Perceptions of health among Black adults living in a diverse urban community

Health is not all about salads: An ethnographic study on health perceptions and health behavior among socially marginalized Danish men

BACKGROUND

The effects of social marginalization and health are well-documented, revealing a complex association between health perceptions and health behavior. This is especially evident among socially marginalized men.

OBJECTIVE

This study aims to explore health perceptions and health behaviors influencing overall health among socially marginalized men who seem to not benefit from existing municipal health care in a large Danish municipality. These men have varying health challenges and engage in risky health behaviors, such as alcohol drinking, tobacco smoking, and lack of physical activity.

DESIGN AND SAMPLE

This was an ethnographic study including 200 hr of participant observations and 25 interviews with socially marginalized men aged 45-65.

RESULTS

Health was perceived as related to the ability to participate in daily life activities, such as getting around effortlessly and the ability to work. Alcohol drinking appeared to be part of a complex approach in managing everyday life, including various personal physical and mental health challenges and admission to social networks.

CONCLUSION

Overall, the results provide important insight into how health perceptions and health behaviors are embedded in the men's everyday lives. This knowledge may be used by public health nurses and other health professionals in providing and developing health services.

Medical Mistrust in Black Breast Cancer Patients: Acknowledging the Roles of the Trustor and the Trustee

Studies indicate that Black patients report higher medical mistrust compared to their White counterparts. However, little is known about factors associated with higher medical mistrust among Black breast cancer patients. We examined predictors of medical mistrust and relationships between medical mistrust, subscales of mistrust, and process of care factors to identify opportunities to promote positive healthcare interactions between the trustees (e.g., providers) and Black breast cancer patients, or the trustors. A secondary analysis was conducted of survey data from 210 Black women with confirmed diagnosis of invasive breast cancer. Participants completed telephone surveys consisting of questions pertaining to sociodemographics, attitudes, and beliefs about medical care and breast cancer treatments. Multiple linear regression determined factors associated with medical mistrust and mistrust subscales. Most participants (61%) were over the age of 50 and currently single (64.8%). Women with greater medical mistrust reported less satisfaction with the trustee's technical ability (p < 0.0001) and greater satisfaction with their own propensity to access care (p < 0.05). Additionally, women with public insurance demonstrated greater mistrust (p < 0.01) and suspicion (p < 0.05) than women with private insurance, and women with less education reported greater perceived discrimination than women who have at least a bachelor's degree. Findings from this study may inform future endeavors to educate providers on ways to effectively interact with and treat Black breast cancer patients. Opportunities to develop interventions that address and tackle issues of mistrust as reported by Black patients may contribute to ongoing efforts to reduce health disparities.