Jaclynn Hawkins

Race/Ethnicity, Educational Attainment, and Foregone Health Care in the United States in the 2007–2009 Recession

OBJECTIVES This study assessed possible associations between recessions and changes in the magnitude of social disparities in foregone health care, building on previous studies that have linked recessions to lowered health care use. METHODS Data from the 2006 to 2010 waves of the National Health Interview Study were used to examine levels of foregone medical, dental and mental health care and prescribed medications. Differences by race/ethnicity and education were compared before the Great Recession of 2007 to 2009, during the early recession, and later in the recession and in its immediate wake. RESULTS Foregone care rose for working-aged adults overall in the 2 recessionary periods compared with the pre-recession. For multiple types of pre-recession care, foregoing care was more common for African Americans and Hispanics and less common for Asian Americans than for Whites. Less-educated individuals were more likely to forego all types of care pre-recession. Most disparities in foregone care were stable during the recession, though the African American-White gap in foregone medical care increased, as did the Hispanic-White gap and education gap in foregone dental care. CONCLUSIONS Our findings support the fundamental cause hypothesis, as even during a recession in which more advantaged groups may have had unusually high risk of losing financial assets and employer-provided health insurance, they maintained their relative advantage in access to health care. Attention to the macroeconomic context of social disparities in health care use is warranted.

Does Gender Influence Participation?: Predictors of Participation in a Community Health Worker Diabetes Management Intervention With African American and Latino Adults

Purpose The purpose of the study was to determine the effects of gender on participation in a community-based, culturally tailored diabetes lifestyle intervention, led by trained community health workers (CHW) and conducted with African Americans and Latinos with type 2 diabetes. Methods This study utilized data collected from 180 participants. Multivariable binary and cumulative logistic regression models were used to analyze associations between gender and race/ethnicity with study completion and participation in 3 aspects of the intervention: group classes, CHW home visits, and CHW-accompanied doctor visits. Results Among Latinos, men were less likely than women to complete the study, attend group classes, and complete CHW home visits. There were no gender differences in participation seen among African Americans. Conclusions Diabetes management interventions may need to adapt their designs to optimize retention and participation of Latino men. Among African American men, the CHW model may be promising. Reasons for low participation among Latino men should receive more study. Future studies should assess whether similar findings apply in other communities and populations.

The Discipline's Escalating Whisper: Social Work and Black Men's Mental Health.

Objective: Though sparse in previous years, research on the mental health of Black men has recently experienced a gradual increase in social work journals. This article systematically organizes and critically examines peer-reviewed, social work evidence on the mental health of Black men. Methods: Twenty-two peer-reviewed articles from social work journals were examined based on their contribution to social work research and practice on the mental health of Black men. Results: The social work evidence on Black men’s mental health can be grouped into one of four categories: psychosocial factors; mental health care and the role of clinicians; fatherhood; and sexual orientation, HIV status, and sexual practices. Conclusions: This representation of the social work literature on Black men’s mental health neglects critical areas germane to social work research and practice with this population. Implications include ways to extend current social work research and practice to improve the health for Black men.

Psychosocial Factors That Influence Health Care Use and Self-Management for African American and Latino Men With Type 2 Diabetes: An Exploratory Study

The purpose of this study was to explore the psychosocial factors that influence diabetes self-management and health care utilization among men of color with type 2 diabetes. Data were collected from focus groups with African American men (n = 9) and Latino men (n = 13) who were part of a diabetes intervention. Sessions were analyzed using thematic content analysis techniques. Five themes were discussed in focus groups, including (a) social support as a motivator, (b) patient–provider relationships as facilitators of healthy behaviors, (c) immigration status and access to resources, (d) waiting until symptoms became severe before seeking medical attention, and (e) structural barriers. Public health interventions may need to tailor interventions to address the specific needs of men of color.

Factors Associated with Cancer Family History Communication between African American Men and Their Relatives

African American men bear disproportionately high burden from cancer in the U.S. The American Cancer Society reports that for all cancer sites combined, African American men are 32% more likely to die than white men (American Cancer Society, 2011). Having family history of cancer elevates an individuals risk for the disease and should inform decision-making around the use of specific cancer screening tests as well as earlier onset and frequency of cancer screening. Adult African American men who attended an annual hospital-based community health fair in the Midwest which targeted minority men, were approached to complete paper-based survey. Participants were asked “have you ever talked with any of your relatives about your family history of cancer (about any members of your family who have been diagnosed with cancer)?” Predictors were evaluated using bivariate analysis and logistic regression; they included socio-demographic, health access, health behavior, health status, and communication variables. Participants were 558 African American men with mean age of 54 years old. African American men were most likely to have ever discussed their family history of cancer with relative if they had specific knowledge of their family history of cancer and if they had ever talked to physician about their family history of cancer. For African American men with familial predisposition to cancer, further examination of barriers and facilitators to discussion with relatives, specifically those related to health access and knowledge, is warranted.

Current Approaches to Support the Psychosocial Care of African American Adults with Diabetes: A Brief Review

African Americans are disproportionately affected by Type 2 diabetes and experience significantly higher age-adjusted prevalence of the disease. Psychosocial support, material resources, and education can have a significant impact on successful diabetes management, particularly among populations with diabetes-related psychological distress such as African Americans. This brief review of the literature identifies and synthesizes current evidence on faith-based, community-based, empowerment-based, strength-based, and culturally competent strategies that may be particularly relevant for social work practitioners supporting African American adults at risk for or diagnosed with Type 2 diabetes. Discussion focuses on multiple influences on the self-determination of clients working to manage their condition.

Identifying subgroups of Black, Hispanic and Asian men at increased risk for comorbid depression and overweight or obesity

Comorbid depression and overweight or obesity increase risk for developing many chronic diseases. Investigating men of color without using a non-Hispanic White male reference group will capture a more nuanced picture of how socio-demographic factors contribute to increased risk for comorbid depression and overweight or obesity among and between men of color. This study used the U.S.-based 2014 National Health Interview Survey (n = 1363) in May 2018 to examine associations between race/ethnicity and comorbid overweight or obesity and depression in men. Men were more likely to be obese or overweight and depressed if they were older (31–54 years old and 55+) [OR = 2.387, 95% CI: 1.526, 3.873, p = 0.000; OR = 2.220, 95% CI: 1.355, 3.635, p = 0.002], Black [OR = 2.745, 95% CI: 1.622, 4.646, p < 0.001], Hispanic [OR = 2.967, 95% CI: 1.762, 4.995, p < 0.001], or earned

The Role of Age and Multimorbidity in Shaping Older African American Men’s Experiences with Patient–Provider Communication

35,000–

Older African American Men’s Perspectives on Factors That Influence Type 2 Diabetes Self-Management and Peer-Led Interventions

74,999 [OR = 1.987, 95% CI: 1.255–3.152, p = 0.004]. We identified socio-demographic sub-groups of men at increased risk for comorbid depression and overweight or obesity. Examining intra-group differences among men of color will help clinicians and researchers to address more nuanced socio-demographic characteristics of groups of men who are more at risk for developing a chronic disease.

Qualitative Evidence in Health Promotion

This study investigated factors associated with older African American men’s unmet health communication needs in the context of patient–provider interactions. Responses to a health survey were analyzed for 430 African American men attending a Midwest community health fair. The outcome measure was the extent to which men could get their health-related questions answered during recent medical visits. Men’s mean age was 54; 39% had one chronic condition and 22% had two or more comorbidities. The 53% who usually or always had their questions answered were older, had less comorbidity, higher educational attainment, higher annual incomes, were more likely to be married and have any type of insurance, and have a personal physician. Access to care was the primary factor in shaping men’s opportunities to ask health-related questions, and older multimorbid and low-income African American men may face increased barriers to healthcare access, and thus barriers to patient-centered care and communication.