Black men, on average, live six years less than white men in the United States ― a grim disparity in lifespan that’s been evident since the government began collecting the data in the early 1900s. But a new report is trying to change that, by first showing how modern-day social stressors contribute to the early deaths and poor health of men of color.
While researchers have long known that social stressors like structural racism contribute to men of color’s poor health, the report published June 18 by the American Psychological Association offered a new and compelling analysis about how this happens. Researchers also detailed how people on the ground can advocate for health care and public policies that will improve the health and lifespan of men of color.
Dr. Wizdom Powell, author of the report and chair of the APA committee studying health disparities in boys and men from underserved populations, told HuffPost that health disparities are often viewed to be rooted in individuals’ own failure to lead a healthy lifestyle. But her team’s analysis shows how multiple social factors compound and give rise to negative health outcomes for men of color, which they defined as non-Hispanic Blacks, Latinos, Asian Americans, Native Hawaiians/Pacific Islander and American Indian/Alaska Native.
“We situated this report in the broader social narrative about discrimination and oppression that these groups face as a consequence of their position in society,” Powell said, adding that the key takeaway for readers should be that there is overwhelming evidence to show that health “disparities and outcomes are largely a consequence of social exposures.”
Their analysis focused on four areas negatively affecting boys and men of color’s health: trauma, substance use, depression and violence. More specifically, researchers broke down how social and cultural factors like racial profiling, the school-to-prison pipeline, restrictive cultural notions of masculinity and more shorten life spans, limit resources and negatively inform those areas.
And changing this narrative is crucial, according to Powell, not only for men but for their communities and the country.
When men and boys die too soon … we all pay a heavy, heavy price. Dr. Wizdom Powell, chair of the APA Working Group on Health Disparities in Boy and Men
“When men and boys die too soon, it has implications for women and children, girls,” she said, such as leaving the financial and caregiving burden on the shoulders of a family’s matriarch. “We all pay a heavy, heavy price and it also has significant implications for our economic growth in the country and our capacity to innovate.”
With this report, Powell and her team hope to reposition men of color’s distressing health outcomes as a social problem that requires collective political action and community advocacy efforts to resolve. In a conversation with HuffPost, Powell discussed the types of health care needed in order for men of color to have longer and healthier lives.
Making Health Care More Accessible
Powell explained that, on average, men are socialized to suppress emotion or view help-seeking as a sign of weakness ― not to mention they’re also more likely to feel the pressure to be their household’s breadwinners and thus sacrifice their emotional and physical well-being in order to provide. For men of color, more culturally restrictive ideas of masculinity heighten all of the above. This makes it more likely that they will wait for significant signs and symptoms of distress before seeking help.
Increasing the likelihood that men will seek help could be as simple as changing hospital and clinic schedules, according to Powell. This means having medical facilities provide health care services at off-peak hours on weekends, for example, or expanding clinic hours so men can go after work.
“That’s something that we could do right now that actually will require very little big policy movement,” she said, adding that another solution would be to deliver health services to places that men already gather, like community barber shops.
Bigger policy changes, she said, could have an even greater impact on men’s well-being. Particularly because social factors are compounded by the fact that men of color are less likely to have health insurance. In 2016, Latinos had the highest uninsured rate, at 16 percent, compared to whites, at 6.3 percent.
“With the Affordable Care Act and the opportunities to expand Medicaid, we saw in this country one of the most significant upticks in health insurance procurement among childless men in a very, very long time,” Powell said. “So that says to me that even a policy intervention like expanding Medicaid can have significant implications for men’s access to care, particularly among low-income men.”
Decriminalizing Substance Use
Black and Latinos comprised approximately 56 percent of the U.S. prison population in 2015, despite making up about 32 percent of the U.S. population. And black Americans are incarcerated at more than five times the rate as whites.
Because men of color are more likely to be incarcerated in the U.S. ― often due to racial profiling or institutionalized bias in the criminal justice system, according to the report ― the need for comprehensive supportive services post-incarceration is crucial to their well-being. This includes having more substance abuse recovery programs that will help them successfully heal and transition back into society, according to Powell.
This is particularly important because men of color have a higher dependence on certain substances. Cocaine is the largest contributor to overdose deaths among black men in the United States, with a death rate of 7.6 people for every 100,000 people. And Latinos’ alcohol dependence is more than double whites’, according to the new report.
“We criminalize drug dependence and substance dependence in our nation in a way that makes it feel less like a supportive service the men are seeking, and more like they’re checking in with their parole officer,” Powell said. “I think we have to change that narrative, and change the way we deliver that care and the way we set it up, so that there’s more incentive for them to stay the course.”
“Because without those recovery services, men can’t successfully reintegrate into their families and communities, and they also get set up for subsequent co-occurring health problems,” she added.
Treating Trauma From Violence
Among Americans who are between 10 to 24 years old, homicide is the leading cause of death for black Americans and the second leading cause of death, behind injury, for Latinos.
“Our boys and men of color and also sexual minority males are embedded in communities that are fraught with disadvantage and significant community violence,” Powell said. “Because of that they are also more vulnerable, if you will, to exposure to trauma. Either directly or indirectly.”
Powell explained that this kind of exposure to violence and trauma has significant implications for men of color’s mental health, and increases their risk for using substances and engaging in violence.
She added that as a society we fail to recognize the “unique way” boys express their trauma, which is more likely to be externalized and show up as bad behavior in a classroom, for example. It’s something researchers are sure is fueling the school-to-prison pipeline, which makes detecting trauma and addressing mental health needs at a young age so crucial for men of color.
Offering Mental Health Support For Families
In order to create sustainable positive impacts on men of color’s lives and health, Powell said special attention should be placed on boys of color’s main support system: Their family.
The idea is that providing culturally sensitive psychotherapeutic services for families will make it easier for boys of color to learn to deal with the sort of trauma they are more likely to face ― like discrimination and violence in their community ― from a young age. Generally speaking, quality mental health services are scarce in low-income communities, and public policy initiatives are needed to change that.
“We believe that a lot of the work that we should be seeking to accomplish has to begin with providing more reliable, culturally appropriate and humble psychotherapeutic services, so that when boys and men are in distress, that they actually have a place to go that delivers the kind of care that speaks for their unique wounds,” she said.
Powell said offering these services to families while men are young can create more opportunities for early detection of depression and suicide risk, both of which go underscreened in this population ― not to mention being able to provide real-time interventions when boys of color are experiencing acute distress.
“If we’re able to intervene earlier in the life course and create a more permissive culture around sharing and emotional vulnerability and seeking help early in the life course, then we’re less likely to see men getting stuck in this pattern of withholding and withdrawing and refusing to seek help as they age,” she said.
All four of these recommendations, in addition to numerous others Powell and her team stress in the new report, are essential to reaching health equity in the country and improving the lives of already vulnerable men.
“If we’re going to really move the needle on better health for our nation, we had better pay attention to this population that’s being left woefully behind with respect to health outcomes,” she said.