Kisha B. Holden

Social determinants of health among African–American men

Abstract The health disparities among African–American men are staggering when compared to other racial, ethnic, and gender groups in the United States. While there have been considerable efforts to eliminate health disparities in recent years, disparity elimination efforts have often focused on changing health behavior with regard to African–American men, and grave health disparities continue to exist among this population. This article argues that a consideration of the social determinants of health among African–American men is long overdue. It highlights the serious health disparities among this population, and considers the social determinants of health of African–American men in relation to health status, health behavior, and health care. Finally, suggestions are offered for addressing the social determinants of health among African–American men.

Disadvantages in mental health care among African Americans.

African Americans experience mental health disadvantages relative to European Americans with respect to financial barriers, barriers to help seeking, and poorer quality services. This paper provides an overview of these mental health inequalities, and offers recommendations for addressing them.

Addressing Obesity and Diabetes Among African American Men: Examination of a Community-Based Model of Prevention

The Save Our Sons study is a community-based, culturally responsive, and gender-specific intervention aimed at reducing obesity and diabetes among a small sample (n = 42) of African American men. The goals of the study were to: (1) test the feasibility of implementing a group health education and intervention model to reduce the incidence of diabetes and obesity among African American men; (2) improve regular access to and utilization of health care services and community supportive resources to promote healthy lifestyles among African American men; and (3) build community networks and capacity for advocacy and addressing some of the health needs of African American men residing in Lorain County, Ohio. Trained community health workers facilitated activities to achieve program aims. Following the 6-week intervention, results indicated that participants had greater knowledge about strategies for prevention and management of obesity and diabetes; increased engagement in exercise and fitness activities; decreased blood pressure, weight, and body mass index levels; and visited a primary care doctor more frequently. Also, local residents elevated African American mens health and identified it as a priority in their community. This model of prevention appears to be a substantial, robust, and replicable approach for improving the health and wellbeing of African American men.

The Relationship Between Obesity and Depression Among Adolescents

Obesity and depression are two major public health problems among adolescents. Both obesity and depression are very prevalent and associated with numerous health complications, including hypertension, coronary heart disease, and increased mortality.1 Because they both carry a risk for cardiovascular disease, a possible association between depression and obesity has been assumed and studied.2 Several evidence-based studies have shown that obese teens have a higher incidence of mental health problems such as depression, anxiety, and poor self-esteem than nonobese teens.3 A reasonable conclusion is that obesity should predict depression, but the findings are not clear.4 In reality, few studies have found that obesity predicted depression over time, thus it has been proposed that instead of looking at the basic main effects of obesity predicting depression, it might be more practical to examine the specific processes or experiences by which obesity might lead to depression among adolescents so that specific interventions can be targeted.5 This article summarizes data on the role of mediating and moderating variables associated with obesity and depression among adolescents. This literature review also examines the thoughts and experiences of obese adolescents that facilitate the development of depressive symptoms.

Depressive Symptoms, Substance Abuse, and Intimate Partner Violence among Pregnant Women of Diverse Ethnicities

This study examines the relationship between self-reported depressive symptoms, substance abuse and intimate partner violence among 602 African American, Hispanic, White, Asian American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander pregnant women who are clients of the Augusta Partnership for Children, Inc., a nonprofit collaborative that works with agencies, organizations, and individuals to improve the lives of children and families in Augusta-Richmond County, Georgia. Descriptive statistics and significant relationships among selected variables using correlation and regression analyses were conducted. Findings are intended to inform strategies for community-based programs better to assist women of diverse ethnicities with addressing depression, substance abuse, and intimate partner violence during their pregnancies, with the ultimate aim of improving health and mental health outcomes for women and children.

Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men

Abstract The social determinants unique to African-American mens health contribute to limited access and utilization of health and mental health care services and can have a deleterious effect on their overall health and well-being. There is a need to examine the complex issues concerning African-American mens help-seeking behaviors relative to mental health concerns. Current research estimates that African-American men are approximately 30% more likely to report having a mental illness compared to non-Hispanic Whites and are less likely to receive proper diagnosis and treatment. There is an extensive body of research that supports the view that women are more likely to seek help for psychological problems than African-American men. This review explores the psychosocial, environmental and socio-cultural factors that influence mental health help-seeking behavior among African-American men and explains the urgency to engage various stakeholders to pursue effective behavioral strategies. Research literatur...

Toward Culturally Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities

Despite decades of research, recognition and treatment of mental illness and its comorbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, which includes provider and patient factors, to the system level, which includes practice culture and system functionality issues. Our multidisciplinary investigative team acknowledges the importance of providing culturally tailored integrative health care to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities.

Prevalence and Correlates of Depressive Symptoms and Resiliency among African American Women in a Community-Based Primary Health Care Center

The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants’ diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW.

Community-based participatory evaluation: the healthy start approach.

The use of community-based participatory research has gained momentum as a viable approach to academic and community engagement for research over the past 20 years. This article discusses an approach for extending the process with an emphasis on evaluation of a community partnership–driven initiative and thus advances the concept of conducting community-based participatory evaluation (CBPE) through a model used by the Healthy Start project of the Augusta Partnership for Children, Inc., in Augusta, Georgia. Application of the CBPE approach advances the importance of bilateral engagements with consumers and academic evaluators. The CBPE model shows promise as a reliable and credible evaluation approach for community-level assessment of health promotion programs.

Psychosocial and Sociocultural Correlates of Depressive Symptoms Among Diverse African American Women

African American women are faced with many challenges regarding their historical, cultural, and social structural position in the United States that may heighten their vulnerability for depression, one of the most prevalent disorders that can engender poor functionality. The purpose of this cross-sectional pilot study was to foster greater understanding about the occurrence and correlates of depressive symptoms among a diverse convenience sample of 63 African American women recruited from a comprehensive primary health care clinic (n = 23), a small private academic institution (n = 25), and an urban community setting (n = 15). Self-report data concerning selected psychological, sociocultural, and biological factors were collected. Descriptive statistics, Pearson product moment correlation, and analysis of variance were used to analyze data. Results indicated several similarities and differences among the 3 groups of women concerning levels of depressive symptoms and their correlates. Among the total sample, symptoms of depression were mild among 65% of the women. Depressive symptoms were significant and positively associated with negative and ruminative thinking (r = 0.79, p < .01), low self-esteem (r = 0.58, p < .01), stressful life events (r = 0.43, p < .05), low social support (r = 0.46, p <.01), depression stigma (r = 0.36, p < 01), and indication of chronic diseases (r = 0.34, p < .01). Depressive symptoms were significant and negatively associated with resiliency (r = -0.48, p < .01) and spiritual well-being (r = -.47, p < .01). This research adds to the empirical data concerning contributors to depressive symptoms for African American women.