May 14 2013
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Breaking the Silence on African-American Men’s Health

Keon L. Gilbert, DrPH, MA, MPA, is an assistant professor in the Department of Behavioral Science & Health Education at St. Louis University's College for Public Health and Social Justice. As a Robert Wood Johnson Foundation New Connections grantee, his research focuses on the social and economic conditions structuring disparities in the health of African American males. His work seeks to identify sources of individual, cultural, and organizational social capital to promote health behaviors, and health care access and utilization, to advance and improve the health and well-being of African American males. This is part of a series of posts looking at diversity in the health care workforce.

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I became a public health professional because I recognized a need to find opportunities and strategies to prevent the chronic diseases I saw silently killing African Americans in the community where I grew up. I vividly recall as a child the whispers surrounding the deaths of community members about cancer, diabetes (or sugar-diabetes, as it is commonly referred to in many communities still today), heart attacks, and strokes. I knew there was stigma and fear, but never heard of programs, interventions, or opportunities to stop these trends.

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My interest in addressing these problems led me to pursue summer programs and internships during high school that allowed me to witness amputations of uncontrolled diabetic patients who had a range of clinical and social co-morbid conditions. Many of these amputees were living in poverty, they had Medicare or Medicaid, and the majority happened to be African American. This experience raised the question about prevention: How could I prevent African American men and women from having amputations? I never heard this conversation around prevention in my community. Many people seemed to accept the reality of developing these chronic conditions as a fate that could not be controlled.

I knew there had to be another way.

My journey into public health was prompted by the lack of chronic disease prevention in many African American communities. I was fortunate to seek interdisciplinary training opportunities at academic institutions to marry an interest in understanding the history and culture of African Americans to basic science, public health, and public policy.

"Many African American men are invisible from health care settings until their health conditions are severe."

As a graduate student I noticed there were few African American students and faculty in schools of public health across the country. This prompts the question: Where are the pipeline programs focused on attracting African Americans like me to gain exposure to the growing needs and challenges of health and health care in the U.S.? The question of pipeline speaks to a larger need in the U.S. to address the widening gap of youth of color who discontinue their education—especially African American and Latino males. Without the basic education requirements, obtaining additional or advance training to work toward improving the quality of health and health care becomes an elusive dream, or at best, a dream deferred.

I recognized during my training both as a doctoral student and postdoctoral scholar that there were few African American men in public health. I also recognized that few people, including men, studied the health and well-being of men. Where were the men? It has taken several efforts such as those by foundations, and professional and scholarly networks such as New Connections to link scholars, practitioners, and researchers together to begin working cohesively to address some of the social, economic, and health needs of African American males.

These same connections and sources of social capital can be leveraged to develop programs to connect and attract young men of color to the health and health care fields, and to begin to find solutions to end the disparities they have witnessed in the same ways I developed a passion for African American men’s health.

My focus as a public health professional has evolved to better understand the social, economic, and health conditions of African American males, by calling attention to this understudied population and the growing challenges many will face across the life course. In particular, as a New Connections grantee, I am interested in understanding how African American males will become engaged in the health care system now that many will have access to health care coverage under the Affordable Care Act.

Many African American men are invisible from health care settings until their health conditions are severe. My work seeks to identify leverage points to promote health and to prevent the onset of chronic disease. The trend of African American men who become disengaged from systems, such as the health care system, begins early as they stop visiting a primary care physician or school nurse as they age. There is something about systems that disallow men from becoming more engaged. My work with high school and middle school African American youth suggests that they lack a sense of belonging or connectedness, they do not feel represented and they develop a sense of distrust. The few studies that have looked at African American men’s health care experiences reflect similar patterns. These are the mechanisms I hope to address in my work supported by the New Connections program.

Learn more about the Robert Wood Johnson Foundation New Connections program here and here.

Tags: Barriers to care: cultural, gender and racial, Black (incl. African American), Chronic disease management, Chronic illness, Disparities, Diversity, Human Capital, New Connections, Toward a More Diverse Health Care Workforce, Voices from the Field