to all men in the county, specific outreach campaigns were implemented to attract Black and Hispanic men. The health fair occurred on Father's Day weekend in 2023 and consisted of health screenings, health information, and other resources (eg, condoms, research studies). Participants who attended the health fair were asked to complete a check-in survey (N = 103) that assessed demographic information and how they heard about the health fair, followed by a survey (N = 58) that assessed facilitators/barriers to participation in a men's health fair.

RESULTS

Results were stratified by the gender of respondent. The results highlight the facilitators/barriers experienced by men to attending health fairs and also highlight important differences in facilitators/barriers for men to attend a health fair as perceived by men and women.

CONCLUSIONS

These findings have implications for the design and implementation of future men's health fairs to promote preventive health service use among Black, Hispanic, and rural men.

Black Mothers in Racially Segregated Neighborhoods Embodying Structural Violence: PTSD and Depressive Symptoms on the South Side of Chicago

This study employs multi-level and mixed-methods approaches to examine how structural violence affects the health of low-income, single Black mothers. We use multilevel regression models to examine how feeling "trapped" in racially segregated neighborhoods with high levels of violence on the South Side of Chicago affects mothers' (N = 69) reports of posttraumatic stress disorder and depressive symptoms. The relationship between feeling "trapped" and variations in expression of mRNA for the glucocorticoid receptor gene NR3C1 using microarray assays was also examined. The regression models revealed that feeling "trapped" significantly predicted increased mental distress in the form of PTSD, depressive symptoms, and glucocorticoid receptor gene regulation. The mothers' voices revealed a nuanced understanding about how a lack of financial resources to move out of the neighborhood creates feelings of being "trapped" in dangerous situations.

Physical Limitations, Health Rumination/Worry, and Depressive Symptoms: Gender Differences among African Americans

Although studies have documented the relationships between physical health, health rumination/worry, and mental health, few investigations have assessed these linkages within African American communities. Using a community-based sample of residents in historically lower-income, African American communities (N = 306), this study assesses the mediating role of health rumination/worry in the physical limitation-depressive symptom relationship, and the moderating effect of gender on the relationship between health rumination/worry-depressive symptoms. Findings demonstrate that health rumination/worry explains half of the physical limitation-depressive symptom relationship, and the relationship between health rumination/worry and depressive symptoms is stronger for African American men than women. The findings underscore the importance of intersectional research for policy efforts aimed at reducing mental health morbidities within African American communities.

Religious service attendance and mortality among older Black men

Religious institutions have been responsive to the needs of Black men and other marginalized populations. Religious service attendance is a common practice that has been associated with stress management and extended longevity. The objective of this study was to examine the relationship between religious service attendance and all-cause mortality among Black men 50 years of age and older. Data for this study were from NHANES III (1988–1994). The analytic sample (n = 839) was restricted to participants at least 50 years of age at the time of interview who self-identified as Black and male. Mortality was the primary outcome for this study and the NHANES III Linked Mortality File was used to estimate race-specific, non-injury-related death rates using a probabilistic matching algorithm, linked to the National Death Index through December 31, 2015, providing up to 27 years follow-up. The primary independent variable was religious service attendance, a categorical variable indicating that participants attended religious services at least weekly, three or fewer times per month, or not at all. The mean age of participants was 63.6±0.3 years and 36.4% of sample members reported that they attended religious services one or more times per week, exceeding those attending three or fewer times per month (31.7%), or not at all (31.9%). Cox proportional hazard logistic regression models were estimated to determine the association between religious service attendance and mortality. Participants with the most frequent religious service attendance had a 47% reduction of all-cause mortality risk compared their peer who did not attend religious services at all (HR 0.53, CI 0.35–0.79) in the fully adjusted model including socioeconomic status, non-cardiovascular medical conditions, health behaviors, social support and allostatic load. Our findings underscore the potential salience of religiosity and spirituality for health in Black men, an understudied group where elevated risk factors are often present.

A Convergent Mixed Methods Study of Cardiovascular Disease Risk Factors among Young Black Men in the United States

Background

An understanding of the factors that influence cardiovascular (CVD) risk among young Black men is critically needed to promote cardiovascular health earlier in the life course and prevent poor outcomes later in life.

Purpose

To explore how individual (eg, depression, racial discrimination) and environmental factors (eg, neighborhood resources) are associated with CVD risk factors among young Black men.

Methods

We conducted a convergent mixed methods study (qualitative/quantitative, QUAL+quant) with Black men aged 18 to 30 years (N = 21; 3 focus groups). Participants completed a self-administered electronic survey immediately prior to the focus groups.

Results

Participants (M age = 23) reported: two or more CVD risk factors (75%; eg, high blood pressure); racial discrimination (32%); and depressive symptoms in the past 2 weeks (50%). Five themes emerged: 1) emergence and navigation of Black manhood stressors; 2) high expectations despite limited available resources; 3) heart disease socialization: explicit and vicarious experiences; 4) managing health care needs against fear, avoidance and toughing it out; and 5) camaraderie and social support can motivate or deter. The integrated qualitative and quantitative analyses highlight race, gender, and class intersectionality factors that are relevant to what it means to be young, Black, male and of lower socioeconomic status in the United States.

Conclusion

Our findings help to identify modifiable, culturally specific and contextually relevant factors that relate to CVD risk factors among young Black men. Such work is crucial to inform interventions, primary prevention efforts, policies, and social-structural changes to thwart the development of CVD and advanced disease stages.

Individually Tailoring Messages to Promote African American Men's Health

In this paper, we describe our approach to individualizing messages to promote the health of middle-aged and older heterosexual, cisgender African American men. After arguing the importance of being population specific, we describe the process we use to increase the salience of health messages for this population by operationalizing the identity concepts of centrality and contextualization. We also present a measure of African American manhood and discuss how manhood is congruent with qualitative research that describes how African American men view their values, identities, goals, and aspirations in ways that can be utilized to create more meaningful and impactful messages to promote and maintain health behaviors. Our tailoring strategy uses an intersectional approach that considers how the centrality of racial identity and manhood and the salience of religiosity, spirituality, and role strains may help to increase the impact of health messages. We highlight the need to consider how the context of health behavior and the meaning ascribed to certain behaviors are gendered, not only from a man's perspective, but also how his social networks, behavioral context, and the dynamic sociopolitical climate may consider gendered ideals in ways that shape behavior. We close by discussing the need to apply this approach to other populations of men, women, and those who are non-gender binary because this strategy builds from the population of interest and incorporates factors that they deem central and salient to their identities and behaviors. These factors are important to consider in interventions using health messages to pursue health equity.

"The Awesomeness and the Vastness of Who You Really Are:" A Culturally Distinct Framework for Understanding the Link Between Spirituality and Health for Black Sexual Minority Men

Despite health inequities, many Black sexual minority men are resilient and often utilize spirituality as a culturally distinct self-protective and self-enhancing resource to maintain their health. However, little is known about how spirituality impacts health within a cultural framework that is specific to Black sexual minority men. We conducted 10 individual in-depth interviews, reaching code saturation, with Black sexual minority men across the USA. Our study was guided by grounded theory and a Black psychology theoretical framework. Seven themes were discovered and revealed that participants' level of spiritual consciousness influenced their engagement in psychological and behavioral processes that were related to mental and physical health. These themes were: (a) suboptimal worldview, (b) emotional revelation, (c) emotional emancipation, (d) emotional regulation, (e) health motivations, (f) health behaviors, and (g) links between spiritual consciousness, mental health, and physical health. Implications of these findings for clinicians and researchers are discussed.

Planful Self-Control, Metabolic Risk, and Psychosocial Outcomes Among Young, Black Men: A Test of Skin-Deep Resilience Theory

Research on skin-deep resilience suggests that for youth and young adults from disadvantaged backgrounds, high levels of planful self-control may promote positive psychosocial outcomes while simultaneously conferring vulnerabilities to chronic diseases related to aging. In this study, we investigated the divergent effects of planful self-control on young Black American men's psychosocial well-being and their metabolic risk. We expected that high levels of planful self-control in emerging adulthood would predict positive outcomes in young adulthood (educational attainment, low depressive symptoms, job satisfaction); however, the combination of high levels of planful self-control and the experience of contextual adversity either in emerging adulthood or in childhood would forecast poor metabolic health. Hypotheses were tested with prospective data from 504 Black American men followed from age 20 to age 26. Planful self-control in emerging adulthood directly forecasted low levels of depressive symptoms, one's likelihood of obtaining a bachelor's degree, increased job satisfaction, and increases in metabolic risk. Exposure to childhood deprivation moderated the influence of planful self-control on metabolic risk. Men with high levels of deprivation and high levels of planful self-control exhibited the worst metabolic profiles in the sample. In contrast, men with high levels of childhood deprivation and low levels of planful self-control exhibited the best metabolic profiles. Documenting the health consequences associated with planful self-control provides a foundation from which to identify modifiable psychosocial factors that affect the course of psychosocial problems and health.

When Resilience Becomes Risk: A Latent Class Analysis of Psychosocial Resources and Allostatic Load Among African American Men

There is a well-established link between psychosocial risks and psychological health among African American (AA) men. Yet, the psychosocial sources and physical health consequences of resilience (i.e., the ability to maintain good health despite adversity) remain underexplored. Using data from 283 AA men in the Nashville Stress and Health Study, the present study investigated the links between psychosocial resilience and allostatic load (AL), a biological indicator of physiological dysregulation. Latent class analysis (LCA) identified distinct resilience profiles comprising eight psychosocial resources across four categories: coping strategies, sense of control, racial identity, and social support. Analysis of variance (ANOVA) tests determined significant class differences in men’s AL scores. LCA results confirm a four-class model was the best fit: Class 1 (high resources, 32%), Class 2 (high coping but low control, 13%), Class 3 (low resources but high racial identity, 20%), and Class 4 (low resources but high mastery, 34%). Results reveal lower AL (better health) among Classes 1 (m = 0.35) and 4 (m = 0.31) and higher AL (worse health) among Classes 2 (m = 0.44) and 3 (m = 0.44). Findings indicate that the “quality” rather than the “quantity” of psychosocial resources matters for physical health among AA men, as positive health outcomes were observed among both low- and high-resource classes. Results suggest different resource combinations produce distinct patterns of resilience among AA men and underscore the need to further elucidate complex resilience processes among this population.

Denominational and Gender Differences in Hypertension Among African American Christian Young Adults

Hypertension, a major cardiovascular disease risk factor, is disproportionately prevalent among African American young adults. Religion and spirituality (R/S) have been studied for their potential effect on blood pressure (BP) outcomes. Despite their disproportionate hypertension risk and high levels of R/S engagement, limited research explores BP differences among religious African Americans. This study investigates whether denominational affiliation predicts within-group differences in odds of having hypertension among African American Christian young adults. Data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine hypertension differences between 1932 African American young adults based on self-reported religious denomination. Gender-separated logistic regressions included religious service attendance and coping measures, as well as personal characteristics and health behaviors to adjust for potential effects on BP. The odds of having hypertension were higher for Pentecostal women compared to Baptist and Catholic women. Hypertension odds for women who reported attending services more than once weekly were lower than those who never attended church. For women, frequent use of religious coping predicted higher odds of having hypertension than seldom or never using religious coping. R/S variables did not predict significant differences among men. The health benefits of R/S do not appear to be consistent within African American Christian young adults. Religion may be viewed as a source of BP risk and resilience, especially among African American young women.

What Are the Relationships between Psychosocial Community Characteristics and Dietary Behaviors in a Racially/Ethnically Diverse Urban Population in Los Angeles County?

To address existing gaps in public health practice, we used data from a 2014 internet panel survey of 954 Los Angeles County adults to investigate the relationships between psychosocial community characteristics (PCCs) and two key chronic disease-related dietary behaviors: fruit and vegetable (F+V) and soda consumption. Negative binomial regression models estimated the associations between 'neighborhood risks and resources' and 'sense of community' factors for each dietary outcome of interest. While high perceived neighborhood violence (p < 0.001) and perceived community-level collective efficacy (p < 0.001) were associated with higher F+V consumption, no PCCs were directly associated with soda consumption overall. However, moderation analyses by race/ethnicity showed a more varied pattern. High perceived violence was associated with lower F+V consumption among White and Asian/Native Hawaiian/Other Pacific Islander (ANHOPI) groups (p < 0.01). Inadequate park access and walking as the primary mode of transportation to the grocery store were associated with higher soda consumption among the ANHOPI group only (p < 0.05). Study findings suggest that current and future chronic disease prevention efforts should consider how social and psychological dynamics of communities influence dietary behaviors, especially among racially/ethnically diverse groups in urban settings. Intervention design and implementation planning could benefit from and be optimized based on these considerations.

Discrimination and Leukocyte Telomere Length by Depressive Symptomatology: The Jackson Heart Study

Background: Psychosocial stressors, such as perceived discrimination and depressive symptoms, may shorten telomeres and exacerbate aging-related illnesses. Methods: Participants from the Jackson Heart Study at visit 1 (2000–2004) with LTL data and Center for Epidemiological Studies-Depression (CES-D) scores (n = 580 men, n = 910 women) were utilized. The dimensions of discrimination scores (everyday, lifetime, burden of lifetime, and stress from lifetime discrimination) were standardized and categorized as low, moderate, and high. Coping responses to everyday and lifetime discrimination were categorized as passive and active coping. Multivariable linear regression analyses were performed to estimate the mean difference (standard errors-SEs) in LTL by dimensions of discrimination and coping responses stratified by CES-D scores < 16 (low) and ≥ 16 (high) and sex. Covariates were age, education, waist circumference, smoking and CVD status. Results: Neither everyday nor lifetime discrimination was associated with mean differences in LTL for men or women by levels of depressive symptoms. Burden of lifetime discrimination was marginally associated with LTL among women who reported low depressive symptoms after full adjustment (b = 0.11, SE = 0.06, p = 0.08). Passive coping with lifetime discrimination was associated with longer LTL among men who reported low depressive symptoms after full adjustment (b = 0.18, SE = 0.09, p < 0.05); and active coping with lifetime discrimination was associated with longer LTL among men who reported high depressive symptoms after full adjustment (b = 1.18, SE = 0.35, p < 0.05). Conclusions: The intersection of perceived discrimination and depressive symptomatology may be related to LTL, and the effects may vary by sex.

African American Manhood and self-rated health: What demographic characteristics, health conditions, and aspects of manhood matter?

Few studies have tested what aspects of manhood are associated with health. In this study, we examine how aspects of African American Manhood are related to health. Using cross-sectional data from a criterion sample of 300 African American men 35-73 years old (M = 46.53), we examined how aspects of African American Manhood, demographic characteristics, and health conditions were related to self-rated health. When we controlled for demographics, SES and health conditions, different aspects of manhood were associated with good/excellent health. Across four linear regression models, we found that the Religion and Spirituality factor was the component of African American Manhood most strongly associated with good/excellent self-rated health. The Religion and Spirituality factor was the only aspect of African American Manhood that remained significant when we controlled for SES and health conditions. Neither Reputation, Respectability, nor aspects of role strain remained significantly associated with good/excellent self-rated health when we controlled for SES and health conditions. In analyses examining the relationship between lower odds of good/excellent self-rated health and aspects of ethnic identity, only Afrocentric subscales that highlight behaviors that demonstrate a connection to Africa (e.g., celebrating Kwanzaa) and greater importance of learning about African culture or spiritual beliefs in Africa remained significant. Finally, we found that African American men who reported a body mass index in the normal range, an income level above $50,000, being employed, and having no chronic conditions were more likely to report good/excellent self-rated health than African American men who reported poor/fair health.

Religious Coping and Quality of Life Among Black and White Men With Prostate Cancer

Prostate cancer is a significant impediment in men’s lives as this condition often exacerbates stress and reduces quality of life. Faith can be a resource through which men cope with health crises; however, few studies examine how religion or spirituality can have implications for racial disparities in health outcomes among men. The purpose of this study is to assess the associations between religious coping and quality of life among black and white men with prostate cancer. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 624 black and white men with complete information on the primary outcome and predictor variables. The primary outcome for this study was overall quality of life as measured by the Functional Assessment of Cancer Therapy-Prostate questionnaire. The main independent variable was religious coping measured by 2 subscales capturing positive and negative forms of coping. Black men in the study had lower overall quality of life scores (134.6 ± 19.6) than their white peers (139.8 ± 14.1). Black men in the sample also had higher average positive religious coping scores (12.9 ± 3.3) than white men (10.3 ± 4.5). Fully adjusted linear regression models of the total sample produced results indicating that positive religious coping was correlated with an increase in quality of life (β = .38, standard error [SE] = 0.18, P < .05). Negative religious coping was associated with a reduction in quality of life (β = −1.48, SE = 0.40, P < .001). Faith-oriented beliefs or perceptions can have implications for quality of life among men with prostate cancer. Sensitivity to the role of religion, spirituality, and faith should be seen by providers of health care as potential opportunities for improved outcomes in patients with prostate cancer and survivors.

THOSE LEFT BEHIND: Socioeconomic Predictors and Social Mediators of Psychological Distress among Working-age African Americans in a Post-industrial City

While the socioeconomic status (SES)-psychological distress gradient is well-documented in the social science literature, less attention has been devoted to how this relationship varies within sociodemographic subgroups. I contribute to this small but growing literature by first examining the relationship between multiple dimensions of SES and two measures of psychological distress (depression and anxiety) among working-aged African Americans. I then test whether three social mediators explain the SES-psychological distress relationship, and whether gender modifies these associations and/or the social mediators that shape them. To address these aims, I analyze two waves of population-representative data from the Detroit Neighborhood Health Study (N=685). Data were collected between 2008 and 2010 in the wake of the Great Recession. I utilize structural equation modeling with latent variables to assess these relationships, and test indirect and conditional effects to detect the presence of mediation and/or moderation, respectively. Findings revealed associations between higher total household income and lower levels of depression/anxiety, as well as unemployment and increased depression/anxiety among working age African Americans. Furthermore, higher educational attainment was associated with reduced anxiety, but not depression, in this population. Gender moderated these findings such that unemployment was associated with higher levels of depression/anxiety among women but not men. I also found that trauma mediated the relationship between unemployment and depression/anxiety as well as educational attainment and anxiety. Gender, however, moderated the association between unemployment and depression/anxiety via traumatic events such that the relationship was stronger among women than men. Collectively, these findings contribute to our limited understanding of African Americans' mental health and underscore the importance of how both socioeconomic forces and life course experiences with traumatic events contribute to poor mental health among this population.

Church Attendance and Mobility Limitation Among Black and White Men With Prostate Cancer

Prostate cancer is a significant impediment that can reduce physical functional status. Mobility is fundamental for quality of life and church attendance to be associated with improved physical functioning. Few studies have examined how religious participation have implications for mobility limitation among men in general and among prostate cancer survivors in particular. The purpose of this study was to assess the association between church attendance and mobility limitation among Black and White prostate cancer patients and survivors. Data for this investigation were drawn from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 804 Black and White men with complete information on the primary outcome and predictor variables. Mobility limitation was the primary outcome variable, and church attendance was the main independent variable. The analytic sample was almost equally divided between Black (N = 382) and White men (N = 422). The proportion of Black men reporting mobility limitation (30.09%) more than doubled the corresponding percentage for White men (14.7%). Black men had a higher proportion of individuals who reported weekly church attendance (49.2% vs. 45.0%). Fully adjusted modified Poisson regression models produced results indicating that respondents attending church weekly had a lower mobility limitation prevalence (PR = 0.56, 95% CI [0.39, 0.81]) than those never attending church. Results from this study contribute to the body of evidence asserting the health benefits of church attendance. These findings suggest that health providers should consider how religion and spirituality can present opportunities for improved outcomes in prostate cancer patients and survivors.

Workplace stress and discrimination effects on the physical and depressive symptoms of underrepresented minority faculty

Evidence-based research and interventions to address systemic institutional racism have never been more urgent. Yet, underrepresented minority (URM) professionals in research institutions who primarily produce that evidence have remained abysmally low for decades. This unique study of URM university professors assesses factors-vocational strain, role overload, discrimination, coping strategies-that contribute to health and well-being, research productivity, and ultimately their retention in high impact research positions. We administered a web-based survey assessing demographics, workplace stressors, perceived discrimination, life events, coping strategies, and physical and depressive symptoms. Study participants include 404 faculty of whom 254 are African Americans, 99 are Mexican Americans, and 51 are Puerto Ricans. Hierarchical regression analyses were employed to assess the associations between workplace stress, coping strategies, and symptoms. Results show that perceived discrimination, vocational strain, role overload, and life events directly affected physical symptoms, with self-care (p < 0.001) moderating these effects. Vocational strain and life events had direct effects on depressive symptoms with self-care (p < 0.05) and social support (p < 0.001) moderating these effects. Findings inform health care providers and university leaders about work stress and health conditions that may explain early morbidity and premature departures of URM faculty, and proffer institutional interventions to retain these faculty.

Mechanisms of Racial Health Disparities: Relationships between Coping and Psychological and Physiological Stress Responses

Objective

Psychological distress and physiological dysregulation represent two stress response pathways linked to poor health and are implicated in racial disparities in aging-related health outcomes among US men. Less is known about how coping relates to these stress responses. The purpose of this exploratory study was to examine whether midlife and older men's coping strategies and behaviors accounted, in part, for Black-White disparities in men's psychological and physiological stress responses.

Methods

We examined racial differences in 12 coping strategies (COPE Inventory subscales, religious/spiritual coping, and behaviors such as stress eating and substance use) and their relationships with psychological distress (Negative Affect scale) and physiological dysregulation (blunted diurnal cortisol slopes) using regression models and cross-sectional data from 696 Black and White male participants aged 35-85 years in the National Survey of Midlife Development in the United States (MIDUS) II, 2004-2006.

Results

Black men exhibited more psychological distress and physiological dysregulation than White men. Black and White men reported comparable use of most coping strategies, none of which demonstrated similar relationships with both stress responses. Coping strategies explained variations in psychological distress consistent with conventional protective-harmful categorizations. Coping accounted for racial disparities in men's psychological distress, as Black men reported using harmful strategies more often and were more susceptible to their negative effects. Neither differential use of coping strategies nor differing relationships accounted for racial disparities in physiological dysregulation.

Conclusions

Findings revealed complex relationships between coping and psychological and physiological stress responses and suggest the importance of differing approaches to reducing associated racial health disparities among men.

An Online Behavioral Health Intervention Promoting Mental Health, Manhood, and Social Support for Young Black Men: The YBMen Project

Conventional definitions of mental health, manhood, and social support create barriers to accessing behavioral health care for Black men ages 18 to 30. Targeted behavioral health interventions sensitive to culture, social norms, and gender that circumvent these barriers are desperately needed to improve access and integrated care for this group. This article reports mixed methods findings from the 2017 iteration of the Young Black Men, Masculinities, and Mental Health (YBMen) project, a social media-based, psychoeducational program that promotes mental health, progressive definitions of manhood, and sustainable social support for Black men. Young Black men (n = 350) across two universities in the Midwest completed baseline surveys on their mental health, definitions of manhood, and social support. Forty of the men participated in the YBMen intervention and at postintervention reported experiencing fewer depressive symptoms on the Patient Health Questionnaire (PHQ-9, Z = -2.05, p < .01) and the Gotland Male Depression Scale (GMDS; Z = -1.76, p < .05). There were also changes on the Conformity to Masculine Norms Inventory (CMNI) for Self-Reliance (Z = -0.34, p = .26) and Heterosexual Self-Presentation (Z = -0.18, p = .59), though these changes were not statistically significant. A qualitative review of postintervention interviews revealed participants' appreciation of the YBMen project and its influence on their mental health, manhood, and social support. Programmatic efforts that support the behavioral health, positive development, and social relationships of Black men translate into positive families, communities, and experiences as they live, learn, love, and work over the life course.

Racial Difference in the Relationship Between Health and Happiness in the United States

Background

Although health is a prerequisite for happiness, the salience of health for maintaining happiness may be diminished for Blacks when compared to Whites, a phenomenon which can be explained by the Black-White mental health paradox and minorities’ diminished returns.

Aim

To understand if Black and White adult Americans differ in the effects of self-rated health (SRH) on happiness.

Methods

This cross-sectional study used data from the General Social Survey (GSS; 1972–2018), a nationally representative survey in the US. Our analytical sample included 42,201 Black and White adults. The independent variable was SRH. Happiness was the dependent variable. Sociodemographic factors were covariates. Race was the moderator. Logistic regression was used to analyze the data without and with interaction terms between race and SRH.

Results

Overall, good SRH was positively associated with happiness, however, there was a significant interaction between race/ethnicity and good SRH on the outcome (i.e. happiness) . This finding suggested that the boosting effect of good SRH on happiness is weaker for Black than White people.

Conclusion

In the United States, due to a weaker concordance between good health and happiness, Blacks who have poor SRH are more likely to report happiness. At the same time, Whites who are healthy report happiness, however, Blacks who are healthy do not necessarily report happiness. Disjointed link between health and happiness may be due to different racial, ethnic, and cultural perceptions of physical health and happiness as well as salience of physical health as a component of happiness. This may be an adaptive response of Blacks to sociopolitical as well as health-related adversities over centuries as a result of the combination of oppression, injustice, and poverty.

Developing a "Tailor-Made" Precision Lifestyle Medicine Intervention for Weight Control among Middle-aged Latino Men

Objective

To identify what is important to middle-aged Latino men and their personal goals and values as foundations for a future precision lifestyle medicine intervention that is rooted in Self-Determination Theory.

Design

We used a phenomenological, thematic approach to analyze data from 20 semi-structured, individual interviews with Latino men aged 35-60 years.

Setting

Community-based settings between November 2017 and May 2018 in South Florida.

Participants

Latino or Hispanic men who were aged 35-60 years. The mean age of the men was 49.8 years.

Results

Two key themes emerged: a) the characteristics that these men say define what it means to be a man; and b) the characteristics that these men say define what is important to them. "What defines a man" includes three primary subthemes: a) the attributes, characteristics and behaviors that participants understood to be ideals that a man should embody and the roles he should fulfill; b) lessons learned growing up about what it means to be a man; and c) how Latino men relate to the ideal of machismo. "What defines me" includes the subthemes: a) comparing themselves with the ideal of machismo; b) caring for family and others; and c) supporting and modeling positive behavior for their children.

Conclusions

We found key candidate mechanisms that may be novel yet critical foundations on which to build a precision lifestyle medicine intervention for Latino men. We identified actionable psychosocial factors that map onto motivational constructs that can shape behaviors that are essential for weight control and be a useful foundation for improving the health of middle-aged Latino men.

Mechanisms of Racial Health Disparities: Evidence on Coping and Cortisol from MIDUS II

OBJECTIVE

Blunted patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress response system dysregulation, are implicated in poor health outcomes and racial health disparities. It is unknown how coping-an important, but understudied, component of the stress-health disparities relationship-relates to these biological mechanisms of health.

METHODS

This study investigated relationships, including racial differences, between 12 coping strategies and early-day cortisol changes (diurnal cortisol slopes from peak to before lunch) among 700 35-85-year-old Black and White male participants in the National Survey of Midlife Development in the United States (MIDUS) II. Cognitive-oriented (e.g., positive reinterpretation, denial, religious/spiritual) and behavioral (e.g., stress eating, substance use) coping strategies were examined.

RESULTS

Overall, Black and White men used similar coping strategies. Most coping strategies were not associated with men's cortisol slopes. Religious/spiritual coping was associated with steeper (more robust) cortisol slopes among White (b = - 0.004, t = - 3.28, p = 0.001) but not Black men. Drug use was associated with steeper cortisol slopes among Black (b = - 0.095, t = - 2.87, p = 0.004) but not White men.

CONCLUSIONS

This exploratory study increases our understanding of relationships between coping and stress-related biological mechanisms underlying racial health disparities among men in later life. With some notable exceptions, men's coping strategies were not associated with their diurnal cortisol slopes. This suggests that the coping strategies currently used by older Black and White men may not be important factors, as determinants or intervention targets, in disparities in diurnal cortisol slopes and associated health outcomes among men in this age group.

Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans

PURPOSE OF REVIEW

Greater racial discrimination is associated with poorer mental health among Black Americans; yet, there remains an incomplete understanding of sex differences in exposure to racial discrimination, and further, of how sex differences in coping with racial discrimination may heighten or diminish risk for poorer mental health.

RECENT FINDINGS

Black men may experience greater exposure to both structural and communal forms of racial discrimination, whereas Black women may face both a wider range of potential sources, as well as encounter greater variability in the subjective experience of racial discrimination. For both Black women and men, racial discrimination may be similarly associated with maladaptive coping strategies (i.e., emotional eating, rumination) that also are linked to poorer mental health; however, emerging findings suggest that mindfulness may partially buffer these deleterious effects. Overall, the recent literature reveals mixed findings with respect to sex differences in the experience and negative mental health impact of racial discrimination. Despite this heterogeneity, evidence documents sex differences in the settings, type, and qualitative experience of racial discrimination among Black Americans. Additionally, growing evidence indicating that racial discrimination is associated with physiological markers of stress reactivity and psychopathology risk further bolsters its characterization as a unique form of chronic stress among Black Americans and other minority groups in the USA.

Perceived racism in relation to telomere length among African American women in the Black Women's Health Study

PURPOSE

Telomere length is considered a biomarker of human aging and premature morbidity and mortality which has been associated with chronic stress.

METHODS

We assessed the relation between perceived racism and telomere length in the Black Women's Health Study, a follow-up study of U.S. black women begun in 1995. Participants were asked about frequency of "everyday racism" (e.g., "people act as if they think you are not intelligent") and "institutional racism" (e.g., "ever treated unfairly due to race by police"). Using quantitative real-time polymerase chain reaction assay, relative telomere lengths (RTL) were measured as the copy number ratio of telomere repeat to a single control gene in 997 participants. Associations of racism variables with log-RTL were estimated by multivariable linear regression, with adjustment for age at blood draw and potential confounders.

RESULTS

Participants were aged 40-70 years (mean = 55.6 years), and mean telomere length was 0.77 (range 0.21-1.38). In stratified analyses, there was an inverse association between everyday racism and log-RTL among women who did not discuss their experiences of racism with others (β = -0.1104; 95% CI = -0.2140 to -0.0067; P = .045).

CONCLUSIONS

Everyday racism was associated with shorter telomere length among women who reported not discussing those experiences with others.

Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress-response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black-White differences in men's health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004-2009). Black men exhibited blunted cortisol slopes relative to White men (-.15 vs. -.21, t = -2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men (b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men's lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

The role of emotional eating in the links between racial discrimination and physical and mental health

The environmental affordances (EA) model posits that maladaptive self-regulatory strategies (e.g., emotional eating) directly and indirectly heighten African Americans' risk for downstream medical morbidities while also potentially mitigating the psychological impact of stressors. We empirically tested the full EA model. In doing so, we investigated the associations among racial discrimination, depressive symptomatology, and physical health proxies as well as the intervening role of emotional eating in these associations among 150 African Americans aged 18-27. The increased frequency of experiencing racial discrimination was significantly associated with poorer self-reported health, greater depressive symptomatology, and more emotional eating. There was no significant association between emotional eating and physical health and emotional eating did not mediate the relation between racial discrimination and physical health. Finally, racial discrimination was associated with depressive symptomatology, but only among African Americans with mean or high levels of emotional eating.

"Health is the Ability to Manage Yourself Without Help": How Older African American Men Define Health and Successful Aging

Objective

Few studies have explored how older African American men understand the relationship between health and successful aging. The goal of this study was to examine how older African American men's conceptions and definitions of health and notions of successful aging are interrelated.

Method

Using data from 22 semistructured individual interviews with African American men ages 55-76, we examine how cultural and normative ideals about health map onto the core components of Rowe and Kahn's (1997) definition of successful aging. We also explore how these notions influence factors that have implications for health.

Results

Consistent with prior research, we found that older African American men operationalized notions of health in ways that mapped onto three elements of successful aging: (a) the absence of disease and disability, (b) the ability to maintain physical and cognitive functioning, and (c) meaningful social engagement in life. A fourth theme, what men actually do, emerged to highlight how regular health practices were key components of how men define health.

Conclusions

These findings highlight key elements of how older African American men conceptualize health in ways that are interrelated with yet expand notions of successful aging in ways that are critical for health promotion research and interventions.

Risk and Protective Factors for Depressive Symptoms Among African American Men: An Application of the Stress Process Model

Objectives

This study employs the stress process model (SPM) to identify risk/protective factors for mental health among adult African American men.

Method

Using a community-based sample of Miami, FL residents linked to neighborhood Census data, this study identifies risk/protective factors for depressive symptomatology using a sample of 248 adult African American men.

Results

The stress process variables independently associated with depressive symptoms were family support, mastery, self-esteem, chronic stressors, and daily discrimination. While mastery and self-esteem mediated the relationship between neighborhood income and depressive symptoms, perceived family support served as a buffer for stress exposure. Collectively, the SPM explains nearly half of the variability in depressive symptoms among African American men.

Discussion

The SPM is a useful conceptual framework for identifying psychosocial risk/protective factors and directing health initiatives and policies aimed at improving the psychological health of African American men.

"I should have …":A Photovoice Study With Women Who Have Lost a Man to Suicide

While the gendered nature of suicide has received increased research attention, the experiences of women who have lost a man to suicide are poorly understood. Drawing on qualitative photovoice interviews with 29 women who lost a man to suicide, we completed a narrative analysis, focused on describing the ways that women constructed and accounted for their experiences. We found that women's narratives drew upon feminine ideals of caring for men's health, which in turn gave rise to feelings of guilt over the man's suicide. The women resisted holding men responsible for the suicide and tended to blame themselves, especially when they perceived their efforts to support the man as inadequate. Even when women acknowledged their guilt as illogical, they were seemingly unable to entirely escape regret and self-blame. In order to reformulate and avoid reifying feminine ideals synonymous with selflessly caring for others regardless of the costs to their own well-being, women's postsuicide bereavement support programs should integrate a critical gender approach.

Sympathetic neural reactivity to mental stress differs in black and non-Hispanic white adults

Black adults have a higher risk of hypertension compared with non-Hispanic white (NHW) adults, but physiological mechanisms underlying this predisposition remain unclear. This study compared muscle sympathetic nerve activity (MSNA) responses to mental stress in a group of young black and NHW participants. We hypothesized that the sympathoexcitation associated with mental stress would be greater in black adults compared with NHW participants. Thirty-five male adults (19 black, 23 ± 1 yr; 16 NHW, 22 ± 1 yr) were examined during 5-min supine baseline and 5 min of mental stress (via mental arithmetic). Baseline mean arterial pressure (80 ± 2 vs. 82 ± 1 mmHg), heart rate (61 ± 4 vs. 61 ± 2 beats/min), MSNA (13 ± 1 vs. 15 ± 2 bursts/min), and sympathetic baroreflex sensitivity (-1.1 ± 0.4 vs. -1.5 ± 0.3 bursts·100 heart beats^-1·mmHg^-1) were not significantly different between NHW and black adults ( P > 0.05), respectively. MSNA reactivity to mental stress was significantly higher in NHW compared with black adults (time × race, P = 0.006), with a particularly divergent responsiveness during the first minute of mental stress in NHW (Δ4 ± 1 burst/min) and black (Δ-2 ± 2 burst/min; P = 0.022) men. Blood pressure and heart rate reactivity to mental stress were similar between groups. In summary, black participants demonstrated a lower MSNA responsiveness to mental stress compared with NHW adults. These findings suggest that, despite a higher prevalence of hypertension, black subjects do not appear to have higher neural and cardiovascular responsiveness to mental stress compared with NHW. NEW & NOTEWORTHY Black men have a blunted muscle sympathetic nerve activity response to mental stress compared with non-Hispanic white (NHW) men, especially at the onset of mental stress when muscle sympathetic nerve activity decreased in blacks and increased in NHW men. Thus, despite a high prevalence of hypertension in blacks, normotensive NHW men display a greater peripheral sympathetic neural reactivity to mental stress than black men.

"They have said that I was slightly depressed but there are circumstances that bring that on": How Middle-Aged and Older African American Men Describe Perceived Stress and Depression

Objective

Few studies have focused on how men perceive stress and depression, and even fewer have examined how men of a specific racial or ethnic group describe their experiences of these conditions. African American men tend to define health in ways that are inclusive of their physical health, health behaviors, and mental health, but research has largely failed to explore how men put their health and mental health in social contexts. The objective of this article is to explore how middle-aged and older African American men who self-identify as having depression: 1) differentiate stress from depression; and 2) describe depression.

Design

Using data from semi-structured, individual interviews conducted between March and April 2014, we used a phenomenological approach to examine how men describe, experience, and perceive stress and depression.

Setting

Nashville, Tennessee.

Participants

18 African American men aged 35-76 years who self-reported a previous or current diagnosis of depression.

Results

Men talked about the experiences of stress and how many of them viewed chronic stress as expected and depression as a normal part of life. They used phrases like being "slightly depressed" or "I take a light antidepressant" to describe how they feel and what they are doing to feel better. Within these narratives, men had difficulty distinguishing between stress and depression and they primarily explained that depression was the result of external stressors and strains.

Conclusions

Men may have difficulty distinguishing between stress and depression and they may frame the causes of depression in ways that decrease their perceived culpability for its causes and limit their perceived control over the causes of depression.

A qualitative meta-synthesis examining the role of women in African American men's prostate cancer screening and treatment decision making

OBJECTIVE

Being an African American man is a risk factor for prostate cancer, and there is little consensus about the use of screening, early detection, and the efficacy of treatment for the disease. In this context, this systematic review examines the roles women, particularly wives, play in African American men's prostate cancer screening and treatment decision making.

METHODS

We searched OVID Medline (R), CINAHL (EBSCO), PsychInfo (EBSCO), PubMED, Cochrane Library, ERIC (Firstsearch), and Web of Science to identify peer-reviewed articles published between 1980 and 2016 that reported qualitative data about prostate cancer screening, diagnosis, or treatment in African American men. We conducted a systematic review of the literature using study appraisal and narrative synthesis.

RESULTS

Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for identifying and screening 1425 abstracts and papers, we identified 10 papers that met our criteria. From our thematic meta-synthesis of the findings from these publications, we found that women played 3 key roles in African American men's decision making regarding prostate cancer screening, diagnosis, or treatment: counselor (ie, offering advice or information), coordinator (ie, promoting healthy behaviors and arranging or facilitating appointments), and confidant (ie, providing emotional support and reassurance).

CONCLUSIONS

Women are often important confidants to whom men express their struggles, fears, and concerns, particularly those related to health, and they help men make appointments and understand medical advice. Better understanding women's supportive roles in promoting positive mental and physical outcomes may be key to developing effective interventions to improve African American men's decision making and satisfaction regarding prostate cancer screening and treatment.

"We Need Help in the Delta"

The purpose of this study was to better understand the barriers to health promotion among African American older men living in the rural Mississippi Delta. A qualitative, intrinsic case study approach was used to explore the phenomenon of health and the barriers to promoting men’s health within the unique context of the Delta. Data included one key informant interview and two focus group interviews with 14 men, with the majority between the ages of 41 and 55 years. Focus group participants were lay community members as well as members of a volunteer community health advisors men’s group. Findings underscore the extensiveness of the term “health” and the importance of attending to structural barriers in addressing men’s health. Three overarching themes emerged: “men don’t talk about health,” “health care is not just the issue, everything is,” and “we need a strong male to lead.” Implications for future research and health promotion efforts are provided.

Differences in Perceptions of the Food Environment Between African American Men Who Did and Did Not Consume Recommended Levels of Fruits and Vegetables

African American men have high rates of chronic disease morbidity and mortality associated with their low rates of fruit and vegetable consumption. In an effort to inform tailored behavioral interventions for this demographic, we sought to assess if men with healthier eating practices viewed their environment differently than those who ate less healthy. We segmented participants into high/low healthy eating categories based on the daily fruit and vegetable serving recommendations from the U.S. Department of Agriculture to determine if differences among environmental and social barriers were associated with different healthy eating patterns. We found key differences between men who consumed the recommended amount of fruits and vegetables (five or more servings/day, high healthy eating) and men who did not (low healthy eating). Men who consumed recommended levels of fruits and vegetables found eating healthy to be easy, and they described how they were able to overcome barriers such as the cost of healthy food, their limited knowledge of nutrition guidelines, and their lack of willpower to make healthier food choices. Men with healthier eating practices also identified individuals, plans, and resources they used or could use to help them have healthier eating practices. Conversely, men who were not eating recommended levels of fruits and vegetables also found eating healthy to be easy; however, they identified barriers limiting their access and did not articulate strategies to overcome these perceived barriers. Many of these men also indicated that they did not have social support to help them engage in healthier eating practices. These findings highlight the need to understand how African American men’s conceptualization of environmental resources and social supports relate to their eating practices.

"Racism?!?… Just Look at Our Neighborhoods": Views on Racial Discrimination and Coping Among African American Men in Saint Louis

Recent events in Ferguson underscore the need to better understand the unique challenges, stressors, and coping mechanisms of African American men. To this end, a focus group study was conducted in Saint Louis, a few miles from Ferguson. Although numerous stress-related themes were discussed, racial discrimination and structural racism emerged as pervasive stressors among these men. Participants described experiences of discrimination in multiple settings including workplace, school, and residential, and within the criminal justice system. Coping strategies included not only drinking and smoking but also religiosity and familial support. Men also mentioned that they found relief in simply discussing their stressors in a group setting. One implication of this study is to develop and implement group support models for this population.

Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health

Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men.