Understanding Tobacco Use Onset Among African Americans

PubMed Central

Colby, Suzanne M.; Lu, Bo; Ferketich, Amy K.

2016-01-01

Introduction: Compared to the majority of non-Hispanic white (“white”) cigarette smokers, many African American smokers demonstrate a later age of initiation. The goal of the present study was to examine African American late-onset smoking (ie, regular smoking beginning at age 18 or later) and determine whether late-onset (vs. early-onset) smoking is protective in terms of quit rates and health outcomes. Methods: We used data from the National Survey of Midlife Development in the United States (MIDUS) because the wide age range of participants (20–75 at baseline) allowed the examination of smoking cessation and mortality incidence across the lifespan. Results: Consistent with previous research, results indicated a later average age of smoking onset among African Americans, compared to whites. Disentangling effects of race from age-of-onset, we found that the cessation rate among late-onset African American smokers was 33%, whereas rates for early-onset African American smokers and early- and late-onset white smokers ranged from 52% to 57%. Finally, results showed that among white, low-socioeconomic status (SES) smokers, the hazard rate for mortality was greater among early- versus late-onset smokers; in contrast, among African American smokers (both low- and high-SES) hazard rates for mortality did not significantly differ among early- versus late-onset smokers. Conclusions: Although late (vs. early) smoking onset may be protective for whites, the present results suggest that late-onset may not be similarly protective for African Americans. Tobacco programs and regulatory policies focused on prevention should expand their perspective to include later ages of initiation, in order to avoid widening tobacco-related health disparities. Implications: This study indicates that late-onset smoking is not only the norm among African American adult smokers, but that late- versus early-onset smoking (ie, delaying onset) does not appear to afford any benefits for African

Regulatory system reform of occupational health and safety in China.

PubMed

Wu, Fenghong; Chi, Yan

2015-01-01

With the explosive economic growth and social development, China's regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined.

Disparities in health-related Internet use among African American men, 2010.

PubMed

Mitchell, Jamie A; Thompson, Hayley S; Watkins, Daphne C; Shires, Deirdre; Modlin, Charles S

2014-03-20

Given the benefits of health-related Internet use, we examined whether sociodemographic, medical, and access-related factors predicted this outcome among African American men, a population burdened with health disparities. African American men (n = 329) completed an anonymous survey at a community health fair in 2010; logistic regression was used to identify predictors. Only education (having attended some college or more) predicted health-related Internet use (P < .001). African American men may vary in how they prefer to receive health information; those with less education may need support to engage effectively with health-related Internet use.

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

PubMed

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity H K; Seddoh, Janet

2005-12-20

The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

PubMed Central

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity HK; Seddoh, Janet

2005-01-01

Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. Results There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income

Regulatory system reform of occupational health and safety in China

PubMed Central

WU, Fenghong; CHI, Yan

2015-01-01

With the explosive economic growth and social development, China’s regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined. PMID:25843565

Health Care Information in African-American Churches

PubMed Central

Harmon, Brook E.; Kim, Sei-Hill; Blake, Christine E.; Hébert, James R.

2014-01-01

Churches are a trusted resource in African American communities; however, little is known about their presentation of health care information. This study characterized health care information disseminated by 11 African American churches. Content analysis conducted on print media systematically collected over one year used a coding scheme with .77 intercoder reliability. Health care information was identified in 243 items and represented three topics (screening, medical services, health insurance). Screening was the most common topic (n=156), flyers/handouts most often used (n=90), and the church the most common source (n=71). Using chi-square tests, information was assessed over time with health insurance information showing a statistically significant increase (χ2=6.08, p <.05). Study churches provided health care information at varying levels of detail with most coming from church and community publications. Future research should examine additional characteristics of health care information, its presence in other churches and community settings, and how exposure influences behaviors. PMID:24509024

The occupational health status of African-American women health care workers.

PubMed

Arnold, C W

1996-01-01

Race, ethnicity, and gender are significant indicators of occupational status, general health status, and thus, occupational health status. Although African-American women constitute only 6.8% of the total U.S. labor force, they hold 20% of the jobs in the health care industry and are disproportionately represented in those jobs that have the highest levels of workplace exposure to hazards. As a result, they are therefore more likely to be at greater exposure and risk to the spectrum of occupational health problems. In order to gain insight into the effects of race and gender on the occupational health status of African-American women health care workers, this article uses three data sources that provide different but complementary sources of information on the demographic characteristics of workers, location of categories of occupations, working conditions of jobs, and other job and worker characteristics. Given the concentration of African-American women in health care positions where there exists a greater likelihood of being exposed to occupational hazards, it is therefore both logical and appropriate for primary care physicians, especially those engaged in office-based practices, to identify this target population for special services and to be more aware of the type of health issues with which these patients are more likely to present and to experience during their working lives. Health care providers have a responsibility to assess occupational factors related to a patient's health problems and to incorporate this information into their treatment protocols and into the design and explanation of each patient's care plan.

Faith-Based Mental Health Interventions with African Americans: A Review

ERIC Educational Resources Information Center

Hays, Krystal; Aranda, Maria P.

2016-01-01

Faith-based interventions have emerged culturally sensitive way to address mental health issues among African Americans. This systematic review explores the scope and efficacy of faith-based mental health intervention outcomes among African Americans. Extracted data included the study population, setting, study design, intervention, adaptations,…

Self-Rated Health and Health Care Access Associated With African American Men's Health Self-Efficacy.

PubMed

Thompson, Terry; Mitchell, Jamie A; Johnson-Lawrence, Vicki; Watkins, Daphne C; Modlin, Charles S

2017-09-01

Health self-efficacy, a measure of one's self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, "Overall, how confident are you in your ability to take good care of your health?" Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.

Understanding Tobacco Use Onset Among African Americans.

PubMed

Roberts, Megan E; Colby, Suzanne M; Lu, Bo; Ferketich, Amy K

2016-04-01

Compared to the majority of non-Hispanic white ("white") cigarette smokers, many African American smokers demonstrate a later age of initiation. The goal of the present study was to examine African American late-onset smoking (ie, regular smoking beginning at age 18 or later) and determine whether late-onset (vs. early-onset) smoking is protective in terms of quit rates and health outcomes. We used data from the National Survey of Midlife Development in the United States (MIDUS) because the wide age range of participants (20-75 at baseline) allowed the examination of smoking cessation and mortality incidence across the lifespan. Consistent with previous research, results indicated a later average age of smoking onset among African Americans, compared to whites. Disentangling effects of race from age-of-onset, we found that the cessation rate among late-onset African American smokers was 33%, whereas rates for early-onset African American smokers and early- and late-onset white smokers ranged from 52% to 57%. Finally, results showed that among white, low-socioeconomic status (SES) smokers, the hazard rate for mortality was greater among early- versus late-onset smokers; in contrast, among African American smokers (both low- and high-SES) hazard rates for mortality did not significantly differ among early- versus late-onset smokers. Although late (vs. early) smoking onset may be protective for whites, the present results suggest that late-onset may not be similarly protective for African Americans. Tobacco programs and regulatory policies focused on prevention should expand their perspective to include later ages of initiation, in order to avoid widening tobacco-related health disparities. This study indicates that late-onset smoking is not only the norm among African American adult smokers, but that late- versus early-onset smoking (ie, delaying onset) does not appear to afford any benefits for African Americans in terms of cessation or mortality. These results

Experiences of undergraduate African health sciences students: A hermeneutic inquiry.

PubMed

Inyama, Davis; Williams, Allison; McCauley, Kay

2015-06-01

While efforts have been made to understand the experiences of African students in predominantly white environments, the experiences of African students in clinical placement areas have rarely been explored. This paper is a report on a study designed to address the gap in educational research on the experiences of African health sciences students in clinical placements in predominantly white environments. Interviews adopting an open approach to conversations were conducted with nine African students from three health disciplines at one metropolitan university in Australia between 2012 and 2013. Interview transcripts were analyzed using philosophical hermeneutics, where shared meanings were arrived at by employing key Gadamerian hermeneutic components. Findings revealed a number of factors that had a direct effect on the meaning students derived from their clinical placement experiences. These, as revealed in the interlinked domains of body, space, relationships, and time included difference, acceptance, resilience, and cultural sensitivity. Insights from this study may lead to the adoption of strategies designed to improve the experiences of African students studying health sciences in predominantly white environments. © 2014 Wiley Publishing Asia Pty Ltd.

Concepts of Healthful Food among Low-Income African American Women

ERIC Educational Resources Information Center

Lynch, Elizabeth B.; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A.

2012-01-01

Objective: Describe beliefs about what makes foods healthful among low-income African American women. Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food…

As I see it: a study of African American pastors' views on health and health education in the black church.

PubMed

Rowland, Michael L; Isaac-Savage, E Paulette

2014-08-01

The Black Church is the only institution that has consistently served the interest of African Americans, and there is no other institution in the African American community that rivals its influence (Camara, 2004). The spiritual well-fare, social support, health, and well-being of its people have been one of its main goals. With health disparities of African Americans still at an alarming rate, the Black Church has used informal education as a means to impart knowledge on health, as well as other non-religious and religious topics. One of the avenues least researched within the Black Church is the pastor's perception of its educational role in health and wellness and its efforts to reduce health discrimination and health disparities between African American and European Americans in the U.S. Since social justice appears as a theme and concern in the traditions of many churches, it is only appropriate that, among other things, the Black Church should address the issue of health education and interventions. The purpose of this study was to explore African American pastors' perceptions of the role of the Black Church in providing health care, health education, and wellness opportunities to African Americans. Many pastors reported their church provided some form of health education and/or health screenings. Their perceptions about the important issues facing their congregants versus African Americans in general were quite similar.

Space and place for WHO health development dialogues in the African Region.

PubMed

Kirigia, Joses Muthuri; Nabyonga-Orem, Juliet; Dovlo, Delanyo Yao Tsidi

2016-07-18

Majority of the countries in the World Health Organization (WHO) African Region are not on track to achieve the health-related Millennium Development Goals, yet even more ambitious Sustainable Development Goals (SDGs), including SDG 3 on heath, have been adopted. This paper highlights the challenges - amplified by the recent Ebola virus disease (EVD) outbreak in West Africa - that require WHO and other partners' dialogue in support of the countries, and debate on how WHO can leverage the existing space and place to foster health development dialogues in the Region. To realise SDG 3 on ensuring healthy lives and promoting well-being for all at all ages, the African Region needs to tackle the persistent weaknesses in its health systems, systems that address the social determinants of health and national health research systems. The performance of the third item is crucial for the development and innovation of systems, products and tools for promoting, maintaining and restoring health in an equitable manner. Under its new leadership, the WHO Regional Office for Africa is transforming itself to galvanise existing partnerships, as well as forging new ones, with a view to accelerating the provision of timely and quality support to the countries in pursuit of SDG 3. WHO in the African Region engages in dialogues with various stakeholders in the process of health development. The EVD outbreak in West Africa accentuated the necessity for optimally exploiting currently available space and place for health development discourse. There is urgent need for the WHO Regional Office for Africa to fully leverage the space and place arenas of the World Health Assembly, WHO Regional Committee for Africa, African Union, Regional economic communities, Harmonization for Health in Africa, United Nations Economic Commission for Africa, African Development Bank, professional associations, and WHO African Health Forum, when it is created, for dialogues to mobilise the required resources to

Health inequalities: promoting policy changes in utilizing transformation development by empowering African American communities in reducing health disparities.

PubMed

Kennedy, Bernice Roberts

2013-01-01

Social inequalities in the United States resulted in negative health outcomes for the African Americans. Their stressful living conditions of poverty, discrimination, racism, abuse and rejection from American society contribute to their negative health outcomes. The lifestyles of African Americans have been influenced by poverty and prior injustices, which have molded their worldview of health and illness. Dr. Martin Luther King, national civil rights leader, brought about social change with much prayer; however, he went a step further with collective gatherings to include the power of non-violence massive public demonstrations. This paper is an analytical review of the literature addressing social inequalities impacting on health inequalities of African Americans resulting in health disparities. Policy changes are propose by implementing transformation development and community empowerment models as frameworks for community/public health nurses in guiding African American communities with addressing health disparities. These models empower members of the community to participate in a collaborative effort in making political and social changes to improve their overall health outcomes.

What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa.

PubMed

Olu, Olushayo; Usman, Abdulmumini; Kalambay, Kalula; Anyangwe, Stella; Voyi, Kuku; Orach, Christopher Garimoi; Azazh, Aklilu; Mapatano, Mala Ali; Nsenga, Ngoy; Manga, Lucien; Woldetsadik, Solomon; Nguessan, Francois; Benson, Angela

2018-04-02

As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce. We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance. These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of

Use of Complementary Health Practices in a Church-Based African American Cohort.

PubMed

Escoto, Kamisha Hamilton; Milbury, Kathrin; Nguyen, Nga; Cho, Dalnim; Roberson, Crystal; Wetter, David; McNeill, Lorna H

2018-06-08

Few studies have examined the use of complementary health practices (e.g., mind/body practices and dietary supplements) among African Americans, particularly those who identify as being spiritual and/or religious. Furthermore, research on the health and health behavior profiles of such complementary health users is scant. The purpose of this study was to explore the use of complementary health practices and their lifestyle and health indicator correlates in a large, church-based African American population. Cross-sectional analysis of 1467 African American adults drawn from a church-based cohort study. Participants reported use of complementary health practices, lifestyle behaviors (e.g., diet and smoking status), and health indicators (e.g., physical health and medical problems). Multiple logistic regressions were conducted to examine associations between lifestyle variables, health indicators, and use of complementary health practices. Outcomes included prevalence of mind/body practices (e.g., meditation and Reiki) and dietary supplements (multivitamins) along with health indicator and lifestyle correlates of use. Use of complementary health practices was high; 40% reported using any mind/body practice and 50% reported using dietary supplements. Poorer physical health was associated with use of mind/body practices, while likelihood of meeting fruit and vegetable recommendations was significantly associated with dietary supplement use. Complementary health practices were used heavily in a church-based sample of African American adults. Poorer physical health was associated with use of complementary health practices, yet users also displayed health conscious behaviors. Given the high engagement in complementary health practices, it may be prudent to consider adapting complementary health approaches for use in wellness interventions targeting African Americans in faith-based settings.

Animal Health Ireland: providing national leadership and coordination of non-regulatory animal health issues in Ireland.

PubMed

More, S J; Doherty, M L; Downey, L; McKenzie, K; Devitt, C; O'Flaherty, J

2011-12-01

Livestock production plays an important role in the Irish economy. Regulatory animal health issues are the responsibility of government, but until recently there has been no national coordination of non-regulatory animal health issues. This gap has recently been filled with the establishment of Animal Health Ireland (AHI), a not-for-profit, partnership-based organisation providing national leadership and coordination of non-regulatory animal health issues in Ireland. Animal Health Ireland provides benefits to livestock producers and processors by providing the knowledge, education and coordination required to establish effective control strategies, both on-farm and nationally. This paper presents a brief overview of the context for AHI, and of its establishment and initial activities. Non-regulatory animal health issues have been prioritised. A series of work programmes (each focusing on a high-priority issue) have been established. Partnership is critical to success, both for AHI as an organisation and for effective farm-level transfer of knowledge. This model for national leadership and coordination of non-regulatory animal health issues may be of relevance elsewhere.

African American Women’s Preparation for Childbirth From the Perspective of African American Health-Care Providers

PubMed Central

Abbyad, Christine; Robertson, Trina Reed

2011-01-01

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women’s mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women’s preparation for birthing. PMID:22211059

Urban poverty and infant-health disparities among African Americans and whites in Milwaukee.

PubMed

Sims, Mario; Rainge, Yolanda

2002-06-01

This study examined neighborhood and infant health disparities between African-American and white mothers in Milwaukee, Wisconsin. Census-block data were used for 1990 and Vital Statistics data were used for 1992 through 1994. African-American mothers lived in less desirable, more segregated neighborhoods than white mothers did in 1990. African-American infant and neonatal mortality rates were twice those of whites (2.3 and 2.0, respectively), while African-American postneonatal mortality rates were three times that of whites (3.0). African-American low and very low birth weight rates were more than twice those of whites (2.5 and 2.6, respectively). All African-American mothers were nearly eight times as likely as all white mothers to have inadequate prenatal care, whereas poor African-American mothers were three times as likely to have inadequate prenatal care as were poor white mothers. Public health experts and practitioners may want to consider the communities of minority patients to devise interventions suitable for addressing health disparities.

Designing social marketing strategies to increase African Americans' access to health promotion programs.

PubMed

Icard, Larry D; Bourjolly, Joretha N; Siddiqui, Nushina

2003-08-01

This qualitative study explored four key factors--source, message, channel, and target--for linking at-risk African Americans with health promotion programs. Among the findings from focus group discussions was that the use of the African American church to involve at-risk African Americans in health promotion programs may actually function as a barrier for some individuals. The study also suggests that use of a high profile person to deliver a message may be counterproductive to efforts to motivate people to use health promotion programs. The significance of these and other findings for designing more effective social marketing strategies to increase at-risk African Americans' access to health promotion programs are discussed.

African concepts of health, disease, and treatment: an ethical inquiry.

PubMed

Omonzejele, Peter F

2008-01-01

This paper is based on the author's fieldwork experience in Edo State, Nigeria. The purpose of the article is to present and discuss African concepts of health, disease, and treatment within the framework of African Traditional Medicine (ATM). The two-fold notion of disease and treatment within the African context is also addressed. The significance of rituals and sacrifices in ATM are explained, and the interactions between ATM, African metaphysics, and cosmology are highlighted. The rules and moral precepts tenable in the practice of ATM are analyzed and discussed. The methodology employed in this study was the interviewing of African traditional healers.

Caregiver Mental Health, Neighborhood, and Social Network Influences on Mental Health Needs among African American Children

ERIC Educational Resources Information Center

Lindsey, Michael A.; Browne, Dorothy C.; Thompson, Richard; Hawley, Kristin M.; Graham, Christopher J.; Weisbart, Cindy; Harrington, Donna; Kotch, Jonathan B.

2008-01-01

In this study, the authors examined the combined effects of caregiver mental health, alcohol use, and social network support/satisfaction on child mental health needs among African American caregiver-child dyads at risk of maltreatment. The sample included 514 eight-year-old African American children and their caregivers who participated in the…

Addressing Mental Health Needs: Perspectives from African Americans Living in the Rural South

PubMed Central

Haynes, Tiffany F.; Cheney, Ann; Sullivan, Greer; Bryant, Keneshia; Curran, Geoffrey; Olson, Mary; Cottoms, Naomi; Reaves, Christina

2017-01-01

OBJECTIVE Rural African Americans are disproportionately impacted by social stressors that place them at risk of developing psychiatric disorders. This study aims to understand mental health from the perspective of rural African American residents and other stakeholders in order to devise culturally acceptable treatment approaches. METHODS Seven focus groups (N=50) were conducted with four stakeholder groups. A semi-structured interview guide was used to elicit perspectives of mental health, mental health treatment, and ways to improve mental health within rural African American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data. RESULTS Stressful living environments (e.g. impoverished communities) and broader community held beliefs (e.g. religious beliefs and mental health stigma) impacted not only perceptions of mental health but also contributed to barriers that impede mental health seeking. Participants also identified community level strategies that can be utilized to improve emotional wellness in rural African American communities. CONCLUSION Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and providing mental health education to the general public may improve use of services in this population. PMID:28142389

Environment, Health and Climate: Impact of African aerosols

NASA Astrophysics Data System (ADS)

Liousse, C.; Doumbia, T.; Assamoi, E.; Galy-Lacaux, C.; Baeza, A.; Penner, J. E.; Val, S.; Cachier, H.; Xu, L.; Criqui, P.

2012-12-01

Fossil fuel and biofuel emissions of particles in Africa are expected to significantly increase in the near future, particularly due to rapid growth of African cities. In addition to biomass burning emissions prevailing in these areas, air quality degradation is then expected with important consequences on population health and climatic/radiative impact. In our group, we are constructing a new integrated methodology to study the relations between emissions, air quality and their impacts. This approach includes: (1) African combustion emission characterizations; (2) joint experimental determination of aerosol chemistry from ultrafine to coarse fractions and health issues (toxicology and epidemiology). (3) integrated environmental, health and radiative modeling. In this work, we show some results illustrating our first estimates of African anthropogenic emission impacts: - a new African anthropogenic emission inventory adapted to regional specificities on traffic, biofuel and industrial emissions has been constructed for the years 2005 and 2030. Biomass burning inventories were also improved in the frame of AMMA (African Monsoon) program. - carbonaceous aerosol radiative impact in Africa has been modeled with TM5 model and Penner et al. (2011) radiative code for these inventories for 2005 and 2030 and for two scenarios of emissions : a reference scenario, with no further emission controls beyond those achieved in 2003 and a ccc* scenario including planned policies in Kyoto protocol and regulations as applied to African emission specificities. In this study we will show that enhanced heating is expected with the ccc* scenarios emissions in which the OC fraction is relatively lower than in the reference scenario. - results of short term POLCA intensive campaigns in Bamako and Dakar in terms of aerosol chemical characterization linked to specific emissions sources and their inflammatory impacts on the respiratory tract through in vitro studies. In this study, organic

The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

PubMed Central

Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

2014-01-01

African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

Factors influencing the migration of West African health professionals

PubMed Central

Lowe, Mat; Chen, Duan-Rung

2016-01-01

Introduction The West African health sector is characterized by a human resource base lacking in numbers and specialized skills. Among the contributory factors to this lack of human resource for health workforce include but not limited to the migration of health professionals. Methods This cross-sectional survey targeted 118 young professionals who have participated in the Young Professional Internship Program (YPIP) of the West African Health Organization (WAHO), from (2005-2013). It inquired about their socio-demographic characteristics associated with migration and reasons for going to their preferred or most likely destinations through online survey. Results Of the 118 young professionals, 100 responded to the online survey, of which (28%) have migrated and (72%) did not migrate. Migration was more common among males and those (age≤31 years old), single with high dependency level and no previous work experience. Having a medical profession and being posted to urban or semi-urban area was also associated with their emigration. Their most important reasons for going to preferred or most likely destinations were to have fair level of workload, job promotion and limited occupational risks. Conclusion This finding suggests that the migration of health professionals is situation dependent, mediated by basic socio-demographic variables and work related conditions. These issues have implications for curbing the brain drain potential of health professionals in the West African health sector. PMID:27800092

Willingness of African American Women to Participate in e-Health/m-Health Research.

PubMed

James, Delores C S; Harville, Cedric; Whitehead, Nicole; Stellefson, Michael; Dodani, Sunita; Sears, Cynthia

2016-03-01

Due to high rates of technology adoption, African American women are well positioned to benefit from e-health/mobile health (m-health) interventions; yet, there are limited data on understanding their use of technology and willingness to participate in e-health/m-health research. A self-administered survey was completed by 589 African American women. Survey items measured sociodemographics, technology use and access, and willingness to participate in e-health/m-health research. Multinomial logistic regression examined associations among three age groups (18-29, 30-50, and 51+years old) and technology access, as well as motivators and barriers to participating in e-health/m-health research. Most participants were willing to receive text messages as part of a research study. Many reported using a health-related application in the past 30 days, with younger women more likely to do so than older women (p<0.0001). Younger women were more likely than older women to be motivated for the greater good (p<0.01) and for financial incentives (p=0.02), whereas older women were more likely than younger women to be motivated if referred by a healthcare provider (p=0.02). Younger women were more likely than older women to report concerns about data plans (p<0.01 for all), whereas older women were more likely to report a lack of a smartphone (p=0.048) and privacy concerns (p<0.001). Culturally tailored e-health/m-health research using smartphones may be of interest to African American women who are interested in risk reduction and chronic disease self-management. Barriers such as smartphone data plans and privacy will need to be addressed.

Health Policy Initiatives for African American Women Veterans.

PubMed

McClerking, Carolyn A; Wood, Felecia

2016-08-01

America's military has experienced great changes in the demographic makeup of its veterans over the past few decades. In fact, the fastest growing group in the U.S. military is women. This demographic trend has also brought new challenges in dealing with gender issues, something that the Veterans Health Administration (VHA) has only recently begun to acknowledge. The VHA has responded in several ways to gender issues in health care and health outcomes. And, although the VHA is dealing with multiple gender matters, this article will focus on initiatives to combat cardiovascular disease (CVD) in women veterans. It will also highlight the significance of CVD, both to women veterans in general and to African American women veterans specifically. The article concludes with a discussion of VHA activities and strategies to improve the cardiovascular health of African American women veterans. © The Author(s) 2016.

[Strengthening health regulation in the Americas: regulatory authorities of regional reference].

PubMed

Ojeda, Lisette Pérez; Cristiá, Rafael Pérez

2016-05-01

Health technology regulation and quality assurance are critical to the development of national pharmaceutical policies, and implementing these actions is the responsibility of national regulatory authorities, whose level of development and maturity affect the quality, safety, and effectiveness of the products made available to the public. On the initiative of the regulatory authorities themselves, together with the Pan American Health Organization, the Region of the Americas promotes the strengthening of health regulation through an evaluation and certification process that allows for the designation of regulatory authorities of regional reference for drugs and biological products. Over the period from its implementation to the present, six authorities have been certified and one is in the process of obtaining certification. These authorities work jointly and promote dialogue and regulatory convergence, information-sharing to facilitate regulatory decision making, and regional cooperation to support the establishment of other authorities in the Region--actions having direct impact on access to effective and quality-assured health technologies. Their combined efforts have led to the recognition of this process of evaluation and certification by the World Health Organization (WHO). Among the actions resulting from the International Consultation on Regulatory Systems Strengthening, WHO recommended taking a close look at this model to assess its potential scale-up at the global level.

Life-course Financial Strain and Health in African-Americans

PubMed Central

Thorpe, Roland J; Whitfield, Keith E

2010-01-01

Differential exposure to financial strain may explain some differences in population health. However, few studies have examined the cumulative health effect of financial strain across the life-course. Studies that have are limited to self-reported health measures. Our objective was to examine the associations between childhood, adulthood, and life-course, or cumulative, financial strain with disability, lung function, cognition, and depression. In a population-based cross-sectional cohort study of adult African-American twins enrolled in the US Carolina African American Twin Study of Aging (CAATSA), we found that participants who reported financial strain as children and as adults are more likely to be physically disabled, and report more depressive symptoms than their unstrained counterparts. Participants who reported childhood financial strain had lower cognitive functioning than those with no childhood financial strain. We were unable to detect a difference in lung function beyond the effect of actual income and education in those who reported financial strain compared to those who did not. Financial strain in adulthood was more consistently associated with poor health than was childhood financial strain, a finding that suggests targeting adult financial strain could help prevent disability and depression among African-American adults. PMID:20452712

Structural health and the politics of African American masculinity.

PubMed

Metzl, Jonathan M

2013-07-01

This commentary describes ways in which notions of African American men's "health" attained by individual choice-embedded in the notion that African American men should visit doctors or engage in fewer risky behaviors-are at times in tension with larger cultural, economic, and political notions of "health." It argues that efforts to improve the health of Black men must take structural factors into account, and failure to do so circumvents even well-intentioned efforts to improve health outcomes. Using historical examples, the article shows how attempts to identify and intervene into what are now called social determinants of health are strengthened by addressing on-the-ground diagnostic disparities and also the structural violence and racism embedded within definitions of illness and health. And, that, as such, we need to monitor structural barriers to health that exist in institutions ostensibly set up to incarcerate or contain Black men and in institutions ostensibly set up to help them.

Subjective Social Status and Health Behaviors Among African Americans

PubMed Central

Reitzel, Lorraine R.; Nguyen, Nga; Strong, Larkin L.; Wetter, David W.; McNeill, Lorna H.

2012-01-01

Objectives To examine associations of the US and community subjective social status (SSS) ladders with smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and body mass index among 1467 church-going African American adults from a larger cohort study. Methods Regression analyses, adjusted for sociodemographics, examined associations between SSS ladders and health behaviors. Results The SSS-US ladder was significantly associated with fruit and vegetable consumption (p = .007) and physical activity (p = .005). The SSS-community ladder was not significantly associated with any health behaviors. Conclusions Among this sample of African Americans, the SSS-US ladder is more predictive of some health behaviors than is the SSS-community ladder. PMID:22943107

"Health is the Ability to Manage Yourself Without Help": How Older African American Men Define Health and Successful Aging.

PubMed

Griffith, Derek M; Cornish, Emily K; Bergner, Erin M; Bruce, Marino A; Beech, Bettina M

2018-01-11

Few studies have explored how older African American men understand the relationship between health and successful aging. The goal of this study was to examine how older African American men's conceptions and definitions of health and notions of successful aging are interrelated. Using data from 22 semistructured individual interviews with African American men ages 55-76, we examine how cultural and normative ideals about health map onto the core components of Rowe and Kahn's (1997) definition of successful aging. We also explore how these notions influence factors that have implications for health. Consistent with prior research, we found that older African American men operationalized notions of health in ways that mapped onto three elements of successful aging: (a) the absence of disease and disability, (b) the ability to maintain physical and cognitive functioning, and (c) meaningful social engagement in life. A fourth theme, what men actually do, emerged to highlight how regular health practices were key components of how men define health. These findings highlight key elements of how older African American men conceptualize health in ways that are interrelated with yet expand notions of successful aging in ways that are critical for health promotion research and interventions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Campus-Community Partnership to Disseminate Health Internet Technology Resources among African Americans

ERIC Educational Resources Information Center

Littlefield, Melissa B.; Edwards, Lorece; Akers, Timothy

2014-01-01

The Internet is increasingly used to disseminate health information about diseases and prevention and to help in obtaining health services. Although technology can empower African Americans to adopt healthy lifestyles, the gap in usage between African Americans and Whites undermines the potential power of health Internet technology (IT) to…

The interdependence of African American men's definitions of manhood and health

PubMed Central

Griffith, Derek M; Brinkley-Rubinstein, Lauren; Bruce, Marino A; Thorpe, Roland J; Metzl, Jonathan M

2015-01-01

In this paper we explore themes that cut across how 24-77 year old African American men define manhood and health. Utilizing a thematic approach, we analyzed data from nine focus groups (N=73). We found that manhood and health were relational constructs that are interrelated in men's minds and experiences. Manhood and health were defined by the characteristics men embody, the behaviors men engage in and the goals and values men had to positively influence their families and communities. Thus, manhood and health are interdependent constructs and their interrelationship should be considered in efforts to promote African American men's health. PMID:26291189

Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans.

PubMed

Mama, Scherezade K; Li, Yisheng; Basen-Engquist, Karen; Lee, Rebecca E; Thompson, Deborah; Wetter, David W; Nguyen, Nga T; Reitzel, Lorraine R; McNeill, Lorna H

2016-01-01

Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001) and U.S. (p < .001) and low social support (p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.

Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans

PubMed Central

Basen-Engquist, Karen; Lee, Rebecca E.; Thompson, Deborah; Wetter, David W.; Reitzel, Lorraine R.

2016-01-01

Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001) and U.S. (p < .001) and low social support (p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans. PMID:27119366

Health-Needs Assessment for West African Immigrants in Greater Providence, RI.

PubMed

Adu-Boahene, Akosua Boadiwaa; Laws, Michael Barton; Dapaah-Afriyie, Kwame

2017-01-06

African immigrants in the United States may experience barriers to health-care access and effectiveness. This mixed-methods study used paper-based surveys of people (N=101) in the target population from Nigeria, Ghana, and Liberia, recruited through convenience and snowball sampling. Semi-structured interviews were conducted with 3 clergy members who pastor churches with large Nigerian, Ghanaian, and Liberian populations, respectively; and five physicians and a clinical pharmacist who serve African immigrants. Length of stay in the United States was associated with the health status of refugee children. Undocumented immigration status was associated with lack of health insurance. Cardiovascular diseases, uterine fibroids and stress-related disorders were the most prevalent reported conditions. Regardless of English fluency, many immigrants are unfamiliar with medical terminology. African immigrants in the state of Rhode Island need more health education and resources to navigate the US health-care system. [Full article available at http://rimed.org/rimedicaljournal-2017-01.asp].

CANCER HEALTH DISPARITIES PERSIST AMONG AFRICAN AMERICANS IN WISCONSIN

PubMed Central

Jones, Nathan R.; Williamson, Amy; Foote, Mary; Creswell, Paul; Strickland, Rick; Remington, Patrick; Cleary, James; Adams, Alexandra

2011-01-01

Background Cancer incidence and mortality rates have decreased over the last few decades, yet not all groups have benefited equally from these successes. This has resulted in increased disparities in cancer burden among various population groups. Objective This study examined trends in absolute and relative disparities in overall cancer incidence and mortality rates between African American and white residents of Wisconsin during 1995 to 2006. Methods Cancer incidence data were obtained from the Wisconsin Cancer Reporting System. Mortality data were accessed from the National Center for Health Statistics’ public use mortality file. Trends in incidence and mortality rates during 1995–2006 for African Americans and whites were calculated and changes in relative disparity were measured using rate ratios. Results With few exceptions, African American incidence and mortality rates were higher than white rates in every year of the period 1995–2006. Although cancer mortality and incidence declined for both groups over the period, relative racial disparities in rates persisted over the period and account for about a third of African American cancer deaths. Conclusions Elimination of cancer health disparities will require further research into the many contributing factors, as well as into effective interventions to address them. In Wisconsin, policy makers, health administrators, and healthcare providers need to balance resources carefully and set appropriate priorities to target racial inequities in cancer burden. PMID:21066932

Perceived and Personal Mental Health Stigma in Latino and African American College Students.

PubMed

DeFreitas, Stacie Craft; Crone, Travis; DeLeon, Martha; Ajayi, Anna

2018-01-01

Mental health stigma occurs when people have negative thoughts and beliefs of those with mental health illnesses or mental health treatment. Mental health stigma is related to an assortment of negative outcomes including discrimination in housing and employment, reduced usage of mental health services, and poor mental health outcomes. These implications may be particularly salient for ethnic minorities such as African Americans and Latinos who already suffer from other types of discrimination. This study examines perceived and personal mental health stigma in African American and Latino college students from a nontraditional university to help elucidate factors related to the development of mental health stigma. Students completed surveys concerning their stigma beliefs. African American students were found to have higher rates of mental health stigma than Latino students. Furthermore, anxiety about those with mental illness was related to greater mental health stigma for both groups. For African Americans, it was found that their perception of their ability to visibly identify those with mental illness was related to greater mental health stigma. These findings suggest that interventions to reduce mental health stigma in college students should target specific ethnic minority groups and focus on issues that are particularly salient to those communities.

Perceived and Personal Mental Health Stigma in Latino and African American College Students

PubMed Central

DeFreitas, Stacie Craft; Crone, Travis; DeLeon, Martha; Ajayi, Anna

2018-01-01

Mental health stigma occurs when people have negative thoughts and beliefs of those with mental health illnesses or mental health treatment. Mental health stigma is related to an assortment of negative outcomes including discrimination in housing and employment, reduced usage of mental health services, and poor mental health outcomes. These implications may be particularly salient for ethnic minorities such as African Americans and Latinos who already suffer from other types of discrimination. This study examines perceived and personal mental health stigma in African American and Latino college students from a nontraditional university to help elucidate factors related to the development of mental health stigma. Students completed surveys concerning their stigma beliefs. African American students were found to have higher rates of mental health stigma than Latino students. Furthermore, anxiety about those with mental illness was related to greater mental health stigma for both groups. For African Americans, it was found that their perception of their ability to visibly identify those with mental illness was related to greater mental health stigma. These findings suggest that interventions to reduce mental health stigma in college students should target specific ethnic minority groups and focus on issues that are particularly salient to those communities. PMID:29536000

Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China

PubMed Central

Brown, Katherine B.; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M.; Bodomo, Adams B.; Yang, Ligang; Yang, Bin; Nehl, Eric J.; Tucker, Joseph D.; Wong, Frank Y.

2014-01-01

Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants. PMID:25294415

Overcoming barriers to health-care access: A qualitative study among African migrants in Guangzhou, China.

PubMed

Lin, Lavinia; Brown, Katherine B; Hall, Brian J; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

2016-10-01

Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised.

Health decision-making preferences among African American men recruited from urban barbershops.

PubMed

Hart, Alton; Smith, Wally R; Tademy, Raymond H; McClish, Donna K; McCreary, Micah

2009-07-01

To examine general health decision-making roles among African American men ages 40 to 70 recruited in barbershops in the Richmond, Virginia, metropolitan area. We adapted the 1-item Control Preference scale to study the associations between health decision-making role preferences and demographic variables. Forty African-American men were recruited from barbershops to complete a self-administered survey. After performing descriptive statistics, we dichotomized our outcome into active vs nonactive (collaborative or passive) decision makers. Data were then analyzed using chi2, Wilcoxon-Mann-Whitney rank sum, and multiple logistic regression. Fifteen subjects responded that they engaged in active decision making, 20 in collaborative, and 5 in passive decision making. Almost all (86.7%) active decision makers were home owners, vs 41.7% of nonactive decision makers. Among active decision makers, 46.7% had incomes of more than $70000, vs 12.5% of nonactive decision makers. The active group reported health status that was good to excellent, while 20.8% of those in the nonactive group reported poor/fair health. African American male barbershop clients preferred an active or collaborative health decision-making role with their physician, rather than a passive role. The relationship among home ownership, income, and decision style may best be understood by considering the historical and cultural influences on gender role socialization among African American males. More comprehensive assessment of decision styles is necessary to better understand health decision making among African American male patients.

The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities.

PubMed

Woods-Giscombé, Cheryl L; Gaylord, Susan A

2014-09-01

African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, "buddy system," etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. © The Author(s) 2014.

Improving Your Health: Tips for African American Men and Women

MedlinePlus

... For Reporters Meetings & Workshops Follow Us Home Health Information Weight Management Health Tips for African-Americans Related Topics Section ... at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

Patterns of family health history communication among older African American adults.

PubMed

Hovick, Shelly R; Yamasaki, Jill S; Burton-Chase, Allison M; Peterson, Susan K

2015-01-01

This qualitative study examined patterns of communication regarding family health history among older African American adults. The authors conducted 5 focus groups and 6 semi-structured interviews with African Americans aged 60 years and older (N = 28). The authors identified 4 distinct patterns of family health history communication: noncommunication, open communication, selective communication (communication restricted to certain people or topics), and one-way communication (communication not reciprocated by younger family members). In general, participants favored open family health history communication, often resulting from desires to change patterns of noncommunication in previous generations regarding personal and family health history. Some participants indicated that they were selective about what and with whom they shared health information in order to protect their privacy and not worry others. Others described family health history communication as one-way or unreciprocated by younger family members who appeared uninterested or unwilling to share personal and family health information. The communication patterns that the authors identified are consistent with communication privacy management theory and with findings from studies focused on genetic testing results for hereditary conditions, suggesting that individuals are consistent in their communication of health and genetic risk information. Findings may guide the development of health message strategies for African Americans to increase family health history communication.

Life-course financial strain and health in African-Americans.

PubMed

Szanton, Sarah L; Thorpe, Roland J; Whitfield, Keith

2010-07-01

Differential exposure to financial strain may explain some differences in population health. However, few studies have examined the cumulative health effect of financial strain across the life-course. Studies that have are limited to self-reported health measures. Our objective was to examine the associations between childhood, adulthood, and life-course, or cumulative, financial strain with disability, lung function, cognition, and depression. In a population-based cross-sectional cohort study of adult African-American twins enrolled in the US Carolina African American Twin Study of Aging (CAATSA), we found that participants who reported financial strain as children and as adults are more likely to be physically disabled, and report more depressive symptoms than their unstrained counterparts. Participants who reported childhood financial strain had lower cognitive functioning than those with no childhood financial strain. We were unable to detect a difference in lung function beyond the effect of actual income and education in those who reported financial strain compared to those who did not. Financial strain in adulthood was more consistently associated with poor health than was childhood financial strain, a finding that suggests targeting adult financial strain could help prevent disability and depression among African-American adults. Copyright 2010 Elsevier Ltd. All rights reserved.

Concepts of healthful food among low-income African American women.

PubMed

Lynch, Elizabeth B; Holmes, Shane; Keim, Kathryn; Koneman, Sylvia A

2012-01-01

Describe beliefs about what makes foods healthful among low-income African American women. In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food healthfulness. Nutrient content, physical effects of food, and food categories were used to judge the healthfulness of foods. Fruits, vegetables, and dairy foods were considered the most healthful and starchy foods the least healthful because they were believed to cause weight gain. Beliefs about which foods contain which nutrients and which foods have particular physical effects varied widely across participants. Participants demonstrated awareness of which foods are healthful but lacked understanding of why those foods are more healthful than others. Knowledge about the health effects of foods may be necessary to motivate individuals to choose healthful foods. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Race and Psychological Distress: The South African Stress and Health Study

PubMed Central

Jackson, Pamela Braboy; Williams, David R.; Stein, Dan J.; Herman, Allen; Williams, Stacey L.; Redmond, Deidre L.

2012-01-01

We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. All blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans. PMID:21131621

The Impact of Racism on the Sexual and Reproductive Health of African American Women

PubMed Central

Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.

2016-01-01

African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women’s sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women’s sexual and reproductive health. PMID:27227533

The Impact of Racism on the Sexual and Reproductive Health of African American Women.

PubMed

Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

2016-07-01

African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health.

The Influence of Ethnic and Mainstream Cultures on African Americans’ Health Behaviors: A Qualitative Study

PubMed Central

Swierad, Ewelina M.; Vartanian, Lenny R.; King, Marlee

2017-01-01

Background: Culture plays an important role in shaping individuals’ health behaviors. This qualitative research examines the relationship between African Americans’ ethnic and mainstream cultures and their health behaviors (i.e., food intake and physical activity). Methods: This study used in-depth semi-structured interview format with a group of 25 African Americans to examine the influence of ethnic and mainstream culture on African Americans’ food intake and physical activity. Thematic analysis was used to identify common themes and patterns related to African Americans’ health behaviors as well as to report these patterns within data. Results: The present study found that African Americans position both their ethnic and mainstream culture as important influences on their health behaviors pertaining to food intake and physical activity. Most participants reported taking advantage of “the best of both worlds” by engaging in picking and choosing healthy behaviors from both cultures to which they belong, and they perceived preparing healthy makeovers as a way to optimize their health. They also identified a range of practical considerations that can facilitate or hinder engagement in healthy eating and physical activity (e.g., affordability, social support). Participants discussed a number of other positive (e.g., resilience, spirituality) and negative (e.g., experience of discrimination) influences on health behaviors. Conclusions: African Americans consider both their ethnic and mainstream cultures important in shaping their health behaviors. These cultural influences need to be understood in the context of other psycho-socio-environmental factors that affect individuals’ health behaviors. The current study has practical implications for designing health promotion programs for African Americans. PMID:28777312

The Influence of Ethnic and Mainstream Cultures on African Americans' Health Behaviors: A Qualitative Study.

PubMed

Swierad, Ewelina M; Vartanian, Lenny R; King, Marlee

2017-08-04

Culture plays an important role in shaping individuals' health behaviors. This qualitative research examines the relationship between African Americans' ethnic and mainstream cultures and their health behaviors (i.e., food intake and physical activity). This study used in-depth semi-structured interview format with a group of 25 African Americans to examine the influence of ethnic and mainstream culture on African Americans' food intake and physical activity. Thematic analysis was used to identify common themes and patterns related to African Americans' health behaviors as well as to report these patterns within data. The present study found that African Americans position both their ethnic and mainstream culture as important influences on their health behaviors pertaining to food intake and physical activity. Most participants reported taking advantage of "the best of both worlds" by engaging in picking and choosing healthy behaviors from both cultures to which they belong, and they perceived preparing healthy makeovers as a way to optimize their health. They also identified a range of practical considerations that can facilitate or hinder engagement in healthy eating and physical activity (e.g., affordability, social support). Participants discussed a number of other positive (e.g., resilience, spirituality) and negative (e.g., experience of discrimination) influences on health behaviors. African Americans consider both their ethnic and mainstream cultures important in shaping their health behaviors. These cultural influences need to be understood in the context of other psycho-socio-environmental factors that affect individuals' health behaviors. The current study has practical implications for designing health promotion programs for African Americans.

The Chinese health care regulatory institutions in an era of transition.

PubMed

Fang, Jing

2008-02-01

The purpose of this paper is to contribute to a better understanding of Chinese health care regulation in an era of transition. It describes the major health care regulatory institutions operating currently in China and analyzes the underlying factors. The paper argues that in the transition from a planned to a market economy, the Chinese government has been employing a hybrid approach where both old and new institutions have a role in the management of emerging markets, including the health care market. This approach is consistent with the incremental reform strategy adopted by the Party-state. Although a health care regulatory framework has gradually taken shape, the framework is incomplete, with a particular lack of emphasis on professional self-regulation. In addition, its effectiveness is limited despite the existence of many regulatory institutions. In poor rural areas, the effectiveness of the regulatory framework is further undermined or distorted by the extremely difficult financial position that local governments find themselves in. The interpretations of the principle of 'rule of law' by policy makers and officials at different levels and the widespread informal network of relations between known individuals (Guanxi) play an important role in the operation of the regulatory framework. The findings of this paper reveal the complex nature of regulating health care in transitional China.

Measuring health systems strength and its impact: experiences from the African Health Initiative.

PubMed

Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

2017-12-21

Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

Health, Human Capital, and African American Migration Before 1910

PubMed Central

Logan, Trevon D.

2009-01-01

Using both IPUMS and the Colored Troops Sample of the Civil War Union Army Data, I estimate the effects of literacy and health on the migration propensities of African Americans from 1870 to 1910. I find that literacy and health shocks were strong predictors of migration and the stock of health was not. There were differential selection propensities based on slave status—former slaves were less likely to migrate given a specific health shock than free blacks. Counterfactuals suggest that as much as 35 percent of the difference in the mobility patterns of former slaves and free blacks is explained by differences in their human capital, and more than 20 percent of that difference is due to health alone. Overall, the selection effect of literacy on migration is reduced by one-tenth to one-third once health is controlled for. The low levels of human capital accumulation and rates of mobility for African Americans after the Civil War are partly explained by the poor health status of slaves and their immediate descendants. PMID:20161107

Health status among black African-born women in Kansas City: a preliminary assessment.

PubMed

Ndikum-Moffor, Florence M; Faseru, Babalola; Filippi, Melissa K; Wei, Hou; Engelman, Kimberly K

2015-10-05

Health information and statistics for Black foreign-born women in the United States are under-reported or not available. Black foreign-born women typically are classified under the general category of African American, ignoring the heterogeneity that exists in the United States Black population. It is important to identify health issues and behaviors of African-born women to effectively address health disparities. Black African-born women (N = 29), 20 years or older completed a survey about general and women's health, health history, acculturation, lifestyle, social and health challenges, beliefs about breast cancer. Data were analyzed using SPSS 14.0 software. Categorical variables were summarized with frequencies and percentages and continuous variables were summarized with means and standard variation. A Likert scale (strongly agree, agree, disagree, and strongly disagree) was used to assess beliefs about breast cancer. Most (71.4%) participants had a high school education or more, 70% were employed, and 50% had health insurance. Two-thirds received health care from primary care doctors, 20.7% from health departments, and 39.3% got annual checkups. Lack of jobs, healthcare cost, language barrier, discrimination, and child care were the top social issues faced by participants. High blood pressure, obesity, oral health, HIV/AIDS, and diabetes were indicated as the most common health problems. The percent of participants (60%) that had not had a mammogram within the previous 2 years was more than the state average (24%) for women 40 years and older reported by the Kansas Department of Health and Environment. The percent of participants (40%) that had a mammogram within the previous 2 years was lower than the national average (73.2%) for African American women. Study provides a snapshot of social concerns and health issues in an African population residing in Midwestern United States. Understanding the socio-cultural characteristics of this population is necessary

Overcoming Barriers to Health Care Access: A Qualitative Study among African Migrants in Guangzhou, China

PubMed Central

Lin, Lavinia; Brown, Katherine B.; Hall, Brian J.; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M.; Bodomo, Adams B.; Yang, Ligang; Yang, Bin; Nehl, Eric J.; Tucker, Joseph D.; Wong, Frank Y.

2015-01-01

Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and traveling to home countries or countries that offer English-speaking doctors for health care. Health care providers and health organizations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health care access for international migrants, particularly those who are marginalized. PMID:26400191

African American administrators in community/migrant health centers.

PubMed

Glover, S H; Shi, L; Samuels, M E

1997-05-01

Community and migrant health centers (CHC/MHCs) play a secondary role as avenues for the development of minority and women health care professionals, groups traditionally underrepresented in administrative and managerial positions within the health care system. This paper focuses on the role of CHC/MHCs in eliminating the barriers that typically limit the professional advancement of these groups. In a survey of both rural and urban CHC/MHC administrators, it was found that CHC/MHCs have higher percentages of minorities in top management positions than general management but do not necessarily reflect the minority composition of those being served. Of the CHC/MHC administrators, 20 percent were African American, less than the population served (31 percent) but greater than the percentage of African Americans in the general U.S. population (12 percent). This suggests that CHC/MHCs have partially met the original goal of upward mobility and that there is room for improvement.

Intrinsic and extrinsic motivations for healthful dietary change in African Americans.

PubMed

Satia, Jessie A; Galanko, Joseph A

2007-01-01

To describe associations of intrinsic and extrinsic motivations for dietary change with participant characteristics and current diet among African Americans. Cross-sectional survey of 658 African American adults in North Carolina provided information on intrinsic (self-image and health concerns) and extrinsic (social influence) motivation scales, participant characteristics, and diet. Most respondents considered it important to change their diet for health reasons; fewer were motivated by self-image or social influence. Motivation scales were significantly associated with demographic, behavioral, and psychosocial characteristics and fat, but not fruit/vegetable consumption, after adjustment for covariates (P<0.05). Tailoring on intrinsic and extrinsic motives may improve the effectiveness of dietary interventions in African Americans.

African-American Solo Grandparents Raising Grandchildren: A Representative Profile of Their Health Status.

PubMed

Whitley, Deborah M; Fuller-Thomson, Esme

2017-04-01

The objective of this study is to document the health profile of 252 African-American grandparents raising their grandchildren solo, compared with 1552 African-American single parents. The 2012 Behavior Risk Factor Surveillance System is used to compare the specific physical and mental health profiles of these two family groups. The findings suggest solo grandparents have prevalence of many health conditions, including arthritis (50.3 %), diabetes (20.1 %), heart attack (16.6 %) and coronary heart disease (16.6 %). Logistic regression analyses suggest that solo grandparents have much higher odds of several chronic health disorders in comparison with single parents, but this difference is largely explained by age. Although solo grandparents have good access to health care insurance and primary care providers, a substantial percentage (44 %) rate their health as fair or poor. Practice interventions to address African American solo grandparents' health needs are discussed.

Theory of perceived access to breast health care in African American women.

PubMed

Garmon, Sandra C

2012-01-01

The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

The West African Health Organization's experience in improving the health research environment in the ECOWAS region.

PubMed

Aidam, Jude; Sombié, Issiaka

2016-04-20

The West African Health Organization (WAHO) implemented a research development program in West Africa during 2009-2013 using the Knowledge for Better Health Research Capacity Development Framework, developed by Pang et al. (Bull World Health Organ 81(11):815-820, 2003), on strategies used to improve the research environment. The framework has the following components: stewardship, financing, sustainable resourcing and research utilization. This paper describes how WAHO implemented this research development program in the West African region to help improve the research environment and lessons learnt. This is a retrospective review of the regional research development program using a triangulation of activity reports, an independent evaluation and the authors' experiences with stakeholders. This program was designed to address gaps along the components of the framework and to improve partnership. The activities, results and challenges are summarised for each component of the framework. The independent evaluation was conducted using over 180 semi-structured interviews of key stakeholders in the West African region and activity reports. WAHO and major stakeholders validated these findings during a regional meeting. All 15 ECOWAS countries benefited from this regional research development program. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance. WAHO, along with other technical and financial partners, organised many capacity-strengthening trainings in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions. Further, WAHO developed strategic research partnerships and mobilised additional funding to support the program. The program

Positioning women's and children's health in African union policy-making: a policy analysis

PubMed Central

2012-01-01

Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010). This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and

Positioning women's and children's health in African union policy-making: a policy analysis.

PubMed

Toure, Kadidiatou; Sankore, Rotimi; Kuruvilla, Shyama; Scolaro, Elisa; Bustreo, Flavia; Osotimehin, Babatunde

2012-02-16

With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010).This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and impact. AU policies related

Under the shadow of Tuskegee: African Americans and health care.

PubMed

Gamble, V N

1997-11-01

The Tuskegee Syphilis Study continues to cast its long shadow on the contemporary relationship between African Americans and the biomedical community. Numerous reports have argued that the Tuskegee Syphilis Study is the most important reason why many African Americans distrust the institutions of medicine and public health. Such an interpretation neglects a critical historical point: the mistrust predated public revelations about the Tuskegee study. This paper places the syphilis study within a broader historical and social context to demonstrate that several factors have influenced--and continue to influence--African American's attitudes toward the biomedical community.

Increasing community capacity to reduce tobacco-related health disparities in African American communities.

PubMed

Jones, Pamela R; Waters, Catherine M; Oka, Roberta K; McGhee, Eva M

2010-01-01

The purpose of this study was to understand the processes and interactions that African American tobacco control organizations use to engage African American communities in tobacco control efforts. The study used grounded theory methods to interpret participant's perspectives on tobacco control. The study sample consisted of African American tobacco control program directors from African American tobacco control organizations throughout the United States. Data collection involved 1 interview per participant using a semistructured interview at a location selected by the participant. Each interview lasted approximately 30-90 min. The results showed that organizations used specific strategies to involve African Americans in tobacco control. The tobacco control organizations built community capacity using 3 processes: developing relationships and partnerships, raising awareness, and creating collective power. Contextual, cultural processes, and historical references used by African American tobacco control organizations provide insight into how to engage African American communities in tobacco control efforts and achieve tobacco-related health parity. Public health professionals and nurses should be aware of these and other strategies that may increase the involvement of African American communities in tobacco control. © 2010 Wiley Periodicals, Inc.

A review of the health effects of sexual assault on African American women and adolescents.

PubMed

Wadsworth, Pamela; Records, Kathie

2013-01-01

To review the research findings for mental and physical health outcomes and health behaviors of African American women and adolescents after sexual assault. Searches of the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO, and PubMed from January 2001 through May 2012 using the terms Blacks, African Americans, sexual abuse, sexual offenses, and rape. Criteria for inclusion included (a) results of primary research conducted in the United States and published in English, (b) African American females age 13 and older, (c) sexual assault or sexual abuse reported as distinct from other types of abuse, and (d) health status as an outcome variable. Twenty-one publications met inclusion criteria. Articles were reviewed for the mental and physical health and health behavior outcomes associated with sexual assault of African American women and adolescents. Sexual assault was associated with increased risk of poor mental and physical health outcomes in the general population of women and adolescents. There was an increased risk of unhealthy behaviors (e.g., drinking, drug use, risky sexual behaviors) for all women and adolescents, with the highest risk reported for African American women and adolescents. Help seeking from family and friends demonstrated conflicting results. Cumulative effects of repeated assaults appear to worsen health outcomes. Sexual assault has significant effects on the physical and mental health and health behaviors of women and adolescents in the general population. Less evidence is available for differences among African American women and adolescents. More research is needed to understand the influence of race on women's and adolescents' responses to assault. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Analysis of Regulatory Guidance for Health Monitoring

NASA Technical Reports Server (NTRS)

Munns, Thomas E.; Beard, Richard E.; Culp, Aubrey M.; Murphy, Dennis A.; Kent, Renee M.; Cooper, Eric G. (Technical Monitor)

2000-01-01

The purpose of this study was to assess the connection between current FAA regulations and the incorporation of Health Management (HM) systems into commercial aircraft. To address the overall objectives ARINC: (1) investigated FAA regulatory guidance, (2) investigated airline maintenance practices, (3) systematically identified regulations and practices that would be affected or could act as barriers to the introduction of HM technology, and (4) assessed regulatory and operational tradeoffs that should be considered for implementation. The assessment procedure was validated on a postulated structural HM capability for the B757 horizontal stabilizer.

Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes.

PubMed

Hall, Wayne

2017-04-01

The claim that the adverse health effects of cannabis are much less serious than those of alcohol has been central to the case for cannabis legalisation. Regulators in US states that have legalised cannabis have adopted regulatory models based on alcohol. This paper critically examines the claim about adverse health effects and the wisdom of regulating cannabis like alcohol. First, it compares what we know about the adverse health effects of alcohol and cannabis. Second, it discusses the uncertainties about the long term health effects of sustained daily cannabis use. Third, it speculates about how the adverse health effects of cannabis may change after legalisation. Fourth, it questions the assumption that alcohol provides the best regulatory model for a legal cannabis market. Fifth, it outlines the major challenges in regulating cannabis under the liberal alcohol-like regulatory regimes now being introduced. Copyright © 2016 Elsevier B.V. All rights reserved.

African American families' expectations and intentions for mental health services.

PubMed

Thompson, Richard; Dancy, Barbara L; Wiley, Tisha R A; Najdowski, Cynthia J; Perry, Sylvia P; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen A

2013-09-01

A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans' engagement in mental health services.

Religion, health and medicine in African Americans: implications for physicians.

PubMed

Levin, Jeff; Chatters, Linda M; Taylor, Robert Joseph

2005-02-01

Recent years have seen a burgeoning of research and writing on the connections between religion and health. The very best of this work comes from epidemiologic studies of African Americans. This paper summarizes results of these investigations, including findings identifying effects of religious participation on both physical and mental health outcomes. Evidence mostly supports a protective religious effect on morbidity and mortality and on depressive symptoms and overall psychological distress among African Americans. This paper also carefully discusses what the results of these studies mean and do not mean, an important consideration due to frequent misinterpretations of findings on this topic. Because important distinctions between epidemiologic and clinical studies tend to get glossed over, reports of religion-health associations oftentimes draw erroneous conclusions that foster unrealistic expectations about the role of faith and spirituality in health and healing. Finally, implications are discussed for clinical practice, medical education and public health.

Health and mental health policies' role in better understanding and closing African American-White American disparities in treatment access and quality of care.

PubMed

Snowden, Lonnie R

2012-10-01

Since publication of the U.S. Surgeon General's report Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 2001), several federal initiatives signal a sustained focus on addressing African American-White American disparities in mental health treatment access and quality and open the way to unprecedented disparity reduction. These initiatives include institutional commitments to (a) research by the National Center for Minority Health and Health Disparities; (b) disparities monitoring by the Agency for Healthcare Research and Quality; (c) new epidemiologic and service delivery information on African American populations from the National Survey of American Life sponsored by the National Institute of Mental Health; as well as (d) opportunities inherent in the World Health Organization's interest in disease burden for making it possible to view African Americans' likely greater disease burden from mental illness as a legitimate source of concern. The Patient Protection and Affordable Care Act affords unprecedented opportunities for increasing African Americans' treatment access and quality of care nationwide. By familiarizing themselves with these initiatives, and taking advantage of possibilities they offer, those committed to reducing African American-White American disparities in mental illness, and treatment access and quality, can make inroads toward improving African Americans' mental health and facilitating their successful functioning in all spheres of community living.

Tales from the "hood:" placing reproductive health communication between African American fathers and children in context.

PubMed

Ohalete, Nnenna; Georges, Jane; Doswell, Willa

2010-01-01

To evaluate reproductive health communication between African American fathers and their children. In this qualitative ethnographic study, data were collected through tape-recorded individual interviews about the content and timing of reproductive health communication, the reproductive health values fathers intended to impart to their children, and their comfort level in doing so. A total sample of 19 African-American fathers participated. Data were coded according to the qualitative analytic principles established by Miles and Huberman (1994), and analyzed using manifest and latent content analysis approaches. Although 10 fathers reported feeling uncomfortable having these conversations, 18 reported having reproductive health communication with their children, and most encouraged their sons and daughters to delay sex until adulthood. These conversations were primarily driven by the fear of HIV/AIDS and the negative consequences of sex; however, some conversations were inappropriate for developmental age. African-American fathers may benefit from education to help them have age appropriate reproductive health communication with their children. Registered Nurses and Nurse Practitioners are well positioned to educate African American adolescents and their fathers on reproductive health. Future dyadic African American father-child studies are needed to explore more fully African-American children's perceptions of reproductive health communication and the effect on delaying sex.

Determinants of health insurance ownership among South African women

PubMed Central

Kirigia, Joses M; Sambo, Luis G; Nganda, Benjamin; Mwabu, Germano M; Chatora, Rufaro; Mwase, Takondwa

2005-01-01

Background Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. Methods The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS). The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy. Results The χ2 test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p ≤ 0.05. Women who had standard 10 education and above (secondary), high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured. Conclusion Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing) for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services. PMID:15733326

Determinants of health insurance ownership among South African women.

PubMed

Kirigia, Joses M; Sambo, Luis G; Nganda, Benjamin; Mwabu, Germano M; Chatora, Rufaro; Mwase, Takondwa

2005-02-28

Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS). The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy. The chi2 test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p < or = 0.05. Women who had standard 10 education and above (secondary), high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured. Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing) for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services.

Alcohol dependence and health care utilization in African Americans.

PubMed

Marshall, Vanessa J; Kalu, Nnenna; Kwagyan, John; Scott, Denise M; Cain, Gloria E; Hill, Karen; Hesselbrock, Victor; Ferguson, Clifford L; Taylor, Robert E

2013-01-01

Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non-alcohol-dependent African Americans. A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non-alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. Xl Test and analysis of variance were used to analyze the data. Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p<.001), loss of consciousness (p=.001), and sexually transmitted diseases: (p<.001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p<.001). This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups.

Alcohol Dependence and Health Care Utilization in African Americans

PubMed Central

Marshall, Vanessa J.; Kalu, Nnenna; Kwagyan, John; Scott, Denise M.; Cain, Gloria E.; Hill, Karen; Hesselbrock, Victor; Ferguson, Clifford L.; Taylor, Robert E.

2013-01-01

Objective Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non alcohol–dependent African Americans. Method A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non–alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. χ2 Test and analysis of variance were used to analyze the data. Results Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p < .001), loss of consciousness (p = .001), and sexually transmitted diseases (p < .001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p < .001). Conclusions This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups. PMID:23862295

Addressing health concerns of pregnant African American women using the lens of complexity theory.

PubMed

Sims, Traci

2014-01-01

Pregnant African American women are at higher risk for multiple complex health issues, including depression, than their European American counterparts (Canady, Bullen, Holzman, Broman, & Tian, 2008; Martin et al, 2011; Mathews & MacDorman, 2007; Orr, Blazer, & James, 2006; Segre, Losch, & O'Hara, 2006). Various strategies must be used to address depression through preventive care and promotion of access to appropriate mental health services. Nurses and other health care providers need to examine the relationships between the multifactorial problems to improve the health and well-being of pregnant African American women and their unborn children. This article presents a case study demonstrating the use of complexity science theory to understand and prevent poor health outcomes for pregnant African American women with depression and their unborn children.

Discrimination, mental health, and leukocyte telomere length among African American men.

PubMed

Chae, David H; Epel, Elissa S; Nuru-Jeter, Amani M; Lincoln, Karen D; Taylor, Robert Joseph; Lin, Jue; Blackburn, Elizabeth H; Thomas, Stephen B

2016-01-01

African American men in the US experience disparities across multiple health outcomes. A common mechanism underlying premature declines in health may be accelerated biological aging, as reflected by leukocyte telomere length (LTL). Racial discrimination, a qualitatively unique source of social stress reported by African American men, in tandem with poor mental health, may negatively impact LTL in this population. The current study examined cross-sectional associations between LTL, self-reported racial discrimination, and symptoms of depression and anxiety among 92 African American men 30-50 years of age. LTL was measured in kilobase pairs using quantitative polymerase chain reaction assay. Controlling for sociodemographic factors, greater anxiety symptoms were associated with shorter LTL (b=-0.029, standard error [SE]=0.014; p<0.05). There were no main effects of racial discrimination or depressive symptoms on LTL, but we found evidence for a significant interaction between the two (b=0.011, SE=0.005; p<0.05). Racial discrimination was associated with shorter LTL among those with lower levels of depressive symptoms. Findings from this study highlight the role of social stressors and individual-level psychological factors for physiologic deterioration among African American men. Consistent with research on other populations, greater anxiety may reflect elevated stress associated with shorter LTL. Racial discrimination may represent an additional source of social stress among African American men that has detrimental consequences for cellular aging among those with lower levels of depression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health-industry linkages for local health: reframing policies for African health system strengthening

PubMed Central

Mackintosh, Maureen; Mugwagwa, Julius; Banda, Geoffrey; Tibandebage, Paula; Tunguhole, Jires; Wangwe, Samuel; Karimi Njeru, Mercy

2018-01-01

Abstract The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013–15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a ‘local health’ policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health–industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with ‘global health’ frameworks but poses a challenge to some of its underlying assumptions. PMID:29562286

Nurses' performance on indigenous and African-Brazilian health care practices.

PubMed

Lima, Maria do Rosário de Araújo; Nunes, Maria Luísa de Almeida; Klüppel, Berta Lúcia Pinheiro; Medeiros, Soraya Maria de; Sá, Lenilde Duarte de

2016-01-01

to analyze the performance of nurses from the Estratégia Saúde da Família (Family Health Strategy) on health care practices rooted in African and Indigenous cultures. Thematic Oral History was used and interviews were conducted with seven participants, who worked with Primary Health Care in Northeastern Brazil. The analysis was based on Leininger's Theory of Cultural Care and the intercultural concept of human rights, among others. nurses are unaware of the religious and historical context of the ethnic groups cared for and do not appreciate their self-care practices in areas with a predominance of African and indigenous cultures. These practices coexist with the hegemonic biomedical model. the debate on cultural competence in the context of professional qualification and exercise is required, aiming to promote the nursing work in the perspective of diversity and comprehensiveness of health care.

Church-based health programs for mental disorders among African Americans: a review.

PubMed

Hankerson, Sidney H; Weissman, Myrna M

2012-03-01

African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.

Health Behaviors and Breast Cancer: Experiences of Urban African American Women

ERIC Educational Resources Information Center

Stolley, Melinda R.; Sharp, Lisa K.; Wells, Anita M.; Simon, Nolanna; Schiffer, Linda

2006-01-01

Breast-cancer survival rates are lower among African American women compared to White women. Obesity may contribute to this disparity. More than 77% of African American women are overweight or obese. Adopting health behaviors that promote a healthy weight status may be beneficial because obesity increases risk for recurrence. Studies among White…

Beyond regulatory compression: confronting the liminal spaces of health research regulation

PubMed Central

Taylor-Alexander, Samuel; Dove, Edward S.; Fletcher, Isabel; Ganguli Mitra, Agomoni; McMillan, Catriona; Laurie, Graeme

2016-01-01

ABSTRACT Biomedicine and the life sciences continuously rearrange the relationship between culture and biology. In consequence, we increasingly look for a suitable regulatory response to reduce perceived uncertainty and instability. This article examines the full implications of this ‘regulatory turn’ by drawing on the anthropological concept of liminality. We offer the term ‘regulatory compression’ to characterise the effects of extant regulatory approaches on health research practices. With its focus on transformation and the ‘in-between’, liminality allows us to see how regulatory frameworks rely on a silo-based approach to classifying and regulating research objects such that they: (1) limit the flexibility necessary in clinical and laboratory research; (2) result in the emergence of unregulated spaces that lie between the bounded regulatory spheres; and (3) curtail modes of public participation in the health research enterprise. We suggest there is a need to develop the notion of ‘processual regulation’, a novel framework that requires a temporal-spatial examination of regulatory spaces and practices as these are experienced by all actors, including the relationship of actors with the objects of regulation. PMID:28058061

Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

PubMed

Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W

2017-11-21

Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.

Religion, health and medicine in African Americans: implications for physicians.

PubMed Central

Levin, Jeff; Chatters, Linda M.; Taylor, Robert Joseph

2005-01-01

Recent years have seen a burgeoning of research and writing on the connections between religion and health. The very best of this work comes from epidemiologic studies of African Americans. This paper summarizes results of these investigations, including findings identifying effects of religious participation on both physical and mental health outcomes. Evidence mostly supports a protective religious effect on morbidity and mortality and on depressive symptoms and overall psychological distress among African Americans. This paper also carefully discusses what the results of these studies mean and do not mean, an important consideration due to frequent misinterpretations of findings on this topic. Because important distinctions between epidemiologic and clinical studies tend to get glossed over, reports of religion-health associations oftentimes draw erroneous conclusions that foster unrealistic expectations about the role of faith and spirituality in health and healing. Finally, implications are discussed for clinical practice, medical education and public health. PMID:15712787

Anxiety Mediates Perceived Discrimination and Health in African-American Women.

PubMed

Carter, Sierra E; Walker, Rheeda L; Cutrona, Carolyn E; Simons, Ronald L; Beach, Steven R H

2016-11-01

We examined the mediational role of symptoms of anxiety in accounting for the association of discrimination and chronic health conditions among African-American women. Participants were 646 African-American women who completed self-report measures of perceived racial discrimination, symptoms of anxiety, and diagnosed chronic health problems. We examined the mediation hypothesis using a path analytic procedure. Mediational analyses indicated that, above and beyond symptoms of depression, age, and education status, anxiety symptoms were associated with both racial discrimination (β = .03, SE = .01, p < .001) and chronic health problems (β = .33, SE = .09, p < .001) and significantly mediated the discrimination-health association (β = -.01, SE = .01, p = .16). These findings highlight the potentially vital role of symptoms of anxiety in the process that occurs from an individual's perception of discrimination to reported chronic health outcomes. Future research expanding our understanding of the interconnection of psychosocial stressors, discrimination, and their biological sequelae is needed.

African American Families’ Expectations and Intentions for Mental Health Services

PubMed Central

Thompson, Richard; Dancy, Barbara L.; Wiley, Tisha R.A.; Najdowski, Cynthia J.; Perry, Sylvia P.; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen

2012-01-01

A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans’ engagement in mental health services. PMID:22791083

Attitudes toward cancer and implications for mental health outcome in African-American cancer patients.

PubMed

Zhang, Amy Y; Gary, Faye; Zhu, Hui

2015-03-01

This study examined African-American cancer patients’ attitudes toward cancer and their relationship with long-term mental health outcomes. Using mixed methods, 74 breast and prostate cancer patients including 34 depressed and 23 nondepressed African-Americans and 17 depressed Whites were interviewed. The interviews were audiotaped and transcribed. Qualitative data analysis identified themes that were coded. The codes were entered into SPSS software. Fisher’s exact test was performed to examine group differences in the identified themes. Nondepressed African-Americans more frequently reported cancer as an adaptive experience (p = 0.047) and less frequently as a struggle (p = 0.012) than the depressed African-Americans and Whites. Groups did not significantly differ in the belief that cancer has no cure (p = 0.763), but depressed African-Americans more frequently reported unwillingness to share a cancer diagnosis with family or friends than depressed Whites (p = 0.50). African-Americans’ adaptive attitudes to cancer exhibit a pragmatist approach and a worldview shaped by their lived experience. Participants’ narratives were examined to illuminate the meanings of these findings. Adaptive attitudes to cancer are associated with better long-term mental health outcomes, and conversely, unpreparedness and inability to cope are associated with a higher risk of depression among African-American cancer patients. Education about cancer and supports for treatment navigation are important measures for improving the long-term mental health of African-Americans living with cancer.

Cis-Regulatory Variants Affect CHRNA5 mRNA Expression in Populations of African and European Ancestry

PubMed Central

Wang, Jen-Chyong; Spiegel, Noah; Bertelsen, Sarah; Le, Nhung; McKenna, Nicholas; Budde, John P.; Harari, Oscar; Kapoor, Manav; Brooks, Andrew; Hancock, Dana; Tischfield, Jay; Foroud, Tatiana; Bierut, Laura J.; Steinbach, Joe Henry; Edenberg, Howard J.; Traynor, Bryan J.; Goate, Alison M.

2013-01-01

Variants within the gene cluster encoding α3, α5, and β4 nicotinic receptor subunits are major risk factors for substance dependence. The strongest impact on risk is associated with variation in the CHRNA5 gene, where at least two mechanisms are at work: amino acid variation and altered mRNA expression levels. The risk allele of the non-synonymous variant (rs16969968; D398N) primarily occurs on the haplotype containing the low mRNA expression allele. In populations of European ancestry, there are approximately 50 highly correlated variants in the CHRNA5-CHRNA3-CHRNB4 gene cluster and the adjacent PSMA4 gene region that are associated with CHRNA5 mRNA levels. It is not clear which of these variants contribute to the changes in CHRNA5 transcript level. Because populations of African ancestry have reduced linkage disequilibrium among variants spanning this gene cluster, eQTL mapping in subjects of African ancestry could potentially aid in defining the functional variants that affect CHRNA5 mRNA levels. We performed quantitative allele specific gene expression using frontal cortices derived from 49 subjects of African ancestry and 111 subjects of European ancestry. This method measures allele-specific transcript levels in the same individual, which eliminates other biological variation that occurs when comparing expression levels between different samples. This analysis confirmed that substance dependence associated variants have a direct cis-regulatory effect on CHRNA5 transcript levels in human frontal cortices of African and European ancestry and identified 10 highly correlated variants, located in a 9 kb region, that are potential functional variants modifying CHRNA5 mRNA expression levels. PMID:24303001

Race, race-based discrimination, and health outcomes among African Americans.

PubMed

Mays, Vickie M; Cochran, Susan D; Barnes, Namdi W

2007-01-01

Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans' continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular.

"Broken windows": Relationship between neighborhood conditions and behavioral health among low-income African American adolescents.

PubMed

Voisin, Dexter R; Kim, Dong Ha

2018-03-01

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

Health Emergency 2003: The Spread of Drug-Related AIDS and Hepatitis C among African American and Latinos. Health Emergency Series.

ERIC Educational Resources Information Center

Day, Dawn

This report is the fifth in a series detailing the impact of the injection-related AIDS epidemic on African Americans and Latinos. Ten chapters include: (1) "Health Emergency: The Spread of AIDS among African Americans Who Inject Drugs"; (2) "Health Emergency: The Spread of AIDS Among Latinos Who Inject Drugs"; (3) "A…

Low Cardiorespiratory Fitness in African Americans: A Health Disparity Risk Factor?

PubMed Central

Swift, Damon L.; Staiano, Amanda E.; Johannsen, Neil M.; Lavie, Carl J.; Earnest, Conrad P.; Katzmarzyk, Peter T.; Blair, Steven N.; Newton, Robert L.; Church, Timothy S.

2013-01-01

Low cardiorespiratory fitness (CRF) is a well-established risk factor for all-cause and cardiovascular disease mortality. African Americans have higher rates of cardiovascular disease compared to their Caucasian counterparts. However, the extent to which lower CRF levels contribute to the excess risk in African Americans has not been fully explored. The purpose of this review is to: 1) explore the literature evaluating the relationship between CRF and mortality specifically in African American populations; and 2) critically evaluate the studies which have compared CRF between African American and Caucasians in epidemiological studies and clinical trials. We have further discussed several potential mechanisms that may contribute to the observation of lower CRF levels in African American compared to Caucasian adults including potential racial differences in physical activity levels, muscle fiber type distribution, and hemoglobin levels. If lower CRF is generally present in African Americans compared to Caucasians, and is of a clinically meaningful difference, this may represent an important public health concern. PMID:23982718

Disease Messaging in Churches: Implications for Health in African-American Communities

PubMed Central

Harmon, Brook E.; Chock, Marci; Brantley, Elizabeth; Wirth, Michael D.; Hébert, James R.

2016-01-01

Using the right messaging strategies, churches can help promote behavior change. Frequencies of disease-specific messages in 21 African-American churches were compared to overall and cancer-specific mortality and morbidity rates as well as church-level variables. Disease messages were found in 1025 of 2166 items. Frequently referenced topics included cancer (n=316), mental health conditions (n=253), heart disease (n=246), and infectious diseases (n=220). Messages for lung and colorectal cancers appeared at low frequency despite high mortality rates in African-American communities. Season, church size, and denomination showed significant associations with health messages. Next steps include testing messaging strategies aimed at improving the health of churchgoing communities. PMID:26296703

Social inequalities, regional disparities and health inequity in North African countries.

PubMed

Boutayeb, Abdesslam; Helmert, Uwe

2011-05-31

During the last decades, North African countries have substantially improved economic, social and health conditions of their populations in average. In all countries, human development in general and life expectancy, literacy and per capita income in particular have increased. However, improvement was not equally shared between groups of different milieu, regions or level of income. Social inequalities and health inequity have persisted or even worsened. Data are generally scarce and few studies were devoted to this topic in North Africa as a region. In this paper, we carry out a comparative study on the achievements of these countries, not only in terms of human development and its components but also in terms of inequalities' reduction and health equity. This study is based on data available for comparison between North African countries. The main data sources are provided by reports released by the World Health Organisation (WHO), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), the World Bank, surveys such as Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) and finally recent papers published on equity in different countries of the region. There is no doubt that education, health and human development in general have improved in North Africa during the last decades. Improvement was, however, uneven and unequally enjoyed by different socioeconomic groups. Indeed, each country included in this study shows large urban-rural disparities, discrepancies between advantaged and disadvantaged regions and cities; and unacceptable differences between rich and poor. Health inequity is particularly seen through access to health services and infant mortality. During the last decades, North African decision makers have endeavoured to improve social and economic conditions of their populations. Globally, health, education and living standard in general have substantially improved in average. However, North

Mental Health and African Americans

MedlinePlus

... than Non-Hispanic whites. The death rate from suicide for African American men was more than four ... for African American women, in 2014. However, the suicide rate for African Americans is 70% lower than ...

Health care access and poverty do not explain the higher esophageal cancer mortality in African Americans.

PubMed

Miller, Jordan A G; Rege, Robert V; Ko, Clifford Y; Livingston, Edward H

2004-07-01

Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. The National Health Interview Survey database for years 1986 to 1994 were combined and linked to the National Death Index. Individuals who died from esophageal carcinoma were assessed in the combined database, thus enabling detailed analysis of their socioeconomic status, race, and health care access. Poverty was 4-fold more frequent in African Americans who died from esophageal carcinoma than whites. Despite poverty, African American patients' access to health care was good and was not statistically related to increased mortality. Although the esophageal carcinoma mortality rate is higher in African Americans than in whites, it is not clearly related to the presence of poverty or to limited health care access. The higher mortality may be related to lifestyle differences, environmental exposure, or difference in disease biology, but it is not related exclusively to socioeconomic factors.

"As a Community, We Need to be More Health Conscious": Pastors' Perceptions on the Health Status of the Black Church and African-American Communities.

PubMed

Gross, Tyra Toston; Story, Chandra R; Harvey, Idethia Shevon; Allsopp, Marie; Whitt-Glover, Melicia

2018-06-01

Churches are recognized for their potential capacity to provide health services and interventions to address health disparities in African-Americans (blacks). Since pastors are central community leaders, their support and involvement can influence both implementation and outcomes for church-based health programs. The purpose of this qualitative study was to explore pastors' perceptions of congregant health status within the black church. Semi-structured interviews were conducted with 11 pastors whose female congregants participated in a physical activity intervention. Thematic analysis techniques were used to analyze interview data. Three major themes emerged: (1) health risks in the African-American community, (2) health promotion in the black church, and (3) the importance of women in the black family and the church. Pastors noted numerous health disparities affecting their congregants and the African-American community at large, including obesity and infant mortality. They viewed health holistically and included faith in their perspectives. According to pastors, holistic health was promoted through health ministry programming in black churches. Women were described as the cornerstone of the black church, yet faced unique health concerns from their roles as family caretakers and congregants. Pastors shared their major concerns for congregant health status and the African-American community. Health interventions focusing on African-Americans in church settings should include pastor involvement and should incorporate holistic approaches to address health risks.

Discussing Adolescent Sexual Health in African American Churches

PubMed Central

Williams, Terrinieka T.; Dodd, Darcy; Campbell, Bettina; Pichon, Latrice C.; Griffith, Derek M.

2012-01-01

This study describes the ways in which two African American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education 1) churches as sources of sexual information; 2) churches as complex communities; and 3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed. PMID:22814618

Diet and long-term health: an African Diaspora perspective.

PubMed

Solomons, Noel W

2003-01-01

The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and

Race, Race-Based Discrimination, and Health Outcomes Among African Americans

PubMed Central

Mays, Vickie M.; Cochran, Susan D.; Barnes, Namdi W.

2014-01-01

Persistent and vexing health disadvantages accrue to African Americans despite decades of work to erase the effects of race discrimination in this country. Participating in these efforts, psychologists and other social scientists have hypothesized that African Americans’ continuing experiences with racism and discrimination may lie at the root of the many well-documented race-based physical health disparities that affect this population. With newly emerging methodologies in both measurement of contextual factors and functional neuroscience, an opportunity now exists to cleave together a comprehensive understanding of the ways in which discrimination has harmful effects on health. In this article, we review emerging work that locates the cause of race-based health disparities in the external effects of the contextual social space on the internal world of brain functioning and physiologic response. These approaches reflect the growing interdisciplinary nature of psychology in general, and the field of race relations in particular. PMID:16953796

Establishing priorities for advocacy in South African Health.

PubMed

Mametja, D; Jinabhai, C C; Ngwane, N; Dolan, C; Twala, J; Mackenzie, A; Gear, J; Russo, R; Tollman, S; Pugh, A

1993-01-01

To develop an appropriate health policy agenda, the National Progressive Primary Health Care Network (NPPHC) and the South African Health and Social Services Organization (SAHSSO) conducted situational analyses in 4 areas: an informal peri-urban area within the Durban functional region in Natal, a rural area in the Mhala-Mapulaneng district in the North Eastern Transvaal, the informal settlement of Botshabelo in the Orange Free State, and a dense township dwelling in Soweto. The analyses were based on interviews with health workers and community leaders, a national survey, and a questionnaire for health service administrators. All 4 areas were characterized by poverty, unemployment, low educational levels, lack of a clean water supply or refuse removal system, housing shortages or overcrowding, and political violence. Preventable diseases, such as water-borne diarrhea and malnutrition, cause substantial morbidity, yet health services tend to be inaccessible, distributed inequitably, of poor quality, and with unclear administrative structures. Community members interviewed indicated that clinic fees were too high, especially given the low quality of care, and there was a general mistrust of the competency of doctors and nurses. There was a lack of consensus on the meaning of community participation; some viewed it as a vehicle for empowerment, while others felt the strategy would be exploited as a means to deny government assistance. Overall, respondents were supportive of a greater role for community health workers and more involvement on the part of nongovernmental organizations. A priority, at present, is attention to the many socioeconomic factors that are compromising the health of black South Africans and overshadowing the rationalization of health services.

Perceived discrimination and health-related quality-of-life: gender differences among older African Americans.

PubMed

Coley, Sheryl L; Mendes de Leon, Carlos F; Ward, Earlise C; Barnes, Lisa L; Skarupski, Kimberly A; Jacobs, Elizabeth A

2017-12-01

Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences. We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables. More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL. Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.

Health Volunteerism and Improved Cancer Health for Latina and African American Women and Their Social Networks: Potential Mechanisms.

PubMed

Molina, Yamile; McKell, Marnyce S; Mendoza, Norma; Barbour, Lynda; Berrios, Nerida M; Murray, Kate; Ferrans, Carol Estwing

2018-02-01

Health volunteerism has been associated with positive health outcomes for volunteers and the communities they serve. This work suggests that there may be an added value to providing underserved populations with information and skills to be agents of change. The current study is a first step toward testing this hypothesis. The purpose is to identify how volunteerism may result in improved cancer health among Latina and African American women volunteers. A purposive sample of 40 Latina and African American female adults who had participated in cancer volunteerism in the past 5 years was recruited by community advocates and flyers distributed throughout community venues in San Diego, CA. This qualitative study included semi-structured focus groups. Participants indicated that volunteerism not only improved their health but also the health of their family and friends. Such perceptions aligned with the high rates of self-report lifetime cancer screening rates among age-eligible patients (e.g., 83-93 % breast; 90-93 % cervical; 79-92 % colorectal). Identified mechanisms included exposure to evidence-based information, health-protective social norms and support, and pressure to be a healthy role model. Our findings suggest that train-the-trainer and volunteer-driven interventions may have unintended health-protective effects for participating staff, especially Latina and African American women.

African-American Fathers' Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication.

PubMed

Randolph, Schenita D; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J

2017-06-01

African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers' perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10-15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers' acceptance of their roles and responsibilities; (b) a positive father-son relationship; and (c) fathers' ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers' difficulty in initiating sexual health discussions with their sons; (b) sons' developmental readiness for sexual health information; and (c) fathers' lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

African-American Fathers’ Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication

PubMed Central

Randolph, Schenita D.; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J.

2017-01-01

African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers’ perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10–15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers’ acceptance of their roles and responsibilities, (b) a positive father-son relationship, and (c) fathers’ ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers’ difficulty in initiating sexual health discussions with their sons, (b) sons’ developmental readiness for sexual health information, and (c) fathers’ lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. PMID:28220553

Recruitment and Participation of African American Men in Church-Based Health Promotion Workshops.

PubMed

Saunders, Darlene R; Holt, Cheryl L; Le, Daisy; Slade, Jimmie L; Muwwakkil, Bettye; Savoy, Alma; Williams, Ralph; Whitehead, Tony L; Wang, Min Qi; Naslund, Michael J

2015-12-01

Health promotion interventions in African American communities are frequently delivered in church settings. The Men's Prostate Awareness Church Training (M-PACT) intervention aimed to increase informed decision making for prostate cancer screening among African American men through their churches. Given the significant proportion and role of women in African American churches, the M-PACT study examined whether including women in the intervention approach would have an effect on study outcomes compared with a men-only approach. The current analysis discusses the men's participation rates in the M-PACT intervention, which consisted of a series of 4 bimonthly men's health workshops in 18 African American churches. Data suggest that once enrolled, retention rates for men ranged from 62 to 69 % over the workshop series. Among the men who were encouraged to invite women in their lives (e.g., wife/partner, sister, daughter, friend) to the workshops with them, less than half did so (46 %), suggesting under-implementation of this "health partner" approach. Finally, men's participation in the mixed-sex workshops were half the rate as compared to the men-only workshops. We describe recruitment techniques, lessons learned, and possible reasons for the observed study group differences in participation, in order to inform future interventions to reach men of color with health information.

Prevalent Health Concerns Among African American Women Belonging to a National Volunteer Service Organization (The Links, Incorporated).

PubMed

Asiedu, Gladys B; Hayes, Sharonne N; Williams, Karen Patricia; Bondaryk, Matthew R; Halyard, Michele Y; Parker, Monica W; Balls-Berry, Joyce E; Pinn, Vivian W; Breitkopf, Carmen Radecki

2017-02-01

African American women bear a disproportionate burden of cardiovascular disease (CVD) and cancer. The purpose of this study was to identify prevalent health concerns among African American women who are members of The Links, Incorporated (Links), a large national service organization with health programming for communities of color. Survey data (n = 391) were collected during the 2012 Links National Assembly. Twenty-six health issues were presented within five groups: cancer, CVD, pulmonary disease, chronic conditions, and behavioral health. For each issue, women indicated if it was a concern for "you/your family" or "the African American community" via check-boxes. Differences in the proportions for "you/your family" and "the African American community" were evaluated using the McNemar test. Hypertension was the most frequently endorsed concern for you/your family (79 %); 73 % indicated this was a concern for the African American community. Sickle cell anemia was the most frequently endorsed concern for the African American community (77 %). Melanoma was the least endorsed health issue overall (15 % you/your family, 55 % community). Breast was the most frequently endorsed cancer concern, while lung was among the least. For 23 out of 26 health issues, the proportion concerned was greater for the "African American community" than for "you/your family" (all p < 0.05). CVD and breast cancer were salient concerns; both are topics for which national awareness campaigns and Links health programming exist. Comparatively lower concern was observed for melanoma, a cancer with known survival disparities, and for lung cancer, a leading cause of death in women.

Marriage and Health in the Transition to Adulthood: Evidence for African Americans in the Add Health Study

ERIC Educational Resources Information Center

Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang

2010-01-01

This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…

Health expenditure and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries.

PubMed

Piabuo, Serge Mandiefe; Tieguhong, Julius Chupezi

2017-12-01

African leaders accepted in the year 2001 through the Abuja Declaration to allocate 15% of their government expenditure on health but by 2013 only five (5) African countries achieved this target. In this paper, a comparative analysis on the impact of health expenditure between countries in the CEMAC sub-region and five other African countries that achieved the Abuja declaration is provided. Data for this study was extracted from the World Development Indicators (2016) database, panel ordinary least square (OLS), fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) were used as econometric technic of analysis. Results showed that health expenditure has a positive and significant effect on economic growth in both samples. A unit change in health expenditure can potentially increase GDP per capita by 0.38 and 0.3 units for the five other African countries that achieve the Abuja target and for CEMAC countries respectively, a significant difference of 0.08 units among the two samples. In addition, a long-run relationship also exist between health expenditure and economic growth for both groups of countries. Thus African Economies are strongly advised to achieve the Abuja target especially when other socio-economic and political factors are efficient.

Learning portfolio models in health regulatory colleges of Ontario, Canada.

PubMed

Tompkins, Marianne; Paquette-Frenette, Denise

2010-01-01

Health regulatory colleges promote continued competence by requiring members to submit yearly portfolios that document learning. Previous studies conclude that portfolios can be valuable tools to promote continuous learning in health college members, but portfolios are time-consuming to complete and difficult to evaluate. This exploratory study compares the features of portfolio models in regulatory colleges, as a basis for future studies. Data were collected through a document review of the portfolio models described on the Web sites of 14 Canadian health regulatory colleges. All models contain 3 common components of self-directed learning: (1) self-diagnosis, (2) learning plan and activities, and (3) self-evaluation. Several include member profiles and peer feedback. A broad range of formal, nonformal, and informal activities are accepted as evidence of learning; a few colleges restrict learners' freedom in selecting these activities. There is a dual philosophy of learning in portfolio models that includes both humanist and technical paradigms. Low numbers of members are selected for audit of completed portfolios. The possibility of last-minute preparation and the lack of support to members who struggle with self-directed learning methods are issues to be resolved. Although portfolios are designed to enhance learning and reflection, quality cannot be ensured unless compliance is enforced, and learning outcomes are measured. Professionals should be guided regarding how to complete portfolios. More health regulatory colleges should announce the number of portfolios they audit. In general, the number of portfolios audited by each profession may need to be increased.

Needs and Preferences for Receiving Mental Health Information in an African American Focus Group Sample

PubMed Central

Mishra, Shiraz I.; Lucksted, Alicia; Gioia, Deborah; Barnet, Beth; Baquet, Claudia R.

2013-01-01

The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. We conducted four focus groups (n=42) among African American adults currently unconnected with the mental health system. Participants expressed fear of stigma and perceptions of racism as major barriers to seeking information and/or services and discussed some normalizing strategies to address these barriers. African Americans harbor cultural and traditional beliefs regarding mental illness which could also act as barriers. Findings have implications for imparting acceptable and culturally-sensitive mental health education and service delivery programs in community settings. PMID:18633704

Financial hardship, unmet medical need, and health self-efficacy among African American men.

PubMed

Tucker-Seeley, Reginald D; Mitchell, Jamie A; Shires, Deirdre A; Modlin, Charles S

2015-06-01

Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p < .05), more likely to report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.

Psychosocial mechanisms linking the social environment to mental health in African Americans

USDA-ARS?s Scientific Manuscript database

Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African Amer...

Regulatory Enforcement and Fiscal Impact in Local Health Agencies

PubMed Central

Rabarison, Kristina M.; Rabarison, Monika K.

2015-01-01

Objectives. We used a cross-sectional, retrospective study design to analyze the association between local health agency regulatory activities and revenues from nonclinical fees and fines (NFF). Methods. We extracted data from the 2010 National Association of County and City Health Officials (NACCHO) Profile Survey, the most recent report including NFF information, and used 2-part multivariable regression models to identify relationships between regulatory activities and revenue. We also interviewed LHD directors on access to revenue from fines. Results. NFFs generated substantial revenue for most LHDs, increasing in scope and amount with jurisdiction size for all but the largest municipalities. The greatest proportion of net revenue came from public pools, campgrounds and recreational vehicles, and solid waste disposal. For small and mid-sized LHDs, enforcement activities generated revenue in a dose–response pattern, with higher returns for increased activities. LHDs in decentralized governance states collected more NFF revenue than those in centralized states. States vary regarding LHD access to revenue from sanctions. Conclusions. The fiscal impact of changes in regulatory activity needs careful assessment to avoid unanticipated consequences of applicable law. PMID:25689178

[Health care access of Sub-Saharan African migrants living with chronic hepatitis B].

PubMed

Vignier, Nicolas; Spira, Rosemary Dray; Lert, France; Pannetier, Julie; Ravalihasy, Andrainolo; Gosselin, Anne; Lydié, Nathalie; Bouchaud, Olivier; Desgrées du Loû, Annabel

2017-07-10

Objective: The objective of this study was to analyse health care access of Sub-Saharan African migrants living with chronic hepatitis B (CHB) in France. Methods: The ANRS-Parcours survey was a life-event survey conducted in 2012-2013 among Sub-Saharan African migrants recruited by health care facilities managing CHB in the Paris region. Data were collected by face-to-face interview using a biographical grid and a standardized questionnaire. Results: 96.4% of the 619 participants basic health insurance coverage with CMU universal health insurance coverage in 18.6% of cases and AME state medical assistance in 23.4% of cases. One-third of basic health insurance beneficiaries did not have any complementary health insurance and 75.7% had long-term disease status. The median time to acquisition of health insurance cover after arrival in France was one year. 22.0% of participants reported delaying health care for financial reasons since their arrival in France and 9.7% reported being refused health care usually due to refusal of CMU or AME. Health care access was effective within one year of the diagnosis. Delayed health care access was more common among people without health insurance coverage in the year of diagnosis. Patients lost to follow-up for more than 12 months were rare. Conclusion: Sub-Saharan African migrants living with chronic hepatitis B rapidly access health insurance coverage and health care. However, barriers to health care access persist for some people, essentially due to absent or incomplete health insurance cover and refusal of care for AME or CMU beneficiaries.

Peer training of community health workers to improve heart health among African American women.

PubMed

Josiah Willock, Robina; Mayberry, Robert M; Yan, Fengxia; Daniels, Pamela

2015-01-01

Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method. We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs' (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations. © 2014 Society for Public Health Education.

Health financing in the African Region: 2000-2009 data analysis.

PubMed

Sambo, Luis Gomes; Kirigia, Joses Muthuri; Orem, Juliet Nabyonga

2013-03-06

In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year increased from 11 to 24

Regional health governance: A suggested agenda for Southern African health diplomacy.

PubMed

Penfold, Erica Dale; Fourie, Pieter

2015-12-01

Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South-South management of the regional social policy, health governance and health diplomacy agenda.

Regional health governance: A suggested agenda for Southern African health diplomacy

PubMed Central

Penfold, Erica Dale; Fourie, Pieter

2015-01-01

Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South–South management of the regional social policy, health governance and health diplomacy agenda. PMID:26635498

Priority Health Behaviors among South African Undergraduate Students

ERIC Educational Resources Information Center

Porter, Kandice; Johnson, Ping Hu; Petrillo, Jane

2009-01-01

This study examined the priority health behaviors of South African youth by administering a questionnaire to 635 undergraduate students enrolled in a large metropolitan university in South Africa. Results indicate that 65.5% of the participants tried cigarettes at least once during their lifetime, over 15.2% had their first cigarette and 31.2% had…

Mental health and physical health of family caregivers for persons with dementia: a comparison of African American and white caregivers.

PubMed

Knight, B G; Longmire, C V Flynn; Dave, J; Kim, J H; David, S

2007-09-01

This investigation analyzed the differences between African American and white caregivers in the effects of family caregiving for a person with dementia on mental health and physical health variables (including subjective health, reported diseases and cardiovascular measures). A population-based sample of 102 caregivers is compared with 102 non-caregivers matched on ethnicity, gender and age. There were no significant group differences for mental health effects. Most significant physical health effects were attributable to main effects of ethnicity rather than caregiving status. However, African American caregivers had higher diastolic blood pressure than all other groups, a finding consistent with group-specific risk for circulatory system disorders.

Pharmacogenomics Implications of Using Herbal Medicinal Plants on African Populations in Health Transition

PubMed Central

Thomford, Nicholas E.; Dzobo, Kevin; Chopera, Denis; Wonkam, Ambroise; Skelton, Michelle; Blackhurst, Dee; Chirikure, Shadreck; Dandara, Collet

2015-01-01

The most accessible points of call for most African populations with respect to primary health care are traditional health systems that include spiritual, religious, and herbal medicine. This review focusses only on the use of herbal medicines. Most African people accept herbal medicines as generally safe with no serious adverse effects. However, the overlap between conventional medicine and herbal medicine is a reality among countries in health systems transition. Patients often simultaneously seek treatment from both conventional and traditional health systems for the same condition. Commonly encountered conditions/diseases include malaria, HIV/AIDS, hypertension, tuberculosis, and bleeding disorders. It is therefore imperative to understand the modes of interaction between different drugs from conventional and traditional health care systems when used in treatment combinations. Both conventional and traditional drug entities are metabolized by the same enzyme systems in the human body, resulting in both pharmacokinetics and pharmacodynamics interactions, whose properties remain unknown/unquantified. Thus, it is important that profiles of interaction between different herbal and conventional medicines be evaluated. This review evaluates herbal and conventional drugs in a few African countries and their potential interaction at the pharmacogenomics level. PMID:26402689

Measuring pesticide ecological and health risks in West African agriculture to establish an enabling environment for sustainable intensification.

PubMed

Jepson, P C; Guzy, M; Blaustein, K; Sow, M; Sarr, M; Mineau, P; Kegley, S

2014-04-05

We outline an approach to pesticide risk assessment that is based upon surveys of pesticide use throughout West Africa. We have developed and used new risk assessment models to provide, to our knowledge, the first detailed, geographically extensive, scientifically based analysis of pesticide risks for this region. Human health risks from dermal exposure to adults and children are severe enough in many crops to require long periods of up to three weeks when entry to fields should be restricted. This is impractical in terms of crop management, and regulatory action is needed to remove these pesticides from the marketplace. We also found widespread risks to terrestrial and aquatic wildlife throughout the region, and if these results were extrapolated to all similar irrigated perimeters in the Senegal and Niger River Basins, they suggest that pesticides could pose a significant threat to regional biodiversity. Our analyses are presented at the regional, national and village levels to promote regulatory advances but also local risk communication and management. Without progress in pesticide risk management, supported by participatory farmer education, West African agriculture provides a weak context for the sustainable intensification of agricultural production or for the adoption of new crop technologies.

Measuring pesticide ecological and health risks in West African agriculture to establish an enabling environment for sustainable intensification

PubMed Central

Jepson, P. C.; Guzy, M.; Blaustein, K.; Sow, M.; Sarr, M.; Mineau, P.; Kegley, S.

2014-01-01

We outline an approach to pesticide risk assessment that is based upon surveys of pesticide use throughout West Africa. We have developed and used new risk assessment models to provide, to our knowledge, the first detailed, geographically extensive, scientifically based analysis of pesticide risks for this region. Human health risks from dermal exposure to adults and children are severe enough in many crops to require long periods of up to three weeks when entry to fields should be restricted. This is impractical in terms of crop management, and regulatory action is needed to remove these pesticides from the marketplace. We also found widespread risks to terrestrial and aquatic wildlife throughout the region, and if these results were extrapolated to all similar irrigated perimeters in the Senegal and Niger River Basins, they suggest that pesticides could pose a significant threat to regional biodiversity. Our analyses are presented at the regional, national and village levels to promote regulatory advances but also local risk communication and management. Without progress in pesticide risk management, supported by participatory farmer education, West African agriculture provides a weak context for the sustainable intensification of agricultural production or for the adoption of new crop technologies. PMID:24535399

Sharing regulatory data as tools for strengthening health systems in the Region of the Americas.

PubMed

Sousa, Varley Dias; Ramalho, Pedro I; Silveira, Dâmaris

2016-05-01

Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs) and Regional Reference Authorities (RRAs). This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report) as tools for strengthening health systems. Based on a narrative (nonsystematic) review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data) and data- and work-sharing (inter-agency data). The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1) the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics) and 2) the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

Peer Training of Community Health Workers to Improve Heart Health Among African American Women

PubMed Central

Willock, Robina Josiah; Mayberry, Robert M.; Yan, Fengxia; Daniels, Pamela

2015-01-01

Introduction Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. Background African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs' (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. Results This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. Discussion/Conclusion CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations. PMID:24891525

Productivity losses associated with tuberculosis deaths in the World Health Organization African region.

PubMed

Kirigia, Joses Muthuri; Muthuri, Rosenabi Deborah Karimi

2016-06-01

In 2014, almost half of the global tuberculosis deaths occurred in the World Health Organization (WHO) African Region. Approximately 21.5 % of the 6 060 742 TB cases (new and relapse) reported to the WHO in 2014 were in the African Region. The specific objective of this study was to estimate future gross domestic product (GDP) losses associated with TB deaths in the African Region for use in advocating for better strategies to prevent and control tuberculosis. The cost-of-illness method was used to estimate non-health GDP losses associated with TB deaths. Future non-health GDP losses were discounted at 3 %. The analysis was conducted for three income groups of countries. One-way sensitivity analysis at 5 and 10 % discount rates was undertaken to assess the impact on the expected non-health GDP loss. The 0.753 million tuberculosis deaths that occurred in the African Region in 2014 would be expected to decrease the future non-health GDP by International Dollars (Int$) 50.4 billion. Nearly 40.8, 46.7 and 12.5 % of that loss would come from high and upper-middle- countries or lower-middle- and low-income countries, respectively. The average total non-health GDP loss would be Int$66 872 per tuberculosis death. The average non-health GDP loss per TB death was Int$167 592 for Group 1, Int$69 808 for Group 2 and Int$21 513 for Group 3. Tuberculosis exerts a sizeable economic burden on the economies of the WHO AFR countries. This implies the need to strongly advocate for better strategies to prevent and control tuberculosis and to help countries end the epidemic of tuberculosis by 2030, as envisioned in the United Nations General Assembly resolution on Sustainable Development Goals (SDGs).

“Church-Based Health Programs for Mental Disorders among African Americans: A Review

PubMed Central

Hankerson, Sidney H.; Weissman, Myrna M.

2014-01-01

Objective African Americans, compared to White Americans, underutilize traditional mental health services. A systematic review is presented of studies involving church-based health promotion programs (CBHPP) for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. Methods A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980 and December 31, 2009. Inclusion criteria included the following: studies were conducted in a church; primary objective(s) involved assessment, perceptions/attitudes, education, prevention, group support, or treatment for Diagnostic and Statistical Manual-IV mental disorders or their correlates; number of participants was reported; qualitative and/or quantitative data were reported; and African Americans were the target population. Results Of 1,451 studies identified, 191 studies were eligible for formal review. Only eight studies met inclusion criteria for this review. The majority of studies focused on substance related disorders (n=5), were designed to assess the effects of a specific intervention (n=6), and targeted adults (n=6). One study focused on depression and was limited by a small sample size of seven participants. Conclusion Although CBHPP have been successful in addressing racial disparities for several chronic medical conditions, the published literature on CBHPP for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans. PMID:22388529

African American and European American Veterans’ Perspectives on Receiving Mental Health Treatment

PubMed Central

Castro, Frank; AhnAllen, Christopher G.; Wiltsey-Stirman, Shannon; Lester-Williams, Kristin; Klunk-Gillis, Julie; Dick, Alexandra M.; Resick, Patricia A.

2015-01-01

Little is known about client attitudes, especially Veterans’, toward the types of structured interventions that are increasingly being offered in public sector and VA mental health clinics, nor is the possible impact these attitudes may have on treatment engagement well understood. Previous work indicates that attitudes of African Americans and European Americans toward treatment may differ in important ways. Attitudes toward treatment have been a proposed explanation for lower treatment engagement and higher dropout rates among African Americans compared to European Americans. Yet to date, the relationship between race and attitudes toward treatment and treatment outcomes has been understudied, and findings inconclusive. The purpose of this study was to explore African American and European American Veteran attitudes toward mental health care, especially as they relate to structured treatments. Separate focus groups were conducted with 24 African American and 37 European American military Veterans. In general, both groups reported similar reasons to seek treatment and similar thoughts regarding the purpose of therapy. Differences emerged primarily regarding therapist preferences. In both groups, some participants expressed favorable opinions of structured treatments and others expressed negative views; treatment preferences did not appear to be influenced by race. PMID:25822316

The Effect of Racial Socialization on Urban African American Use of Child Mental Health Services

PubMed Central

Cavaleri, Mary A.; Rodriguez, James; McKay, Mary M.

2009-01-01

SUMMARY Objective To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. Methods A cross-sectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. Results At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. Conclusion Parental endorsement of racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued. PMID:20228964

African American patients' attitudes toward proactive health behaviors after exposure to direct-to-consumer advertising.

PubMed

Yang, Yi; Gourley, Dick R; Gourley, Greta A; Faris, Richard J; Womeodu, Robin J; Yang, Jun; Likens, Carol C

2010-05-01

Previous research on direct-to-consumer advertising (DTCA) has not focused exclusively on the African American population. The purpose of this study was to explore African Americans' attitudes toward proactive health behaviors following exposure to DTCA of atorvastatin calcium (Lipitor, Pfizer Inc). One-hundred fifty African American patients participated in the study. Participants' functional health literacy and health locus of control were assessed. The participants were asked to view a DTCA of Lipitor, followed by face-to-face interviews. After watching the DTCA of Lipitor, 89.4% of participants agreed that they would talk to their physician about their cholesterol, 88.6% agreed that they would ask their physician to test their cholesterol level, and 47.3% agreed that they would ask their physician to write them a prescription for Lipitor. Those who had a history of high cholesterol were more likely to agree to ask their physician to test their cholesterol levels. Low household income, having public health insurance, and prior experience with taking Lipitor were significant positive predictors of patients agreeing to ask their physician to write a prescription of the advertised drug. African American patients showed favorable attitudes toward proactive health behaviors after exposure to DTCA of Lipitor.

Population health status of South Asian and African-Caribbean communities in the United Kingdom.

PubMed

Calvert, Melanie; Duffy, Helen; Freemantle, Nick; Davis, Russell; Lip, Gregory Y H; Gill, Paramjit

2012-04-25

Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. It is unclear whether the health status in black and minority ethnic groups are comparable to these population health status data. The aim of this study was to evaluate health-status in South Asian and African-Caribbean populations. Cross-sectional study recruiting participants aged ≥ 45 years (September 2006 to July 2009) from 20 primary care centres in Birmingham, United Kingdom.10,902 eligible subjects were invited, 5,408 participated (49.6%). 5,354 participants had complete data (49.1%) (3442 South Asian and 1912 African-Caribbean). Health status was assessed by interview using the EuroQoL EQ-5D. The mean EQ-5D score in South Asian participants was 0.91 (standard deviation (SD) 0.18), median score 1 (interquartile range (IQR) 0.848 to 1) and in African-Caribbean participants the mean score was 0.92 (SD 0.18), median 1 (IQR 1 to 1). Compared with normative data from the UK general population, substantially fewer African-Caribbean and South Asian participants reported problems with mobility, usual activities, pain and anxiety when stratified by age resulting in higher average health status estimates than those from the UK population. Multivariable modelling showed that decreased health-related quality of life (HRQL) was associated with increased age, female gender and increased body mass index. A medical history of depression, stroke/transient ischemic attack, heart failure and arthritis were associated with substantial reductions in HRQL. The reported HRQL of these minority ethnic groups was substantially higher than anticipated compared to UK normative data. Participants with chronic disease experienced significant reductions in HRQL and should be a target for health intervention.

Legal and regulatory considerations associated with use of patient-generated health data from social media and mobile health (mHealth) devices.

PubMed

Petersen, C; DeMuro, P

2015-01-01

Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of personal health information is easy, quick, and appealing to patients. However, adoption of social media and mHealth by providers is hampered by legal and regulatory concerns with regard to data ownership and data use. This article defines common forms of patient-generated health data (PGHD) and describes how PGHD is used in clinical settings. It explores issues related to protection of personal health information, including that of children and adolescents, data security, and other potential barriers such as physician licensure. It also discusses regulatory and legal considerations providers and patients should consider before using social media and mobile health apps.

Masculinities fathering and health: the experiences of African-Caribbean and white working class fathers.

PubMed

Williams, Robert Alan

2007-01-01

There is a developing body of research that investigates the links between masculinities and men's health experiences, but the links between masculinities and the health of fathers has been a neglected focus for research in the UK. This paper presents some of the findings drawn from a parent study which investigated African-Caribbean and white working class fathers' experiences of fathering, health and social connectedness. Data are drawn from interviews with 13 men (6 African-Caribbean and 7 White working class) living in a city in the West Midlands area of the UK. In this paper, I analyse and discuss African-Caribbean and white working class fathers' stories about the meaning of health, the influences upon their health, and their health practices. It was found that for the African-Caribbean fathers specifically, anticipated or perceived racist prejudice, abuse or discrimination influenced their health experiences. However, the meaning of health for both ethnic groups of fathers was as functional capacity, that is health was an asset that allowed fathers to meet the obligations of paid work and fathering. These obligations were also associated with a restricted sense of personal agency for the men interviewed, and the associated constraints were linked to transgressive consumption of alcohol, food and tobacco. In addition, fathers were also involved in solitary ways of dealing with their vulnerability, vulnerability that was associated with fathers' health concerns, and other difficult life experiences. Fathers' solitary experiences of vulnerability were also mediated by hegemonic forms of masculinity. Nevertheless, the experience of fathering within the lifecourse influenced men's health experiences: reflexivity and challenges to both transgressive consumption and solitary experiences were linked to fathers' perceived obligations to children. The significance of gender, ethnicity and social class for theory and future research with working class fathers and boys

Diaspora engagement of African migrant health workers - examples from five destination countries.

PubMed

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals.

eHealth Literacy, Online Help-Seeking Behavior, and Willingness to Participate in mHealth Chronic Disease Research Among African Americans, Florida, 2014-2015.

PubMed

James, Delores C S; Harville, Cedric

2016-11-17

The high rate of ownership of smartphones among African Americans provides researchers with opportunities to use digital technologies to reduce the prevalence of chronic diseases in this population. This study aimed to assess the association between eHealth literacy (EHL) and access to technology, health information-seeking behavior, and willingness to participate in mHealth (mobile health) research among African Americans. A self-administered questionnaire was completed by 881 African American adults from April 2014 to January 2015 in north central Florida. EHL was assessed by using the eHealth Literacy Scale (eHEALS) with higher scores (range, 8-40) indicating greater perceived skills at using online health information to help solve health problems. Overall eHEALS scores ranged from 8 to 40, with a mean of 30.4 (standard deviation, 7.8). The highest score was for the item "I know how to find helpful health resources on the Internet," and the lowest score was for "I can tell high quality from low quality health resources on the Internet." Most respondents owned smartphones (71%) and searched online for health information (60%). Most were also willing to participate in health research that used text messages (67%), smartwatches/health tracking devices (62%), and health apps (57%). We found significantly higher eHEALS scores among women, smartphone owners, those who use the Internet to seek health information, and those willing to participate in mHealth research (P < .01 for all). Most participants owned smartphones, used the Internet as a source of information, and were willing to participate in mHealth research. Opportunities exist for improving EHL and conducting mHealth research among African Americans to reduce the prevalence of chronic diseases.

Engaging communities to improve mental health in African and African Caribbean groups: a qualitative study evaluating the role of community well-being champions.

PubMed

Mantovani, Nadia; Pizzolati, Micol; Gillard, Steve

2017-01-01

Over the last decade, Britain has undergone reforms to promote engagement in local structures of governance. These reforms have encouraged the promotion of active citizenship and have been central to the government's public service modernisation agenda. This article presents the findings from a study evaluating a pilot outreach intervention which adopted a community engagement model to address the mental health needs of African and African Caribbean groups, which entailed a partnership between faith-based organisations, local public services and community organisations to co-produce the pilot project. Lay people were trained to raise awareness about mental health among these communities in South London. Between 2012 and 2013, a qualitative participatory approach was used to evaluate the pilot project, which enabled a researcher to take part in the engagement phase of the pilot project, and the project co-ordinators to be involved in the research process. Semi-structured, one-to-one interviews were carried out with 13 community and well-being champions (CWBCs) recruited from African and African Caribbean communities (seven male and six female). This study examines the impact of the relationship between the intervention and community through the participants' engagement in the pilot outreach project and the action undertaken as champions. We found that although CWBCs used circles of influence to share ideas about mental health and well-being and to encourage change, they encountered resistance on the part of the people they engaged with, which resulted from a lack of knowledge about mental health, taboos and ascribed stigma. We argue that CWBCs acted as healthy examples to communicate mental health knowledge to those approached, but that they needed to be equipped with bespoke communication skills to be able to talk about such sensitive issues as mental health. © 2015 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Interaction initiatives between regulatory, health technology assessment and coverage bodies, and industry.

PubMed

Frønsdal, Katrine; Pichler, Franz; Mardhani-Bayne, Logan; Henshall, Chris; Røttingen, John-Arne; Mørland, Berit; Klemp, Marianne

2012-10-01

There has been an increased focus on the relationship between health technology assessment (HTA) and regulatory assessments and how regulatory, HTA and coverage bodies, and industry can work better together to improve efficiency and alignment of processes. There is increasingly agreement across sectors that improved communication and coordination could contribute to facilitating timely patient access to effective, affordable treatments that offer value to the health system. Discussions on aspects of this relationship are being held in different forums and various forms of coordination and collaboration are being developed or piloted within several jurisdictions. It is therefore both timely and of value to stakeholders to describe and reflect on current initiatives intended to improve interactions between regulatory, HTA and coverage bodies, and industry. Drawing on 2011 meetings of the HTAi Policy Forum and the Center for Innovation in Regulatory Science (CIRS), this study aims to describe and compare initiatives, and point to success factors and challenges that are likely to inform future work and collaboration.

Effects of Moderate Aerobic Exercise Training on Vascular Health and Blood Pressure in African Americans

PubMed Central

Feairheller, Deborah L.; Diaz, Keith M.; Kashem, Mohammed A.; Thakkar, Sunny R.; Veerabhadrappa, Praveen; Sturgeon, Kathleen M.; Ling, Chenyi; Williamson, Sheara T.; Kretzschmar, Jan; Lee, Hojun; Grimm, Heather; Babbitt, Dianne M.; Vin, Charmie; Fan, Xiaoxuan; Crabbe, Deborah L.; Brown, Michael D.

2014-01-01

As healthcare progresses toward individualized medicine, understanding how different racial groups respond to lifestyle interventions is valuable. It is established that African Americans have disproportionate levels of cardiovascular disease and impaired vascular health, and clinical practice guidelines suggest lifestyle interventions as the first line of treatment. Recently, we reported six months of aerobic exercise improved inflammatory markers, flow-mediated dilation (FMD), and levels of circulating endothelial microparticles (EMPs) in African American adults. This study is a subgroup analysis of the aerobic exercise-induced changes in vascular health and blood pressure (BP) measures; carotid artery intima-media thickness (IMT), nitroglycerin-mediated dilation (NMD), ambulatory BP, and office BP. Sedentary African American adults (53.4±6.2yrs;21F,5M) showed improved vascular health, but no change in BP. Carotid artery IMT decreased 6.4%, plasma NO levels increased 76.6%, plasma EMP levels decreased, percent FMD increased 59.6%, and FMD/NMD ratio increased 36.2% (P <0.05 for all). Six months of aerobic exercise training is sufficient to elicit improvements in vascular structure and function in African Americans, even without improvements in BP measures or NMD (i.e., smooth muscle function). To our knowledge, this is the first study to report such findings in African Americans. PMID:24779748

Financial Hardship, Unmet Medical Need, and Health Self-Efficacy among African American Men

ERIC Educational Resources Information Center

Tucker-Seeley, Reginald D.; Mitchell, Jamie A.; Shires, Deirdre A.; Modlin, Charles S., Jr.

2015-01-01

Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet…

Engaging African American and Latino Adolescent Males through School-Based Health Centers

ERIC Educational Resources Information Center

Bains, Ranbir Mangat; Franzen, Carolyn W.; White-Frese', Jesse

2014-01-01

African American and Latino males are less likely to seek mental health services and obtain adequate care than their White counterparts. They are more likely to receive mental health services in school-based health centers (SBHCs) than in other community-based setting. The purpose of this article was to understand the issues and reasons these…

Exploring corruption in the South African health sector.

PubMed

Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

2016-03-01

Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

Health financing in the African Region: 2000–2009 data analysis

PubMed Central

2013-01-01

Background In order to raise African countries probability of achieving the United Nations Millennium Development Goals by 2015, there is need to increase and more efficiently use domestic and external funding to strengthen health systems infrastructure in order to ensure universal access to quality health care. The objective of this paper is to examine the changes that have occurred in African countries on health financing, taking into account the main sources of funding over the period 2000 to 2009. Methods Our analysis is based on the National Health Accounts (NHA) data for the 46 countries of the WHO African Region. The data were obtained from the WHO World Health Statistics Report 2012. Data for Zimbabwe was not available. The analysis was done using Excel software. Results Between 2000 and 2009, number of countries spending less than 5% of their GDP on health decreased from 24 to 17; government spending on health as a percentage of total health expenditure increased in 31 countries and decreased in 13 countries; number of countries allocating at least 15% of national budgets on health increased from 2 to 4; number of countries partially financing health through social security increased from 19 to 21; number of countries where private spending was 50% and above of total health expenditure decreased from 29 (64%) to 23 (51%); over 70% of private expenditure on health came from household out-of-pocket payments (OOPS) in 32 (71%) countries and in 27 (60%) countries; number of countries with private prepaid plans increased from 29 to 31; number of countries financing more than 20% of their total health expenditure from external sources increased from 14 to 19; number of countries achieving the Commission for Macroeconomics and Health recommendation of spending at least US$34 per person per year increased from 11 to 29; number of countries achieving the International Taskforce on Innovative Financing recommendation of spending at least US$44 per person per year

[Computer simulation of thyroid regulatory mechanisms in health and malignancy].

PubMed

Abduvaliev, A A; Gil'dieva, M S; Khidirov, B N; Saĭdalieva, M; Saatov, T S

2010-07-01

The paper describes a computer model for regulation of the number of thyroid follicular cells in health and malignancy. The authors'computer program for mathematical simulation of the regulatory mechanisms of a thyroid follicular cellular community cannot be now referred to as good commercial products. For commercialization of this product, it is necessary to draw up a direct relation of the introduced corrected values from the actually existing normal values, such as the peripheral blood concentrations of thyroid hormones or the mean values of endocrine tissue mitotic activity. However, the described computer program has been also used in researches by our scientific group in the study of thyroid cancer. The available biological experimental data and theoretical provisions on thyroid structural and functional organization at the cellular level allow one to construct mathematical models for quantitative analysis of the regulation of the size of a cellular community of a thyroid follicle in health and abnormalities, by using the method for simulation of the regulatory mechanisms of living systems and the equations of cellular community regulatory communities.

Eliminating health disparities in the African American population: the interface of culture, gender, and power.

PubMed

Airhihenbuwa, Collins O; Liburd, Leandris

2006-08-01

Since the release of former Secretary Margaret Heckler's Secretary's Task Force Report on Black and Minority Health more than two decades ago, excess death from chronic diseases and other conditions between African Americans and Whites have increased. The conclusion of that report emphasized excess death and thus clinical care, paying little attention to the sociocultural environment and its effects on risk of disease. The authors of this article contend that eliminating health disparities between the African American and White populations in the United States requires a focus on improving the social environment of African Americans. They examine the interface of culture, gender, and power and how those are central to analysis of the root causes of health disparities. The REACH 2010 project of the Centers for Disease Control offers examples on how a coalition of community and research organizations can infuse community interventions with informed considerations of culture, gender, and power to eliminate health disparities.

Health-related quality of life of African-American female breast cancer survivors, survivors of other cancers, and those without cancer.

PubMed

Claridy, Mechelle D; Ansa, Benjamin; Damus, Francesca; Alema-Mensah, Ernest; Smith, Selina A

2018-04-27

The purpose of this study was to compare differences in health-related quality of life (HRQOL) between African-American female breast cancer survivors, African-American female survivors of other cancers, and African-American women with no history of cancer. Using data from the 2010 National Health Interview Survey (NHIS), the HRQOL of African-American women aged 35 years or older was compared by cancer status. Physical and mental health items from the Patient-Reported Outcomes Measurement Information System (PROMIS) global health scale were used to assess differences in HRQOL. For summary physical and mental health measures, no significant differences were found between breast cancer survivors and women with no history of cancer; survivors of other cancers reported poorer physical and mental health than did women with no history of cancer. Similar differences were found at the item level. When we examined the two African-American female cancer survivor groups, we found that cancer survivors whose cancer was being treated reported substantially poorer physical health and mental health than did those whose cancer was not being treated. Survivors who had private insurance and were cancer free reported better physical and mental health than did those who did not have private insurance and those who were not cancer free. Breast cancer survivors reported slightly better physical and mental health than did survivors of other cancers. Our findings highlight the need for public health agencies to adopt practices to improve the mental and physical health of African-American female survivors of cancer.

Effects of Racial Discrimination and Health Behaviors on Mental and Physical Health of Middle-Class African American Men

ERIC Educational Resources Information Center

Sellers, Sherrill L.; Bonham, Vence; Neighbors, Harold W.; Amell, James W.

2009-01-01

This research is an examination of the effects of racial discrimination and health-promoting behaviors on the physical and mental health of a sample of 399 well-educated African American men. One would think that the attainment of higher education would increase health-promoting behaviors and might decrease discriminatory experiences that impact…

Perceived discrimination and mental health among older African Americans: the role of psychological well-being.

PubMed

Yoon, Eunkyung; Coburn, Corvell; Spence, Susie A

2018-01-15

Examine the effect of perceived discrimination (both racial and non-racial) on the mental health of older African Americans and explore the buffering role of psychological well-being (purpose in life and self-acceptance). Using an older African American subsample from the National Health Measurement Study (n = 397), multiple regression model by gender was used to estimate the effects of two types of discrimination (every day and lifetime) on SF-36 mental component and mediating role of two concepts of psychological well-being. With no gender difference on the everyday discrimination, older men experienced more lifetime discrimination than older women. The older men's model found that the depressive symptomology was significantly explained by only everyday discrimination and mediated by self-acceptance. The older women's model was significant, with everyday discrimination and both self-acceptance and purpose in life emerging as mediating variables. The prevalence of institutional lifetime discrimination for older African American men is consistent with previous research. Inconsistency with past research indicated that only everyday discrimination is statistically associated with depressive symptoms. Considering the buffering role of psychological well-being served for mental health problems, practitioners need to emphasize these factors when providing services to older African Americans. Equally important, they must address racial discrimination in mental health care settings.

Infusing Culture into Practice: Developing and Implementing Evidence-Based Mental Health Services for African American Foster Youth

ERIC Educational Resources Information Center

Briggs, Harold Eugene; McBeath, Bowen

2010-01-01

The lack of culturally appropriate health and mental health care has contributed to the large number of African American youth and families involved in the child welfare system. This article reviews the consequences of the insufficient access to culturally sensitive, evidence-supported interventions for African American foster youth. The authors…

Marriage Trajectories and Health Risk Behaviors Throughout Adulthood Among Urban African Americans

PubMed Central

Green, Kerry M.; Doherty, Elaine E.; Fothergill, Kate E.; Ensminger, Margaret E.

2015-01-01

Although previous studies have identified a protective effect of marriage on risky health behaviors, gaps remain in our understanding of how marriage improves health, particularly among African Americans. This study uses longitudinal data to take selection into account and examines whether marital trajectories that incorporate timing, stability, and duration of marriage affect health risk behaviors among a community cohort of urban African Americans followed for 35 years (N = 1,049). For both men and women, we find six marital trajectories. Men and women in consistently married trajectories are less likely to smoke, drink heavily (women only), and use illegal drugs than those in unmarried or previously married trajectories. Late marrying men do not fare worse in midlife than men in earlier marrying trajectories, but late marrying women show increased risk of midlife drug use. Results suggest policies supporting marriage may have an impact on health but only if stable unions are achieved. PMID:26136611

A situational analysis of ocular health promotion in the South African primary health-care system.

PubMed

Sithole, Hlupheka Lawrence

2017-03-01

South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment. Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion. The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy. Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. © 2016 Optometry Australia.

Health complaints and regulatory reform: Implications for vulnerable populations?

PubMed

Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S

2016-03-01

Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

PubMed

London, Leslie; Tangwa, Godfrey; Matchaba-Hove, Reginald; Mkhize, Nhlanhla; Nwabueze, Remi; Nyika, Aceme; Westerholm, Peter

2014-06-23

International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

PubMed Central

2014-01-01

Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address

Health information-seeking behavior and older African American women.

PubMed Central

Gollop, C J

1997-01-01

This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults. PMID:9160150

Health information-seeking behavior and older African American women.

PubMed

Gollop, C J

1997-04-01

This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults.

Lifetime exposure to family violence: implications for the health status of older African American women.

PubMed

Paranjape, Anuradha; Sprauve-Holmes, Nancy E; Gaughan, John; Kaslow, Nadine J

2009-02-01

Family violence among older women encompasses intimate partner violence (IPV) and elder maltreatment, both linked to poor health status. Little is known about the association between family violence and the health status of older innercity African American women. One hundred fifty-eight African American women, aged >/=50, were interviewed in the ambulatory clinics of a large public hospital. Lifetime family violence exposure as an adult was measured by the Family Violence against Older Women (FVOW) scale; physical and mental health status were measured by the physical and mental component summary scores of the Short Form 8 scale. Mean participant age was 61.5 years (SD 7.1). Participants with FVOW scores in the top quartile were considered to have high lifetime family violence exposure. Participants with higher family violence exposure and those younger, unemployed, or disabled reported worse physical and mental health status. Lower income and not having Medicare were associated with worse physical and mental health status, respectively. Using stepwise linear regression techniques, only employment status and high family violence exposure were associated with worse physical (F = 7.16, p = 0.0011) and mental health (f = 7.09, p = 0.0012) status. Women with high FVOW scores reported physical and mental component summary scores that were 4.18 and 4.6 points lower, respectively, than those of women with lower FVOW scores. Among older, innercity, African American women, lack of employment and high levels of family violence exposure as an adult are associated with worse physical and mental health status. Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status.

Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men.

PubMed

Hammond, Wizdom Powell; Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle

2010-12-01

The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23). Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men

A survey of African American physicians on the health effects of climate change.

PubMed

Sarfaty, Mona; Mitchell, Mark; Bloodhart, Brittany; Maibach, Edward W

2014-11-28

The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society of African American physicians who care for a disproportionate number of African American patients, to determine whether they were seeing the health effects of climate change in their practices; the response rate was 30% (n = 284). Over 86% of respondents indicated that climate change was relevant to direct patient care, and 61% that their own patients were already being harmed by climate change moderately or a great deal. The most commonly reported health effects were injuries from severe storms, floods, and wildfires (88%), increases in severity of chronic disease due to air pollution (88%), and allergic symptoms from prolonged exposure to plants or mold (80%). The majority of survey respondents support medical training, patient and public education regarding the impact of climate change on health, and advocacy by their professional society; nearly all respondents indicated that the US should invest in significant efforts to protect people from the health effects of climate change (88%), and to reduce the potential impacts of climate change (93%). These findings suggest that African American physicians are currently seeing the health impacts of climate change among their patients, and that they support a range of responses by the medical profession, and public policy makers, to prevent further harm.

Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). A structured questionnaire was used to solicit financial information from health research institutions. Forty-two sub-Saharan African countries. Key informants in 847 health research institutions in the 42 sub-Saharan African countries. Expenditure on health research by institutions, funders and subject areas. An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005-2006. The most notable funders for health research activities were external funding, ministries of health, other government ministries, own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research, with medical schools spending 82% and government agencies 62%. Hospitals spent 38% of their resources on management, and other institutions (universities, firms, etc.) spent 87% of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30% of funds, followed by research on other communicable diseases and maternal, perinatal and nutritional conditions (23%). Research on major health problems of the Region, such as communicable diseases, accounts for most of the research expenditures. However, the total expenditure is very low compared with other WHO regions. © The Royal Society of Medicine.

Marriage Trajectories and Health Risk Behaviors throughout Adulthood among Urban African Americans

ERIC Educational Resources Information Center

Green, Kerry M.; Doherty, Elaine E.; Fothergill, Kate E.; Ensminger, Margaret E.

2012-01-01

Although previous studies have identified a protective effect of marriage on risky health behaviors, gaps remain in our understanding of how marriage improves health, particularly among African Americans. This study uses longitudinal data to take selection into account and examines whether marital trajectories that incorporate timing, stability,…

Regulatory Pathways That Facilitated Timely Registration of a New Group A Meningococcal Conjugate Vaccine for Africa's Meningitis Belt Countries.

PubMed

Dellepiane, Nora; Akanmori, Bartholomew Dicky; Gairola, Sunil; Jadhav, Suresh S; Parker, Cathy; Rodriguez, Carmen; Srivastava, Swati

2015-11-15

Through its normative and public health leadership roles, the World Health Organization (WHO) plays a key role in the availability of vaccine products in low-and middle-income countries. The recent introduction of a new group A meningococcal conjugate vaccine, PsA-TT (MenAfriVac), in Africa exemplifies this process. WHO requires that any new vaccine to be introduced in countries for public health reasons and supplied through United Nations centralized mechanisms be licensed by the national regulatory agency (NRA) in the producing country, then prequalified and given a marketing authorization in the user countries. PsA-TT was manufactured by the Serum Institute of India, Ltd (SIIL), which submitted a license application in April 2009 to the Drug Controller General of India (DCGI), the Indian NRA responsible for licensing vaccines. WHO encouraged the DCGI to establish a collaboration with Health Canada's Centre for Vaccine Evaluation for the review. Through this collaborative effort, registration was facilitated and in December 2009 an export license was granted to SIIL, which subsequently submitted an application for WHO prequalification. Given the importance of the vaccine, WHO "fast tracked" the prequalification review, and after a detailed review and site visit, WHO prequalification was granted to PsA-TT in June 2010. Country use of the new vaccine could not occur until the vaccine was a registered product in each country seeking its use. WHO facilitated country reviews by conducting regulatory training exercises (in French and English) for country NRA staff, which used the PsA-TT registration as a case study. PsA-TT was gradually registered in African countries as vaccine introduction proceeded. The regulatory pathway for this new group A meningococcal conjugate vaccine proved to be a useful training opportunity both in India and Africa, because the availability of the vaccine was a high African public health priority, as well as for WHO as a case study to

Results from a secondary data analysis regarding satisfaction with health care among African American women living with HIV/AIDS.

PubMed

Baker, Jillian Lucas; Rodgers, Caryn R R; Davis, Zupenda M; Gracely, Edward; Bowleg, Lisa

2014-01-01

To analyze satisfaction with health care among African American women living with HIV/AIDS. Secondary analysis of baseline data of African American women who participated in Protect and Respect, a sexual risk reduction program for women living with HIV/AIDS SETTING: HIV Care Clinic in an urban city in the northeast United States. One hundred fifty-seven (157) African American women living with HIV/AIDS. Regression analyses were used to examine the relationships between demographic variables, self-reported health characteristics, communication with health care providers, and satisfaction with health care provider. A majority of women reported satisfaction with medical services (88%, n = 140). Communication with health care providers, detectable viral load, education, income, self-reported health status, and sexual orientation were significantly bivariately associated with satisfaction with healthcare (all ps < .05). In the multivariate models, no variables significantly predicted satisfaction with healthcare. Because satisfaction with health care can influence the quality of care received, health outcomes, and adherence to provider recommendations among patients living with HIV/AIDS, health care providers' ability to elicit satisfaction from their patients is just as important as the services they provide. This project is one of the first studies to find high rates of satisfaction with health care among African American women living with HIV/AIDS. Further examination of satisfaction with health care among African American women living HIV/AIDS may help in narrowing health care disparities and negative treatment outcomes. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Effects of moderate aerobic exercise training on vascular health and blood pressure in African Americans.

PubMed

Feairheller, Deborah L; Diaz, Keith M; Kashem, Mohammed A; Thakkar, Sunny R; Veerabhadrappa, Praveen; Sturgeon, Kathleen M; Ling, Chenyi; Williamson, Sheara T; Kretzschmar, Jan; Lee, Hojun; Grimm, Heather; Babbitt, Dianne M; Vin, Charmie; Fan, Xiaoxuan; Crabbe, Deborah L; Brown, Michael D

2014-07-01

As healthcare progresses toward individualized medicine, understanding how different racial groups respond to lifestyle interventions is valuable. It is established that African Americans have disproportionate levels of cardiovascular disease and impaired vascular health, and clinical practice guidelines suggest lifestyle interventions as the first line of treatment. Recently, the authors reported that 6 months of aerobic exercise improved inflammatory markers, flow-mediated dilation (FMD), and levels of circulating endothelial microparticles (EMPs) in African American adults. This study is a subgroup analysis of the aerobic exercise-induced changes in vascular health and blood pressure (BP) measures, including carotid artery intima-media thickness (IMT), nitroglycerin-mediated dilation (NMD), ambulatory BP, and office BP. Sedentary African American adults (53.4±6.2 years; 21 women and 5 men) showed improved vascular health but no change in BP. Carotid artery IMT decreased 6.4%, plasma nitric oxide levels increased 76.6%, plasma EMP levels decreased, percentage of FMD increased 59.6%, and FMD/NMD ratio increased 36.2% (P<.05 for all). Six months of aerobic exercise training is sufficient to elicit improvements in vascular structure and function in African Americans, even without improvements in BP measures or NMD (ie, smooth muscle function). To our knowledge, this is the first study to report such findings in African Americans. ©2014 Wiley Periodicals, Inc.

African Americans' perceived sociocultural determinants of suicide: afrocentric implications for public health inequalities.

PubMed

Borum, Valerie

2014-01-01

The cultural values of African Americans have not been adequately incorporated as a theoretical base to develop new public health models. The major objectives of this study were to explore, with a purposive sample, via seven focus groups, 40 African American college students, the following: How do (a) ethnic culture and (b) a "minoritized" status influence perceptions of sociocultural determinants in explaining increases in the incidence of suicide among African Americans? Thematic results of focus group discussions including the following: (a) racism, discrimination, and stereotyping; (b) U.S. individualism; (c) integration and cultural assimilation; and, (d) the prison industrial complex.

Health care in a community of followers of traditional African-Brazilian religions.

PubMed

Alves, Miriam Cristiane; Seminotti, Nedio

2009-08-01

To understand the concept of health and the source of psychological distress among followers of a traditional African-Brazilian religion. Qualitative study performed in a community of followers of a traditional African-Brazilian religion, in the city of Porto Alegre, Southern Brazil, between 2007 and 2008. The priest/Babalorixá and six followers of this community participated in the study. Open interviews, which were recorded and subsequently transcribed, were conducted to collect data and construct the corpus of analysis. Report categorization, based on the complex systemic approach, enabled the construction of two main themes: 1) religious community and concept of health, and 2) origin of psychological distress and cultural identity. In this religious community, traditional health therapies, such as the use of herbs, baths, diets and/or initiation rites, were associated with conventional therapies proposed by the Sistema Unico de Saúde (SUS - Unified Health System). Bonds with and belonging to a territory, the relationships among individuals, and the relationship among their spiritual, psychological and physical dimensions are considered in their concepts of psychological distress and health. The way to understand and act in the world, as experienced in this community, with its myths, rites, beliefs and values, constitutes a set of legitimate types of knowledge in its context, which oftentimes opposes and goes beyond professionals' technical-scientific knowledge and truths. This community is a space marked by welcoming, counseling and treatment of followers, where the physical, psychological and spiritual dimensions are integrated in these practices. As regards the black population health, psychological distress results from their having been uprooted from African black cultures.

Anxiety symptomatology and perceived health in African American adults: Moderating role of emotion regulation

PubMed Central

Carter, Sierra E.; Walker, Rheeda L.

2014-01-01

Though emotional health has been theoretically and empirically linked to physical health, the anxiety-physical health association in particular is not well understood for African American adults. This study examined anxiety as a specific correlate of perceived health in addition to testing the potential moderating role of emotion regulation, an index of how and when individuals modulate emotions, in the association for anxiety to perceived health. Study participants were 151 community-based African American adults who completed measures of anxiety symptomatology and emotion regulation in addition to responding to a self-report question of perceived health. Results showed that higher levels of anxiety symptomatology were associated with poorer health ratings for those who reported more limited access to emotion regulation strategies but not those who reported having more emotion regulation strategies. The findings suggest that anxiety-related distress and health problems may be interrelated when emotion regulation strategies are limited. PMID:25045943

The impact of parallel regulatory-health technology assessment scientific advice on clinical development. Assessing the uptake of regulatory and health technology assessment recommendations.

PubMed

Tafuri, Giovanni; Lucas, Inês; Estevão, Steve; Moseley, Jane; d'Andon, Anne; Bruehl, Hannah; Gajraj, Elangovan; Garcia, Sonia; Hedberg, Niklas; Massari, Marco; Molina, Andrea; Obach, Mercè; Osipenko, Leeza; Petavy, Frank; Petschulies, Marco; Pontes, Caridad; Russo, Pierluigi; Schiel, Anja; Van de Casteele, Marc; Zebedin-Brandl, Eva-Maria; Rasi, Guido; Vamvakas, Spiros

2018-05-01

The parallel regulatory-health technology assessment scientific advice (PSA) procedure allows manufacturers to receive simultaneous feedback from both EU regulators and health technology assessment (HTA) bodies on development plans for new medicines. The primary objective of the present study is to investigate whether PSA is integrated in the clinical development programmes for which advice was sought. Contents of PSA provided by regulators and HTA bodies for each procedure between 2010 and 2015 were analysed. The development of all clinical studies for which PSA had been sought was tracked using three different databases. The rate of uptake of the advice provided by regulators and HTA bodies was assessed on two key variables: comparator/s and primary endpoint. In terms of uptake of comparator recommendations at the time of PSA in the actual development, our analysis showed that manufacturers implemented comparators to address both the needs of regulators and of at least one HTA body in 12 of 21 studies. For primary endpoints, in all included studies manufacturers addressed both the needs of the regulators and at least one HTA body. One of the key findings of this analysis is that manufacturers tend to implement changes to the development programme based on both regulatory and HTA advice with regards to the choice of primary endpoint and comparator. It also confirms the challenging choice of the study comparator, for which manufacturers seem to be more inclined to satisfy the regulatory advice. Continuous research efforts in this area are of paramount importance from a public health perspective. © 2018 The British Pharmacological Society.

Dance for health: improving fitness in African American and Hispanic adolescents.

PubMed

Flores, R

1995-01-01

Cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs designed for children and adolescents. Regular physical activity is an important part of primary prevention programs, and school physical education programs have potential for the promotion of regular physical activity. Cardiovascular disease is the major cause of death among Hispanics and African Americans in the United States. Low levels of fitness and increased body mass index are common in African American and Hispanic adolescents. Increased physical activity and the adoption of healthy eating habits would increase fitness and reduce body mass index among these adolescents. The purpose of the study was to undertake a small-scale controlled trial to determine if Dance for Health, an intervention program designed to provide an enjoyable aerobic program for African American and Hispanic adolescents, has a significant effect on improving aerobic capacity, helping students maintain or decrease weight, and on improving attitudes toward physical activity and physical fitness. In the first year of the program (1990-91), approximately 110 boys and girls ages 10-13 years participated in an aerobic dance pilot program three times per week for 12 weeks. Dance for Health was revised and continued in the 1992-93 school year with seventh grade students and an added culturally sensitive health curriculum. Forty-three students were randomized to Dance for Health and 38 to usual physical activity. Those in the intervention class received a health education curriculum twice a week and a dance oriented physical education class three times a week. The usual physical activity consisted mostly of playground activities. Students in the intervention had a significantly greater lowering in body mass index and resting heart rate than students in regular physical activity.

Health claims on food products in Southeast Asia: regulatory frameworks, barriers, and opportunities.

PubMed

Tan, Karin Y M; van der Beek, Eline M; Chan, M Y; Zhao, Xuejun; Stevenson, Leo

2015-09-01

The Association of Southeast Asian Nations aims to act as a single market and allow free movement of goods, services, and manpower. The purpose of this article is to present an overview of the current regulatory framework for health claims in Southeast Asia and to highlight the current barriers and opportunities in the regulatory frameworks in the Association of Southeast Asian Nations. To date, 5 countries in Southeast Asia, i.e., Indonesia, Malaysia, the Philippines, Singapore, and Thailand, have regulations and guidelines to permit the use of health claims on food products. There are inconsistencies in the regulations and the types of evidence required for health claim applications in these countries. A clear understanding of the regulatory frameworks in these countries may help to increase trade in this fast-growing region and to provide direction for the food industry and the regulatory community to develop and market food products with better nutritional quality tailored to the needs of Southeast Asian consumers. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Giving Our Daughters What We Never Received: African American Mothers Discussing Sexual Health With Their Preadolescent Daughters.

PubMed

Grigsby, Sheila R

2018-04-01

African American girls experience disparate rates of pregnancy and acquisition of sexually transmitted infections, including human immunodeficiency virus, when compared to their non-Hispanic White counterparts. Among African American girls, current pregnancy rates are equal to the national crisis levels of teen pregnancy reported in 1990. This qualitative elicitation study was conducted to gain insight into the ways in which African American mothers and their daughters, between the ages of 9 and 14, communicate about sexual health. Early sexual health communication between mothers and daughters is known to enhance the sexual health outcomes of girls. A series of four focus groups and three in-depth interviews were conducted between July and September 2014. The theory of planned behavior was the organizing framework. Theoretical constructs that guided this study were attitudes, perceived behavioral control, and subjective norms. Results showed that what African American women share with their daughters about sexual health stems from their personal faith, values, and experiences. Findings from this study can inform interventions to provide support for this understudied population. Moreover, there are implications for health-care providers, particularly school nurses, who are in an ideal position to help increase mothers' self-efficacy to engage in sexual health conversations with their young daughters.

Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

ERIC Educational Resources Information Center

Myers, Bronwyn; Fakier, Nuraan

2009-01-01

To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

Family Violence Exposure and Health Outcomes Among Older African American Women: Do Spirituality and Social Support Play Protective Roles?

PubMed Central

Kaslow, Nadine

2010-01-01

Abstract Background Family violence (FV), spirituality, and social support are salient psychosocial determinants of health. FV is associated with poor health among older African American women. The effect of spirituality and social support levels on the health of older African American women is unknown. Methods To assess the role of spirituality and social support as culturally relevant determinants of health status for older African American women independent of FV levels, we used a cross-sectional observational study. Two hundred twelve African American women, aged ≥50, were interviewed in two urban primary care practices. The measures used were (1) Family Violence Against Older Women (FVOW) scale, (2) Physical and Mental Composite Scores of the Short-Form 8® scale, (3) Medical Outcomes of Social Support survey (MOSS), and (4) Spiritual Well-Being Scale (SWBS). Spearman correlation coefficients estimated to test associations among lifetime FV exposure, spirituality, social support, and health status outcomes and multivariate regression models were used to examine the independent effect of spirituality and social support on physical and mental health status, controlling for FV and significant demographic variables. Results Mean participant age was 63.9 years. Higher spirituality levels were significantly associated with better physical health status after adjusting for FV levels and demographic factors (F = 6.17, p = 0.0001). Similarly, higher levels of spirituality and social support both significantly correlated with better mental health status in the multivariate model (F = 13.45, p < 0.0001) that controlled for lifetime FV levels and demographic factors. Conclusions Spirituality and social support are two potentially modifiable determinants of health for older African American women. Culturally appropriate mechanisms to enhance social support and spirituality levels need to be explored as potential inteventions to improve the health of those

Capacity development for health research in Africa: experiences managing the African Doctoral Dissertation Research Fellowship Program

PubMed Central

2010-01-01

Africa's progress depends on her capacity to generate, adapt, and use scientific knowledge to meet regional health and development needs. Yet, Africa's higher education institutions that are mandated to foster this capacity lack adequate resources to generate and apply knowledge, raising the need for innovative approaches to enhance research capacity. In this paper, we describe a newly-developed program to support PhD research in health and population sciences at African universities, the African Doctoral Dissertation Research Fellowship (ADDRF) Program. We also share our experiences implementing the program. As health research capacity-strengthening in Africa continues to attract attention and as the need for such programs to be African-led is emphasized, our experiences in developing and implementing the ADDRF offer invaluable lessons to other institutions undertaking similar initiatives. PMID:20587016

77 FR 33253 - Regulatory Guide 8.24, Revision 2, Health Physics Surveys During Enriched Uranium-235 Processing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... NUCLEAR REGULATORY COMMISSION [NRC-2010-0115] Regulatory Guide 8.24, Revision 2, Health Physics..., ``Health Physics Surveys During Enriched Uranium-235 Processing and Fuel Fabrication'' was issued with a... specifically with the following aspects of an acceptable occupational health physics program that are closely...

Diaspora engagement of African migrant health workers – examples from five destination countries

PubMed Central

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

Exploration of Culturally Proficient Mental Health Assessment and Treatment Practices of Black/African American Clients

ERIC Educational Resources Information Center

Glover, Tina Marie

2012-01-01

Changing trends within the mental health system treatment practices demand exploration of the cultural context of assessment and treatment of Black/African Americans. Culturally competent assessments include a realistic integration of historical context. Clinicians counseling Black/African Americans must be prepared to assess and address PTSD,…

Rurality and African American Perspectives on Children's Mental Health Services

ERIC Educational Resources Information Center

Mukolo, Abraham; Heflinger, Craig Anne

2011-01-01

The combined effect of race and place of residence on caregivers' perceptions of children's mental health services is underresearched. Differences in caregiver strain, barriers-to-care endorsement, and provider satisfaction are examined among 175 rural and urban African American caregivers from one Southern state whose children received Medicaid…

Contextual Stress and Health Risk Behaviors among African American Adolescents

ERIC Educational Resources Information Center

Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.

2011-01-01

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…

Integrating Oral Health with Non-Communicable Diseases as an Essential Component of General Health: WHO's Strategic Orientation for the African Region.

PubMed

Varenne, Benoit

2015-05-01

In the context of the emerging recognition of non-communicable diseases (NCDs), it has never been more timely to explore the World Health Organization (WHO) strategic orientations on oral health in the WHO African region and to raise awareness of a turning point in the search for better oral health for everyone. The global initiative against NCDs provides a unique opportunity for the oral health community to develop innovative policies for better recognition of oral health, as well as to directly contribute to the fight against NCDs and their risk factors. The WHO African region has led the way in developing the first regional oral health strategy for the prevention and control of oral diseases integrated with NCDs. The support of the international oral health community in this endeavor is urgently needed for making a success story of this initiative of integrating oral health into NCDs.

"If you do nothing about stress, the next thing you know, you're shattered": Perspectives on African American men's stress, coping and health from African American men and key women in their lives.

PubMed

Ellis, Katrina R; Griffith, Derek M; Allen, Julie Ober; Thorpe, Roland J; Bruce, Marino A

2015-08-01

Stress has been implicated as a key contributor to poor health outcomes; however, few studies have examined how African American men and women explicitly describe the relationships among stress, coping, and African American men's health. In this paper, we explore strategies men use to cope with stress, and beliefs about the consequences of stress for African American men's health behaviors, morbidity and mortality from the perspectives of African American men and women. A phenomenological analytic approach was used to examine focus group data collected from 154 African American men (18 focus groups) and 77 African American women (8 focus groups). Women's perspectives were captured because women often observe men under stress and can provide support to men during stressful times. Our findings indicate that African American men in this study responded to stress by engaging in often identified coping behaviors (i.e., consumption of calorie dense food, exercise, spiritually-related activities). Men in our study, however, did not always view their responses to stress as explicit coping mechanisms. There was also some discordance between men's and women's perceptions of men's coping behaviors as there were occasions where they seemed to interpret the same behavior differently (e.g., resting vs. avoidance). Men and women believed that stress helped to explain why African American men had worse health than other groups. They identified mental, physical and social consequences of stress. We conclude by detailing implications for conceptualizing and measuring coping and we outline key considerations for interventions and further research about stress, coping and health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women

PubMed Central

Sprauve-Holmes, Nancy E; Gaughan, John; Kaslow, Nadine J.

2009-01-01

Abstract Background Family violence among older women encompasses intimate partner violence (IPV) and elder maltreatment, both linked to poor health status. Little is known about the association between family violence and the health status of older innercity African American women. Methods One hundred fifty-eight African American women, aged ≥50, were interviewed in the ambulatory clinics of a large public hospital. Lifetime family violence exposure as an adult was measured by the Family Violence against Older Women (FVOW) scale; physical and mental health status were measured by the physical and mental component summary scores of the Short Form 8® scale. Results Mean participant age was 61.5 years (SD 7.1). Participants with FVOW scores in the top quartile were considered to have high lifetime family violence exposure. Participants with higher family violence exposure and those younger, unemployed, or disabled reported worse physical and mental health status. Lower income and not having Medicare were associated with worse physical and mental health status, respectively. Using stepwise linear regression techniques, only employment status and high family violence exposure were associated with worse physical (F = 7.16, p = 0.0011) and mental health (f = 7.09, p = 0.0012) status. Women with high FVOW scores reported physical and mental component summary scores that were 4.18 and 4.6 points lower, respectively, than those of women with lower FVOW scores. Conclusions Among older, innercity, African American women, lack of employment and high levels of family violence exposure as an adult are associated with worse physical and mental health status. Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status. PMID:19183088

Discourses of culture and illness in South African mental health care and indigenous healing, Part I: Western psychiatric power.

PubMed

Yen, Jeffery; Wilbraham, Lindy

2003-12-01

This discourse analytic study explores constructions of culture and illness in the talk of psychiatrists, psychologists and indigenous healers as they discuss possibilities for collaboration in South African mental health care. Versions of 'culture', and disputes over what constitutes 'disorder', are an important site for the negotiation of power relations between mental health practitioners and indigenous healers. The results of this study are presented in two parts. Part I explores discourses about western psychiatric/psychological professionalism, tensions in diagnosis between cultural relativism and psychiatric universalism, and how assertion of 'cultural differences' may be used to resist psychiatric power. Part II explores how discursive constructions of 'African culture' and 'African madness' work to marginalize indigenous healing in South African mental health care, despite repeated calls for collaboration.

Comparison of systemic health conditions between African American and Caucasian complete denture patients.

PubMed

Szylkowska, Ewelina; Kaste, Linda M; Schreiner, Joseph; Gordon, Sara C; Lee, Damian J

2014-07-01

To compare prevalence of systemic health conditions (SHC) between African American and Caucasian edentulous patients presenting for complete dentures (CD) at an urban dental school. The study included patients presenting for CD 1/1-12/31/2010, ages 20 to 64 years, and either African American or Caucasian. Covariates included: age group, gender, employment status, Medicaid status, smoking history, and alcohol consumption. SHC included at least one of the following: arthritis, asthma, cancer, diabetes, emphysema, heart attack, heart murmur, heart surgery, hypertension, or stroke. The group (n = 88) was 44.3% African American, 65.9% ≥50, 45.5% male, 22.7% employed, and 67.0% with at least one SHC. African Americans were older (p = 0.001) and more likely to have one or more SHC (p = 0.011). Patients with at least one SHC were older (p = 0.018) and more likely female (p = 0.012). The total sample logistic regression model assessing SHC yielded only gender as statistically significant (males < OR 0.32, 95% CI 0.11 to 0.92). Caucasian males were less likely to have SHC (OR 0.17, 95% CI 0.04 to 0.77), and Caucasians ≥50 were more likely (OR 5.36, 95% CI 1.19 to 24.08). African Americans yielded no significant associations. Among selected completely edentulous denture patients at an urban dental school, two out of three patients had at least one SHC. This exploratory study suggests there may be health status differences between African American and Caucasian patients in this setting, calling for further study. © 2014 by the American College of Prosthodontists.

Struggling to Survive: Sexual Assault, Poverty, and Mental Health Outcomes of African American women

PubMed Central

Bryant-Davis, Thema; Ullman, Sarah E.; Tsong, Yuying; Tillman, Shaquita; Smith, Kimberly

2013-01-01

A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder (PTSD), substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women’s increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, PTSD, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed. PMID:20397989

A Comparative Effectiveness Education Trial for Lifestyle Health Behavior Change in African Americans

ERIC Educational Resources Information Center

Halbert, Chanita Hughes; Bellamy, Scarlett; Briggs, Vanessa; Delmoor, Ernestine; Purnell, Joseph; Rogers, Rodney; Weathers, Benita; Johnson, Jerry C.

2017-01-01

Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a…

The Brand's PREACH Model: Predicting Readiness to Engage African American Churches in Health.

PubMed

Brand, Dorine J; Alston, Reginald J

2017-09-01

Despite many attempts to reduce health disparities, health professionals face obstacles in improving poor health outcomes within the African American (AA) community. To promote change for improved health measures, it is important to implement culturally tailored programming through a trusted institution, such as the AA church. While churches have the potential to play an important role in positively impacting health among AAs, it is unclear what attributes are necessary to predict success or failure for health promotion within these institutions. The purpose of this study was to create a model, the Brand's PREACH ( Predicting Readiness to Engage African American Churches in Health) Model, to predict the readiness of AA churches to engage in health promotion programming. Thirty-six semistructured key informant interviews were conducted with 12 pastors, 12 health leaders, and 12 congregants to gain information on the relationship between church infrastructure (physical structure, personnel, funding, and social/cultural support), readiness, and health promotion programming. The findings revealed that church infrastructure has an association with and will predict the readiness of a church to engage in health promotion programming. The ability to identify readiness early on will be useful for developing, implementing, and evaluating faith-based interventions, in partnership with churches, which is a key factor for sustainable and effective programs.

Tuskegee as Sacred Rhetoric: Focal Point for the Emergent Field of African American Religion and Health.

PubMed

Laws, Terri

2018-02-01

Scholars in African American religion engage the Tuskegee Syphilis Study as the focal point of the African American experience in institutional medicine. Seeking a way forward from this history and its intentional evil, the author proposes to position Tuskegee as a form of Lynch's culturally contextual sacred rhetoric to make use of its metaphoric value in the emerging field of African American religion and health. In this broader meaning-making frame, Tuskegee serves as a reminder that African American religious sensibility has long been an agential resource that counters abuse of the Black body. It also acknowledges the complex decisions facing African American clinical trial participants.

Psychometric Properties of the German Version of the Health Regulatory Focus Scale

PubMed Central

Schmalbach, Bjarne; Spina, Roy; Steffens-Guerra, Ileana; Franke, Gabriele H.; Kliem, Sören; Michaelides, Michalis P.; Hinz, Andreas; Zenger, Markus

2017-01-01

The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prevention and promotion focus in a health-specific context. The main objective of this study was to examine the psychometric properties of the newly translated German version of the HRFS. Reliability and item characteristics were found to be satisfactory. Validity of both subscales toward other psychological constructs including behavioral approach and avoidance, core self-evaluations, optimism, pessimism, neuroticism, as well as several measures of physical and mental health was shown. In addition, invariance of the measure across age and gender groups was shown. Exploratory as well as confirmatory factor analyses clearly indicated a two-factorial structure with a moderate correlation between the two latent constructs. Differences in health promotion and prevention focus between socio-demographic groups are discussed. The HRFS is found to be a valid and reliable instrument for the assessment of regulatory focus in health-related environments. PMID:29184528

Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls

PubMed Central

Hipwell, Alison E.; Stepp, Stephanie D.; Keenan, Kate

2015-01-01

Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization. PMID:25380787

Allostatic Load and Health Status of African Americans and Whites

ERIC Educational Resources Information Center

Deuster, Patricia A.; Kim-Dorner, Su Jong; Remaley, Alan T.; Poth, Merrily

2011-01-01

Objectives: To compare health risks in 84 healthy African American and 45 white men and women after calculating allostatic load (AL) from biologic, psychosocial, and behavioral measures. Methods: Participants (18-45 years) ranging in weight from normal to obese and without hypertension or diabetes. Fitness, body fat, CRP, mood, social support,…

Masculinity, Medical Mistrust, and Preventive Health Services Delays Among Community-Dwelling African-American Men

PubMed Central

Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle

2010-01-01

BACKGROUND The contribution of masculinity to men’s healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). MEASUREMENTS Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60–0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45–0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34–5.20), blood pressure (OR: 3.03; 95% CI: 1.45–6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03–4.23). CONCLUSIONS Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men’s blood pressure and cholesterol screening. Routine

The contribution of community and family contexts to African American young adults' romantic relationship health: a prospective analysis.

PubMed

Kogan, Steven M; Lei, Man-Kit; Grange, Christina R; Simons, Ronald L; Brody, Gene H; Gibbons, Frederick X; Chen, Yi-Fu

2013-06-01

Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.

The Contribution of Community and Family Contexts to African American Young Adults’ Romantic Relationship Health: A Prospective Analysis

PubMed Central

Kogan, Steven M.; Lei, Man-Kit; Grange, Christina R.; Simons, Ronald L.; Brody, Gene H.; Gibbons, Frederick X.; Chen, Yifu

2013-01-01

Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10–22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths’ exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults’ romantic relationships. PMID:23494451

Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men.

PubMed

Powell, Wizdom; Adams, Leslie B; Cole-Lewis, Yasmin; Agyemang, Amma; Upton, Rachel D

2016-01-01

Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism.

One Health: Past Successes and Future Challenges in Three African Contexts

PubMed Central

Okello, Anna L.; Bardosh, Kevin; Smith, James; Welburn, Susan C.

2014-01-01

Background The recent emergence of zoonotic diseases such as Highly Pathogenic Avian Influenza (HPAI) and Severe Acute Respiratory Syndrome (SARS) have contributed to dominant Global Health narratives around health securitisation and pandemic preparedness, calling for greater co-operation between the health, veterinary and environmental sectors in the ever-evolving One Health movement. A decade later, One Health advocates face increasing pressure to translate the approach from theory into action. Methodology/Principal Findings A qualitative case study methodology was used to examine the emerging relationships between international One Health dialogue and its practical implementation in the African health policy context. A series of Key Informant Interviews (n = 32) with policy makers, government officials and academics in Nigeria, Tanzania and Uganda are presented as three separate case studies. Each case examines a significant aspect of One Health operationalisation, framed around the control of both emerging and Neglected Zoonotic Diseases including HPAI, Human African Trypanosomiasis and rabies. The research found that while there is general enthusiasm and a strong affirmative argument for adoption of One Health approaches in Africa, identifying alternative contexts away from a narrow focus on pandemics will help broaden its appeal, particularly for national or regionally significant endemic and neglected diseases not usually addressed under a “global” remit. Conclusions/Significance There is no ‘one size fits all’ approach to achieving the intersectoral collaboration, significant resource mobilisation and political co-operation required to realise a One Health approach. Individual country requirements cannot be underestimated, dismissed or prescribed in a top down manner. This article contributes to the growing discussion regarding not whether One Health should be operationalised, but how this may be achieved. PMID:24851901

What makes African American health disparities newsworthy? An experiment among journalists about story framing.

PubMed

Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A; Kreuter, Matthew W

2011-12-01

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946-52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed.

What makes African American health disparities newsworthy? An experiment among journalists about story framing

PubMed Central

Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.

2011-01-01

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946–52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed. PMID:21911844

[People of African descent in the region of the Americas and health equity].

PubMed

Torres, Cristina

2002-01-01

The Region of the Americas and the Caribbean has a complex demographic profile from an ethnic and racial perspective. One of the largest groups is composed of persons of African descent, who in some countries, such as Brazil and the Dominican Republic, comprise 46 and 84% of the total population, respectively. Recent analyses of the statistics available in some countries of the Region show wide gaps in terms of living conditions and health in these communities, as well as gaps in access to health services. PAHO, through its Public Policy and Health Program, under the Division of Health and Human Development, supports sectorial efforts and those of civil organizations that aim to improve health conditions in this segment of the population, while taking into account their sociodemographic and cultural characteristics. This article briefly summarizes health conditions and access to health services in selected countries, as well as some aspects of the recent changes to the legislation in those countries. Finally, collaborative activities on the part of United Nations agencies and international financial institutions for the benefit of people of African descent and other ethnic minorities are described.

Middle East and North African Health Informatics Association (MENAHIA): Building Sustainable Collaboration.

PubMed

Al-Shorbaji, Najeeb; Househ, Mowafa; Taweel, Adel; Alanizi, Abdullah; Mohammed, Bennani Othmani; Abaza, Haitham; Bawadi, Hala; Rasuly, Hamayon; Alyafei, Khalid; Fernandez-Luque, Luis; Shouman, Mohamed; El-Hassan, Osama; Hussein, Rada; Alshammari, Riyad; Mandil, Salah; Shouman, Sarah; Taheri, Shahrad; Emara, Tamer; Dalhem, Wasmiya; Al-Hamdan, Zaid; Serhier, Zineb

2018-04-22

There has been a growing interest in Health Informatics applications, research, and education within the Middle East and North African Region over the past twenty years. People of this region share similar cultural and religious values, primarily speak the Arabic language, and have similar health care related issues, which are in dire need of being addressed. Health Informatics efforts, organizations, and initiatives within the region have been largely under-represented within, but not ignored by, the International Medical Informatics Association (IMIA). Attempts to create bonds and collaboration between the different organizations of the region have remained scattered, and often, resulted in failure despite the fact that the need for a united health informatics collaborative within the region has never been more crucial than today. During the 2017 MEDINFO, held in Hangzhou, China, a new organization, the Middle East and North African Health Informatics Association (MENAHIA) was conceived as a regional non-governmental organization to promote and facilitate health informatics uptake within the region endorsing health informatics research and educational initiatives of the 22 countries represented within the region. This paper provides an overview of the collaboration and efforts to date in forming MENAHIA and displays the variety of initiatives that are already occurring within the MENAHIA region, which MENAHIA will help, endorse, support, share, and improve within the international forum of health informatics. Georg Thieme Verlag KG Stuttgart.

Religion, kinship and health behaviors of African American women.

PubMed

Coe, Kathryn; Keller, Colleen; Walker, Jenelle R

2015-02-01

A positive relationship exists between functional health and religion. We present an empirical definition of religion and describe the key elements of religious behavior, building a model that can be used to explore the presumed relationship between religion and health. Semi-structured interactive interviews were conducted with 22 participants over a 6-month period. Head Start programs and churches located in the inner city of a large metropolitan area. Twenty-two African American women were aged from 21 to 45. We focus on social relationships and propose that prophet-created religions mimic kinship relationships and encourage kinship-like cooperation between members.

How Do We Promote Health?: From the Words of African American Older Adults With Dementia and Their Family Members.

PubMed

Epps, Fayron; Skemp, Lisa; Specht, Janet K

2016-11-01

As population diversity increases, understanding what health promotion means to ethnically diverse older adults and their family members aids in the design of health programming. This understanding is particularly relevant for the African American population who experience a high prevalence of Alzheimer's disease and related dementias (ADRD). The purpose of the current study was to describe family members' definition of health, health promotion activities (HPAs), barriers to HPAs, and the perceived effectiveness of HPAs for African American older adults with ADRD. A qualitative descriptive design was used to collect data from African American family caregivers (n = 26) and care recipients (n = 18). Transcripts, journals, and field notes were reviewed using inductive content analysis. Common health promotion activities included taking care of self, positive attitude on life, social engagement, spiritual and religious activity, stimulation and active movement, and financial stability. This research informs person-centered care strategies for African American families caring for older adults with ADRD. [Res Gerontol Nurs. 2016; 9(6):278-287.]. Copyright 2016, SLACK Incorporated.

Positive and Negative Religious Beliefs Explaining the Religion-Health Connection Among African Americans.

PubMed

Holt, Cheryl L; Clark, Eddie M; Roth, David L

2014-01-01

Theory and literature suggests that the reason religiously-involved people tend to have good health outcomes is because they have healthy lifestyles and behaviors in accord with religious beliefs. Other literature suggests that religious involvement may play a negative role in health outcomes due to beliefs about illness originating as punishment for sins. These ideas were tested as part of a theoretical model of the religion-health connection, in a national sample of African Americans. Outcomes included a variety of health-related behaviors. Study participants (N=2,370) randomly selected from a US national call list completed a telephone survey assessing religious involvement, health behaviors, and demographic characteristics. Structural equation modeling was used to analyze study data. Findings indicate that perceived religious influence on health behavior mediated the relationship between religious beliefs and behaviors and higher fruit consumption, and lower alcohol use and smoking. Belief that illness is the result of punishment for sin mediated the relationship between 1) religious beliefs and higher vegetable consumption and lower binge drinking; and 2) religious behaviors and lower vegetable consumption and higher binge drinking. These findings could be applied to health education activities conducted in African American faith-based organizations such as health ministries, in the effort to eliminate health disparities.

Positive and Negative Religious Beliefs Explaining the Religion–Health Connection Among African Americans

PubMed Central

Holt, Cheryl L.; Clark, Eddie M.; Roth, David L.

2016-01-01

Theory and literature suggests that the reason religiously-involved people tend to have good health outcomes is because they have healthy lifestyles and behaviors in accord with religious beliefs. Other literature suggests that religious involvement may play a negative role in health outcomes due to beliefs about illness originating as punishment for sins. These ideas were tested as part of a theoretical model of the religion-health connection, in a national sample of African Americans. Outcomes included a variety of health-related behaviors. Study participants (N=2,370) randomly selected from a US national call list completed a telephone survey assessing religious involvement, health behaviors, and demographic characteristics. Structural equation modeling was used to analyze study data. Findings indicate that perceived religious influence on health behavior mediated the relationship between religious beliefs and behaviors and higher fruit consumption, and lower alcohol use and smoking. Belief that illness is the result of punishment for sin mediated the relationship between 1) religious beliefs and higher vegetable consumption and lower binge drinking; and 2) religious behaviors and lower vegetable consumption and higher binge drinking. These findings could be applied to health education activities conducted in African American faith-based organizations such as health ministries, in the effort to eliminate health disparities. PMID:28546736

Nanosilver and global public health: international regulatory issues.

PubMed

Faunce, Thomas; Watal, Aparna

2010-06-01

Silver in nanoparticle form is used extensively worldwide in hospital and general practice settings, in dressings as a treatment for external wounds, burns and ulcers. Nanosilver is also an increasingly important coating over embedded medical devices, inhibiting the development of biofilm. Nanosilver disinfectant sprays and polymer coatings are being widely promoted as protective against viral infections. In addition, nanosilver is widely used for its antibacterial properties in food processing and packaging, as well as in consumer products used for domestic cleaning and clothing. This article argues that medical devices, therapeutic products, and domestic food and goods containing nanosilver, although offering therapeutic benefits, must be subject to precautionary regulation owing to associated public health and environmental risks, particularly from large volumes of nanosilver in waste water. The article first examines the use of nanosilver in a variety of contemporary medical and domestic products, the utilization of which may assist in resolving global public health problems, such as restricted access to safe food, water and medical care. It then discusses the mechanisms of toxicity for nanosilver, whether it should be classified as a new chemical entity for regulatory purposes and whether its increased usage poses significant environmental and public health risks. The article next critically analyses representative international regulatory regimes (the USA, EU, UK and Australia) for medical and domestic use of nanosilver. The conclusion includes a set of recommendations for improving international regulation of nanosilver.

Gender as a Moderator of the Relation between Race-Related Stress and Mental Health Symptoms for African Americans

ERIC Educational Resources Information Center

Greer, Tawanda M.; Laseter, Adrian; Asiamah, David

2009-01-01

The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe…

A Summer Health Program for African-American High School Students in Baltimore, Maryland: Community Partnership for Integrative Health.

PubMed

Pierce, Beverly; Bowden, Brandin; McCullagh, Molly; Diehl, Alica; Chissell, Zachary; Rodriguez, Rebecca; Berman, Brian M; D Adamo, Christopher R

Physical inactivity, poor nutrition, and chronic stress threaten the health of African-American youth in urban environments. Conditions often worsen in summer with diminished access to healthy foods and safe venues for physical activity. A public-private partnership was formed to develop and evaluate an integrative health intervention entitled "Mission Thrive Summer" (MTS). The MTS setting was an urban farm and adjacent school in a low-income community in Baltimore, Maryland. The intervention included farming, nutrition education, cooking, physical activity, yoga, mindfulness, and employment. Mixed-methods outcomes evaluation was conducted. Quantitative measures included accelerometry and self-reported health behaviors, using the Child and Adolescent Mindfulness Measure, Perceived Stress Scale, Physical Activity Questionnaire for Adolescents (PAQA), CDC Youth Risk Behavior Survey, and Block Kids Food Screener (BKFS). Outcomes were compared pre- and post-intervention using paired t-tests. Qualitative evaluation was based on participant and parent interviews. In total, 36 African-American 9th- and 10th-grade students joined MTS (17 in 2013, 26 in 2014, and 7 participating both years). In total, 88% of participants completed MTS. Accelerometry revealed that participants took 7158 steps and burned 544 calories per day during MTS. Participants experienced statistically significant improvements in self-reported physical activity (PAQA) and dietary habits (BKFS). Surveys did not detect changes in stress or mindfulness (P > .05). Qualitative data demonstrated new knowledge and skills, increased self-efficacy, health behavior change, and program enjoyment. MTS was feasible among African-American high school students in Baltimore. Mixed-methods outcomes evaluation provided preliminary evidence of health behavior change during the summer and at follow-up. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Health Messaging and African-American Infant Sleep Location: A Randomized Controlled Trial

PubMed Central

Moon, Rachel Y; Mathews, Anita; Joyner, Brandi L.; Oden, Rosalind P.; He, Jianping; McCarter, Robert

2016-01-01

Background Infant-parent bedsharing increases the risk of SIDS and other sleep-related deaths. Despite AAP recommendations to avoid bedsharing, public health efforts have been unsuccessful in changing behaviors. African-American infants are more than twice as likely to die from SIDS and other sleep-related deaths, and are also twice as likely to bedshare with their parents. Further, African-American parents have a high degree of self-efficacy with regards to preventing infant suffocation, but low self-efficacy with regards to SIDS risk reduction. It is unclear whether messages emphasizing suffocation prevention will decrease bedsharing. Objectives To evaluate the impact of specific health messages on African-American parental decisions regarding infant sleep location. Methods We conducted a randomized, controlled trial of African-American mothers of infants. The control group received standard messaging emphasizing AAP-recommended safe sleep practices, including avoidance of bedsharing, for the purposes of SIDS risk reduction. The intervention group received enhanced messaging emphasizing safe sleep practices, including avoidance of bedsharing, for both SIDS risk reduction and suffocation prevention. Participants completed interviews at 2–3 weeks, 2–3 months, and 5–6 months after the infant’s birth. Results 1194 mothers were enrolled in the study, and 637 completed all interviews. Bedsharing, both usually (aOR 1.005 [95% CI 1.003, 1.006]) and last night (aOR 1.004 [95% CI 1.002, 1.007]) increased slightly but statistically significantly with infant age (p<0.001). Receipt of the enhanced message did not impact on sleep location. Maternal belief that bedsharing increased the risk of SIDS or suffocation declined over 6 months (p<0.001) and did not differ by group assignment. Conclusion African-American mothers who received an enhanced message about SIDS risk reduction and suffocation prevention were no less likely to bedshare with their infants. PMID:27470122

Social support among African Americans with heart failure: is there a role for community health advisors?

PubMed

Durant, Raegan W; Brown, Qiana L; Cherrington, Andrea L; Andreae, Lynn J; Hardy, Claudia M; Scarinci, Isabel C

2013-01-01

The study had 2 objectives: (1) to gather the observations of community health advisors (CHAs) on the role of social support in the lives of African Americans; and (2) to develop a lay support intervention framework, on the basis of the existing literature and observations of CHAs, depicting how social support may address the needs of African American patients with heart failure. Qualitative data were collected in semistructured interviews among 15 CHAs working in African American communities in Birmingham, Alabama. Prominent themes included the challenge of meeting clients' overlapping health care and general life needs, the variation in social support received from family and friends, and the opportunities for CHAs to provide multiple types of social support to clients. CHAs also believed that their support activities could be implemented among populations with heart failure. The experience of CHAs with social support can inform a potential framework of a lay support intervention among African Americans with heart failure. Published by Mosby, Inc.

Community-based fortified dietary intervention improved health outcomes among low-income African-American women.

PubMed

Salihu, Hamisu M; Adegoke, Korede K; Das, Rachita; Wilson, Ronee E; Mazza, Jessica; Okoh, Jennifer O; Naik, Eknath; Berry, Estrellita Lo

2016-08-01

Poor dietary exposure disproportionately affects African-Americans and contributes to the persistence of disparities in health outcomes. In this study, we hypothesized that fortified dietary intervention (FDI) will improve measured dietary and related health outcomes and will be acceptable among low-income African-American women living in Tampa, FL. These objectives were tested using a prospective experimental study using pretest and posttest design with a control group, using a community-based participatory research approach. The intervention (FDI) was designed by the community through structural modification of a preexisting, diet-based program by the addition of a physical and mental health component. Paired sample t tests were used to examine preintervention and postintervention changes in study outcomes. A total of 49 women participated in the study, 26 in the FDI group and 23 controls. Two weeks postintervention, there were significant improvements in waist circumference and health-related quality of life related to physical health (P< .0001), physical fitness subscores (P= .002), and nutritional subscores (P= .001) in the FDI group. Among overweight/obese women, improvement in health-related quality of life related to physical health, a significant decrease in depressive score, and a reduction in waist circumference were noted. In the control group, a decrease in waist circumference was observed. Implementation of the FDI through a community-based participatory research approach is feasible and effective among low-income African-American women in general and overweight/obese women in particular. Social reengineering of a nutritional intervention coupled with community-based approach will enhance health outcomes of low-income women. Copyright © 2016 Elsevier Inc. All rights reserved.

Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs.

PubMed

Dreer, Laura E; Weston, June; Owsley, Cynthia

2014-01-01

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research.

Relationship Between Depression and Specific Health Indicators Among Hypertensive African American Parents and Grandparents

PubMed Central

Taylor, Jacquelyn Y.; Washington, Olivia G. M.; Artinian, Nancy T.; Lichtenberg, Peter

2010-01-01

African Americans are at greater risk for hypertension than are other ethnic groups. This study examined relationships among hypertension, stress, and depression among 120 urban African American parents and grandparents. This study is a secondary analysis of a larger nurse-managed randomized clinical trial testing the effectiveness of a telemonitoring intervention. Baseline data used in analyses, with the exception of medication compliance, were collected at 3 months' follow-up. Health indicators, perceived stress, and social support were examined to determine their relationship with depressive symptoms. A total of 48% of the variance in depressive symptomology was explained by perceived stress and support. Health indicators including average systolic blood pressure explained 21% of the variance in depressive symptomology. The regression analysis using average diastolic blood pressure explained 26% of the variance in depressive symptomology. Based on study results, African Americans should be assessed for perceived stress and social support to alleviate depressive symptomology. PMID:18843828

Obesity and African Americans

MedlinePlus

... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... youthonline . [Accessed 08/18/2017] HEALTH IMPACT OF OBESITY People who are overweight are more likely to ...

Racial disparities in the health benefits of educational attainment: a study of inflammatory trajectories among African American and white adults.

PubMed

Fuller-Rowell, Thomas E; Curtis, David S; Doan, Stacey N; Coe, Christopher L

2015-01-01

The current study examined the prospective effects of educational attainment on proinflammatory physiology among African American and white adults. Participants were 1192 African Americans and 1487 whites who participated in Year 5 (mean [standard deviation] age = 30 [3.5] years), and Year 20 (mean [standard deviation] age = 45 [3.5]) of an ongoing longitudinal study. Initial analyses focused on age-related changes in fibrinogen across racial groups, and parallel analyses for C-reactive protein and interleukin-6 assessed at Year 20. Models then estimated the effects of educational attainment on changes in inflammation for African Americans and whites before and after controlling for four blocks of covariates: a) early life adversity, b) health and health behaviors at baseline, c) employment and financial measures at baseline and follow-up, and d) psychosocial stresses in adulthood. African Americans had larger increases in fibrinogen over time than whites (B = 24.93, standard error = 3.24, p < .001), and 37% of this difference was explained after including all covariates. Effects of educational attainment were weaker for African Americans than for whites (B = 10.11, standard error = 3.29, p = .002), and only 8% of this difference was explained by covariates. Analyses for C-reactive protein and interleukin-6 yielded consistent results. The effects of educational attainment on inflammation levels were stronger for white than for African American participants. Why African Americans do not show the same health benefits with educational attainment is an important question for health disparities research.

Internalized racism and mental health among African-Americans, US-born Caribbean Blacks, and foreign-born Caribbean Blacks.

PubMed

Mouzon, Dawne M; McLean, Jamila S

2017-02-01

The tripartite model of racism includes personally mediated racism, institutionalized racism, and the less-oft studied internalized racism. Internalized racism - or negative beliefs about one's racial group - results from cultural racism that is endemic in American society. In this project, we studied whether these negative stereotypes are associated with mental health among African-Americans and Caribbean Blacks. Using secondary data from the National Survey of American Life, we investigated the association between internalized racism and mental health (measured by depressive symptoms and serious psychological distress (SPD)) among these two groups. We also explored whether ethnicity/nativity and mastery moderate the association between internalized racism and mental health among African-Americans and Caribbean Blacks. Internalized racism was positively associated with depressive symptoms and SPD among all Black subgroups. However, internalized racism was a weaker predictor of SPD among foreign-born Caribbean Blacks than US-born Caribbean Blacks and US-born African-Americans. Additionally, higher mastery was protective against distress associated with internalized racism. Internalized racism is an important yet understudied determinant of mental health among Blacks. Future studies should take into account additional heterogeneity within the Black population (e.g. African-born individuals) and other potential protective mechanisms in addition to mastery (e.g. self-esteem and racial identity).

Assessing the health attitudes, beliefs, and behaviors of African Americans attending church: a comparison from two communities.

PubMed

Lewis, R K; Green, B L

2000-06-01

Public health officials and researchers continue to be increasingly concerned about the health of populations of color, especially African Americans. A survey was administered in African American churches in two communities (Wichita, KS and Tuscaloosa, AL) to gather information concerning health behaviors and beliefs and to design interventions that might improve their health status. The study examined the homogeneity of attitudes, beliefs, and behaviors across these samples and to determine the readiness to change using the Transtheoritical Model. Individuals completed a 33-item survey: 6 demographic questions, 12 health behavior questions, 8 health belief questions, 3 church attendance questions, and 4 church-based health promotion program questions. The total sample consisted of 429 respondents. The results showed that 93% of respondents have had their blood pressure checked in the past 2 years. While only 44% indicated eating a high fiber diet during the week. Thirty percent of respondents indicated that their health was dependent on fate or destiny. The findings from this study confirm that among both samples that health attitudes, beliefs, and behaviors need to be changed to lower the risk of certain diseases and disorders. The findings also indicate that both samples have similar beliefs about health that may have important implications for disseminating information to the community. Innovative and culturally sensitive programs are needed in the African American community if disparities in health are to diminish.

Beliefs about racism and health among African American women with diabetes: a qualitative study.

PubMed

Wagner, Julie A; Osborn, Chandra Y; Mendenhall, Emily A; Budris, Lisa M; Belay, Sophia; Tennen, Howard A

2011-03-01

Exposure to racism has been linked to poor health outcomes. Little is known about the impact of racism on diabetes outcomes. This study explored African American women's beliefs about how racism interacts with their diabetes self-management and control. Four focus groups were conducted with a convenience sample of 28 adult African American women with type 2 diabetes who were recruited from a larger quantitative study on racism and diabetes. The focus group discussions were transcribed verbatim and analyzed by the authors. Women reported that exposure to racism was a common phenomenon, and their beliefs did in fact link racism to poor health. Specifically, women reported that exposure to racism caused physiological arousal including cardiovascular and metabolic perturbations. There was consensus that physiological arousal was generally detrimental to health. Women also described limited, and in some cases maladaptive, strategies to cope with racist events, including eating unhealthy food choices and portions. There was consensus that the subjective nature of perceiving racism and accompanying social prohibitions often made it impossible to address racism directly. Many women described anger in such situations and the tendency to internalize anger and other negative emotions, only to find that the negative emotions would be reactivated repeatedly with exposure to novel racial stressors, even long after the original racist event remitted. African American women in this study believed that racism affects their diabetes self-management and control. Health beliefs can exert powerful effects on health behaviors and may provide an opportunity for health promotion interventions in diabetes.

Cross race comparisons between SES health gradients among African-American and white women at mid-life

PubMed Central

Salsberry, Pamela J.

2014-01-01

This study explored how multiple indicators of socioeconomic status (SES) inform understanding of race differences in the magnitude of health gains associated with higher SES. The study sample, 1268 African-American women and 2066 white women, was drawn from the National Longitudinal Surveys of Youth 1979. The outcome was the Physical Components Summary from the SF-12 assessed at age 40. Ordinary least squares regressions using education, income and net worth fully interacted with race were conducted. Single measure gradients tended to be steeper for whites than African-Americans, partly because “sheepskin” effects of high school and college graduation were higher for whites and low income and low net worth whites had worse health than comparable African-Americans. Conditioning on multiple measures of SES eliminated race disparities in health benefits of education and net worth, but not income. A discussion of current public policies that affect race disparities in levels of education, income and net wealth is provided. PMID:24632052

Disability and Health: Exploring the Disablement Experience of Young Adult African Americans

PubMed Central

Harrison, Tracie

2013-01-01

Purpose The objective of this study was to examine disablement as experienced by young adult African American men and women with permanent mobility impairment. Methods This study included a sample of 5 male and 5 female participants ranging in age from 22 to 39. An exploratory descriptive design and qualitative methods, including interviews and fieldnotes, were used. Interview data was analyzed using the process of inductive qualitative content analysis. Results Basic desires for independence, shared intimacy, and psychological and physical health were not diminished by physical limitations. The disablement experience of this group is reflected in the themes of “Cumulative Losses” and “Sustained Desires.” The findings of this study describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being within the context of their impairments. Conclusion This study provides a better understanding of the contextual factors and experiences that may contribute to the development of further disability and subsequent health-related problems over time. Increased knowledge of the disablement experience of these young men and women may assist health care entities and social service providers in improving health care and rehabilitation efforts targeting this group. PMID:23745770

Distinct Age and Self-Rated Health Crossover Mortality Effects for African Americans: Evidence from a National Cohort Study

PubMed Central

Roth, David L.; Skarupski, Kimberly A.; Crews, Deidra C.; Howard, Virginia J.; Locher, Julie L.

2016-01-01

The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may “crossover” at about 75 to 80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

Distinct age and self-rated health crossover mortality effects for African Americans: Evidence from a national cohort study.

PubMed

Roth, David L; Skarupski, Kimberly A; Crews, Deidra C; Howard, Virginia J; Locher, Julie L

2016-05-01

The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may "crossover" at about 75-80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

Effects of racial discrimination and health behaviors on mental and physical health of middle-class African American men.

PubMed

Sellers, Sherrill L; Bonham, Vence; Neighbors, Harold W; Amell, James W

2009-02-01

This research is an examination of the effects of racial discrimination and health-promoting behaviors on the physical and mental health of a sample of 399 well-educated African American men. One would think that the attainment of higher education would increase health-promoting behaviors and might decrease discriminatory experiences that impact health. However, regression analysis indicated a more complex picture. Health-promoting behaviors were positively related to mental health, whereas experiences of racial discrimination contributed to poorer mental health. Relationships between health-promoting behaviors and that of racial discrimination to physical health were found to be nonsignificant. In conclusion, the authors discuss the importance of culturally appropriate health-promotion efforts.

Obesity and Body Ideals in the Media: Health and Fitness Practices of Young African-American Women

ERIC Educational Resources Information Center

Duncan, Margaret Carlisle; Robinson, T. Tavita

2004-01-01

This study explores the female body ideal and its implications for health and fitness practices in African-American culture. Employing Patricia Hill Collins's (1986) notion of the "outsider-within," we analyze a focus group discussion on women's body ideals, exercise, and fitness. Our group comprises 9 young, college-educated African-American…

African American community breast health education: a pilot project.

PubMed

Robertson, Ethel M; Franklin, Anett Wakefield; Flores, AnnMarie; Wherry, Shari; Buford, Juanita

2006-01-01

This paper reports the results of a project designed to examine the effectiveness of a Train the Trainer breast health education and screening program for African American, elderly and underserved women residing in the greater Nashville area. The project aimed to identify a cadre of women from the community willing to serve as leaders advocated and peer breast health educators. Data collected from the community leaders and the women from the local community during the course of the project suggest that the Train the Trainer model was well suited to provide education, support and breast cancer resource referral to women residing within this rural Tennessee community.

Mental health service use among South Africans for mood, anxiety and substance use disorders.

PubMed

Seedat, Soraya; Williams, David R; Herman, Allen A; Moomal, Hashim; Williams, Stacey L; Jackson, Pamela B; Myer, Landon; Stein, Dan J

2009-05-01

Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. A nationally representative survey of 4351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) diagnoses, severity, and service utilisation were determined using the World Health Organization Composite International Diagnostic Interview (CIDI). Twelve-month treatment was categorised by sector and province. South Africans in households and hostel quarters were interviewed between 2002 and 2004 in all nine provinces. 4 317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender. Of respondents with a mental disorder, 25.2% had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders, and among those with a mental disorder it varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment, and this was largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder. There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need.

Pilgrimage to Wellness: An Exploratory Report of Rural African American Clergy Perceptions of Church Health Promotion Capacity

PubMed Central

Carter-Edwards, Lori; Hooten, Elizabeth Gerken; Bruce, Marino A.; Toms, Forrest; Lloyd, Cheryl LeMay; Ellison, Calvin

2013-01-01

Churches serve a vital role in African American communities and may be effective vehicles for health promotion in rural areas where disease burden is disproportionately greater and healthcare access is more limited than other communities. Endorsement by church leadership is often necessary for the approval of programs and activities within churches; however, little is known about how church leaders perceive their respective churches as health promotion organizations. The purpose of this exploratory pilot was to report perceptions of church capacity to promote health among African American clergy leaders of predominantly African American rural churches. The analysis sample included 27 pastors of churches in Eastern NC who completed a survey on church health promotion capacity and perceived impact on their own health. Capacities assessed included perceived need and impact of health promotion activities, church preparedness to promote health, health promotion actions to take, and the existence and importance of health ministry attributes. The results from this pilot study indicated a perceived need to increase the capacity of their churches to promote health. Conducting health programs, displaying health information, collaborations within the church (i.e., kitchen committee working with the health ministry), partnerships outside of the church, and funding were most commonly reported needed capacities. Findings from this exploratory work lay the foundation for the development of future, larger observational studies that can specify some of the key factors associated with organizational change and ultimately health promotion in these rural church settings. PMID:22694157

Preparing African Americans for careers in health care: the Jackson Heart Study.

PubMed

Srinivasan, Asoka; Brown, James; Fahmy, Nimr; Heitman, Elizabeth; Singh, Madhu; Szklo, Moyses; Taylor, Herman; White, Wendy

2005-01-01

The Jackson Heart Study Undergraduate Training Center (UTC) at Tougaloo College was developed to increase the numbers of African-American students entering public health and health related fields. The UTC includes a scholars program for undergraduate students at Tougaloo College, three four-week programs for high school students called the SLAM (science, language arts, and mathematics) workshops, and an introductory epidemiology course for healthcare professionals and graduate students. The scholars program recruits 12 Tougaloo College freshmen annually for the duration of their undergraduate education. As of the 2005 summer, 512 students have enrolled in the SLAM workshops. The introduction to epidemiology course has provided training for 155 individuals from 1999 to 2004. This paper documents the need for this program based on the conspicuously small proportion of African Americans who are health practitioners in Mississippi. The content and selection process for each program is described, and a summary of the enrollment history, characteristics of the program participants, and their accomplishments is presented. Finally, the methods of program assessment and tracking are discussed.

Using peer education to increase sexual health knowledge among West African refugees in Western Australia.

PubMed

Drummond, Peter D; Mizan, Ayse; Brocx, Katie; Wright, Bernadette

2011-03-01

Ten bilingual West African peer educators conducted a 3-hour workshop on sexual health for small groups of West African refugees (N = 58) who recently had settled in Perth, Western Australia. There were significant increases in the participants' knowledge of sexually transmitted infections and HIV, how these infections are spread, and how to protect against infection. In addition, attitudes toward condom use became more positive. We conclude that the peer-education approach was successful in assisting a new and emerging community to work effectively on sexual health topics generally considered "taboo" or too sensitive to discuss.

The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women

PubMed Central

Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B.

2013-01-01

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n=206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included. PMID:24041186

Masculinity and race-related factors as barriers to health help-seeking barriers among African-American men

PubMed Central

Powell, Wizdom; Adams, Leslie B.; Cole-Lewis, Yasmin; Agyemang, Amma; Upton, Rachel D.

2016-01-01

Men’s tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African-American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience, everyday racism (ERD), racial identity (RI), sense of control (SOC) and depressive symptomatology as key barriers to African-American men’s health help-seeking. 458 African-American men were recruited primarily from U.S. barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent χ2(4,N = 457) = 3.84, p > .05; CFI = .99; TLI = 1.00; RMSEA = .00, and 90% CI [.00, .07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African-American men’s health help-seeking should not only address masculinity norms, but also threats to sense of control, and negative psychological sequelae induced by everyday racism. PMID:27337619

A mixed methods study of health and social disparities among substance-using African American/Black men who have sex with men.

PubMed

Buttram, Mance E; Kurtz, Steven P

2015-03-01

African American/Black men who have sex with men (MSM) in the U.S. experience health and social disparities at greater rates than MSM of other races/ethnicities, including HIV infection and substance use. This mixed methods paper presents: 1) a quantitative examination of health and social disparities among a sample of substance-using African American/Black MSM (N=108), compared to Caucasian/White MSM (N=250), and 2) in-depth qualitative data from a subsample of African American/Black MSM (N=21) in order to contextualize the quantitative data. Findings indicate that compared to Caucasian/White MSM, African American/Black MSM experienced a wide range of health and social disparities including: substance use and dependence; buying, trading or selling sex; educational attainment; employment; homelessness; identifying as gay; HIV status; arrest history; social support; and satisfaction with one's living situation. Qualitative data suggests that structural interventions that address homophobia and the social environment would be likely to mitigate many of the health and social disparities experienced by African American/Black MSM.

Exploring uncertainty in advance care planning in African Americans: does low health literacy influence decision making preference at end of life.

PubMed

Melhado, Lolita; Bushy, Angeline

2011-11-01

African Americans over 65 represent 3.5 of the 35.6 million Americans. Morbidity and mortality rates are highest among this group; associated with lack of resources and awareness of health problems. But health needs are the same at end of life, yet care is less than optimal. African Americans are less likely to have advance directives nonetheless desire communication, information, respect, and a trusting doctor-patient relationship. Low health literacy may contribute to this disparity. This scholarly review examines the health literacy in advance care planning and refines concepts of uncertainty in illness theory deriving a model for advance care planning in African Americans.

Counting the cost of child mortality in the World Health Organization African region.

PubMed

Kirigia, Joses M; Muthuri, Rosenabi Deborah Karimi; Nabyonga-Orem, Juliet; Kirigia, Doris Gatwiri

2015-11-06

Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years of age". There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children's welfare. A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss. The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3

Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap.

PubMed

Müller, Alexandra

2013-12-27

People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town's medical curriculum. A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as well as providing them with specific LGBT

Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap

PubMed Central

2013-01-01

Background People who identity as lesbian, gay, bisexual and transgender (LGBT) have specific health needs. Sexual orientation and gender identity are social determinants of health, as homophobia and heteronormativity persist as prejudices in society. LGBT patients often experience discrimination and prejudice in health care settings. While recent South African policies recognise the need for providing LGBT specific health care, no curricula for teaching about LGBT health related issues exist in South African health sciences faculties. This study aimed to determine the extent to which LGBT health related content is taught in the University of Cape Town’s medical curriculum. Methods A curriculum mapping exercise was conducted through an online survey of all academic staff at the UCT health sciences faculty, determining LGBT health related content, pedagogical methodology and assessment. Results 127 academics, across 31 divisions and research units in the Faculty of Health Sciences, responded to the survey, of which 93 completed the questionnaire. Ten taught some content related to LGBT health in the MBChB curriculum. No LGBT health related content was taught in the allied health sciences curricula. The MBChB curriculum provided no opportunity for students to challenge their own attitudes towards LGBT patients, and key LGBT health topics such as safer sex, mental health, substance abuse and adolescent health were not addressed. Conclusion At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure. Coordinated initiatives to integrate LGBT health related content into all health sciences curricula should be supported, and follow an approach that challenges students to develop professional attitudes and behaviour concerning care for patients from LGBT backgrounds, as

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

PubMed Central

Lumpkins, Crystal Y.; Saint Onge, Jarron M.

2017-01-01

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health. PMID:28165368

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD).

PubMed

Lumpkins, Crystal Y; Saint Onge, Jarron M

2017-02-04

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups ( n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.

“If you do nothing about stress, the next thing you know, you’re shattered”: Perspectives on African American men’s stress, coping and health from African American men and key women in their lives

PubMed Central

Ellis, Katrina; Griffith, Derek M.; Allen, Julie Ober; Thorpe, Roland J.; Bruce, Marino A.

2015-01-01

Stress has been implicated as a key contributor to poor health outcomes; however, few studies have examined how African American men and women explicitly specify the relationships among stress, coping, and African American men’s health. In this paper, we explore strategies men use to cope with stress, and beliefs about the consequences of stress for African American men’s health behaviors, morbidity and mortality from the perspectives of African American men and women. A phenomenological analytic approach was used to examine focus group data collected from 154 African American men (18 focus groups) and 77 women (8 focus groups). Women’s perspectives were captured because women often observe men under stress and can provide support to men during stressful times. Our findings indicate that African American men in this study responded to stress by engaging in often identified coping behaviors (i.e., consumption of calorie dense food, exercise, spiritually-related activities). Men in our study, however, did not always view their responses to stress as explicit coping mechanisms. There was also some discordance between men’s and women’s perceptions of men’s coping behaviors as there were occasions where they seemed to interpret the same behavior differently (e.g., resting vs. avoidance). Men and women believed that stress helped to explain why African American men had worse health than other groups. They identified mental, physical and social consequences of stress. We conclude by detailing implications for conceptualizing and measuring coping and we outline key considerations for interventions and further research about stress, coping and health. PMID:26183018

Self-Regulatory Fatigue, Quality of Life, Health Behaviors, and Coping in Patients with Hematologic Malignancies

PubMed Central

Ehlers, Shawna L.; Patten, Christi A.; Gastineau, Dennis A.

2015-01-01

Background Self-regulatory fatigue may play an important role in a complex medical illness. Purpose Examine associations between self-regulatory fatigue, quality of life, and health behaviors in patients pre- (N=213) and 1-year post-hematopoietic stem cell transplantation (HSCT; N=140). Associations between self-regulatory fatigue and coping strategies pre-HSCT were also examined. Method Pre- and 1-year post-HSCT data collection. Hierarchical linear regression modeling. Results Higher self-regulatory fatigue pre-HSCT associated with lower overall, physical, social, emotional, and functional quality of life pre- (p’s<.001) and 1-year post-HSCT (p’s<.01); lower physical activity pre-HSCT (p<.02) and post-HSCT (p<.03) and less healthy nutritional intake post-HSCT (p<.01); changes (i.e., decrease) in quality of life and healthy nutrition over the follow-up year; and use of avoidance coping strategies pre-HSCT (p’s<.001). Conclusion This is the first study to show self-regulatory fatigue pre-HSCT relating to decreased quality of life and health behaviors, and predicting changes in these variables 1-year post-HSCT. PMID:24802991

Self-regulatory processes underlying structural stigma and health.

PubMed

Richman, Laura Smart; Lattanner, Micah R

2014-02-01

In this article, we examine self-regulatory processes that are initiated by structural stigma. To date, the literature on self-regulation as a mechanism that underlies stigma and health outcomes has focused primarily on harmful health-related behaviors that are associated with perceived discrimination. Numerous studies find that when people experience discrimination, they are more likely to engage in behaviors that pose risks for health, such as overeating and substance use. However, a large body of literature also finds that low power - which is also a chronic, though often more subtle, experience for stigmatized groups - is associated with a heightened activation of inhibitory processes. This inhibition system has wide-ranging influences on cognition, behavior, and affect. We provide an overview of these two literatures, examine synergies, and propose potential implications for measurement and research design. Copyright © 2014 Elsevier Ltd. All rights reserved.

African American patients' intent to screen for colorectal cancer: Do cultural factors, health literacy, knowledge, age and gender matter?

PubMed

Brittain, Kelly; Christy, Shannon M; Rawl, Susan M

2016-02-01

African Americans have higher colorectal cancer (CRC) mortality rates. Research suggests that CRC screening interventions targeting African Americans be based upon cultural dimensions. Secondary analysis of data from African-Americans who were not up-to-date with CRC screening (n=817) was conducted to examine: 1) relationships among cultural factors (i.e., provider trust, cancer fatalism, health temporal orientation (HTO)), health literacy, and CRC knowledge; 2) age and gender differences; and 3) relationships among the variables and CRC screening intention. Provider trust, fatalism, HTO, health literacy and CRC knowledge had significant relationships among study variables. The FOBT intention model explained 43% of the variance with age and gender being significant predictors. The colonoscopy intention model explained 41% of the variance with gender being a significant predictor. Results suggest that when developing CRC interventions for African Americans, addressing cultural factors remain important, but particular attention should be given to the age and gender of the patient.

'Walk with your head high': African and African-Caribbean fatherhood, children's mental well-being and social capital.

PubMed

Williams, Robert; Hewison, Alistair; Wagstaff, Chris; Randall, Duncan

2012-01-01

The findings presented in this article were unanticipated and came to light during a study which investigated African and African-Caribbean fathers' views about preventive primary care services. This article reports findings which indicate that African and African-Caribbean fathers strive to enable and protect children's mental well-being and create social, cultural and symbolic forms of capital. It also seeks to identify implications for health and social care policy and practice in England. There is limited literature examining African and African-Caribbean fathers' health experiences in England. Consequently an exploratory research approach was required. This involved nine, in-depth, semi-structured qualitative group interviews undertaken with 46 African and African-Caribbean fathers. The data were analysed thematically using abductive reasoning, informed by Bourdieu's theoretical work. Fathers were striving to enable and protect children's mental well-being through providing authoritative, loving, affectionate fatherhood involving reasoning, good communication and promoting self-esteem. These practices were seen to be necessary if children were to prosper in a harsh social world characterised by structural hazards including racism, negative stereotypes and limited opportunities. The fathers reported their efforts to develop what Bourdieu has termed symbolic, cultural and social capital as means of promoting the mental well-being of their children and the children of others. The implications for theory, future research, public health policy and practice, in relation to the needs of African and African-Caribbean fathers and families, are also discussed, with specific focus on how to realise the potential of African and African-Caribbean fathers' positive contributions to family and community health.

Endodontic treatment-related antibiotic prescribing patterns of South African oral health professionals.

PubMed

Lalloo, R; Solanki, G; Ramphoma, K; Myburgh, N G

2017-11-01

To assess the antibiotic prescribing patterns of South African dentists for patients undergoing endodontic treatment. This study used data from 2013 health insurance claims submitted by South African oral health professionals to determine the antibiotic prescribing patterns related to endodontic treatment. A logistic regression model was used to test the fully adjusted statistical significance of the association between the exploratory variables (gender, age group, event type, abscess treatment, chronic health) and the dependent variable (antibiotic prescription). Odds ratios with 95% confidence intervals (CI) are reported, and a 95% CI excluding 1 was considered statistically significant. Almost 10% of endodontic treatments were prescribed an antibiotic. There were no significant differences in prescribing patterns by gender, age and chronic health status. Prescriptions were more common at the preparatory stage (9.4%) of root canal treatment compared to the therapy (4.7%) and canal filling (2%) stages. Patients who received apical surgery (OR = 2.28; 95% CI 1.38-3.76) and treatment of an abscess (OR = 2.57; 95% 1.82-3.63) had a significantly increased odds of being prescribed an antibiotic. Almost three-quarters of prescriptions were for narrow spectrum antibiotics. The frequency of antibiotic prescribing by South African dental practitioners for patients undergoing endodontic treatment is relatively low and predominantly involved narrow spectrum antibiotics. It, however, remains important that antibiotics are only prescribed when clinically essential, such as when there are obvious systemic effects. These include fever above 37 degrees, malaise, lymphadenopathy, trismus, increase swelling, cellulitis, osteomyelitis and persistent infection. The wider dissemination and adherence to clear evidence-based prescribing guidelines for antibiotics in this clinical area are important. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

African Immigrants in Low-Wage Direct Health Care: Motivations, Job Satisfaction, and Occupational Mobility.

PubMed

Covington-Ward, Yolanda

2017-06-01

This study explores motivations, job satisfaction, and overall perceived occupational mobility for African immigrants working in low-wage direct health care occupations. The study uses qualitative semi-structured interviews with a sample of thirty African immigrant workers in the greater Pittsburgh metropolitan area. Results show that four major themes captured the motivations of interviewees for doing direct care work: passion for care work, quick money, easily obtained employment, and direct care work as a pathway to other health occupations. The majority of the interviewees were satisfied with their jobs, yet almost all of them saw their occupations as temporary or transitional employment. Most of the interviewees also saw their jobs as lacking occupational mobility. In light of the increased national demand for direct care workers, the growing numbers of immigrants in the direct care labor force, and the high turnover and low retention rates of direct care workers overall, the study suggests that more must be done to make direct care work attractive and rewarding for African immigrant workers.

Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia.

PubMed

Mohale, Hlengiwe; Sweet, Linda; Graham, Kristen

2017-08-01

Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care. The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia. Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark's approach to thematic analysis. Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care. The study provides an understanding of Sub-Saharan African women's experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women's health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

State of equity: childhood immunization in the World Health Organization African Region

PubMed Central

Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

2017-01-01

Introduction In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. Methods We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. Results DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Conclusion Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these

State of equity: childhood immunization in the World Health Organization African Region.

PubMed

Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

2017-01-01

In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children's Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting

Health Messaging and African-American Infant Sleep Location: A Randomized Controlled Trial.

PubMed

Moon, Rachel Y; Mathews, Anita; Joyner, Brandi L; Oden, Rosalind P; He, Jianping; McCarter, Robert

2017-02-01

Infant-parent bedsharing increases the risk of SIDS and other sleep-related deaths. Despite AAP recommendations to avoid bedsharing, public health efforts have been unsuccessful in changing behaviors. African-American infants are more than twice as likely to die from SIDS and other sleep-related deaths, and are also twice as likely to bedshare with their parents. Further, African-American parents have a high degree of self-efficacy with regards to preventing infant suffocation, but low self-efficacy with regards to SIDS risk reduction. It is unclear whether messages emphasizing suffocation prevention will decrease bedsharing. To evaluate the impact of specific health messages on African-American parental decisions regarding infant sleep location. We conducted a randomized, controlled trial of African-American mothers of infants. The control group received standard messaging emphasizing AAP-recommended safe sleep practices, including avoidance of bedsharing, for the purposes of SIDS risk reduction. The intervention group received enhanced messaging emphasizing safe sleep practices, including avoidance of bedsharing, for both SIDS risk reduction and suffocation prevention. Participants completed interviews at 2-3 weeks, 2-3 months, and 5-6 months after the infant's birth. 1194 mothers were enrolled in the study, and 637 completed all interviews. Bedsharing, both usually (aOR 1.005 [95 % CI 1.003, 1.006]) and last night (aOR 1.004 [95 % CI 1.002, 1.007]) increased slightly but statistically significantly with infant age (p < 0.001). Receipt of the enhanced message did not impact on sleep location. Maternal belief that bedsharing increased the risk of SIDS or suffocation declined over 6 months (p < 0.001) and did not differ by group assignment. African-American mothers who received an enhanced message about SIDS risk reduction and suffocation prevention were no less likely to bedshare with their infants. Clinical Trials.gov identifier NCT01361880.

Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans

PubMed Central

Holt, Cheryl L.; Roth, David L.; Clark, Eddie M.; Debnam, Katrina

2012-01-01

Self-esteem and self-efficacy are theorized to serve as mediators of the relationship between religious involvement and health outcomes. Studies confirming these relationships have produced mixed evidence. This study examined whether self-esteem and self-efficacy mediate the relationship between religious involvement (beliefs, behaviors) and a set of modifiable health behaviors in a national probability sample of African Americans. African Americans, in general, are relatively high in religious involvement and have higher than average rates of chronic disease. Participants were interviewed by telephone, and a Religion-Health Mediational Model was tested using structural equation modeling. Results suggest that self-esteem and self-efficacy at least in part mediate the relationship between religious beliefs (e.g., relationship with God) and greater fruit and vegetable consumption, and lower alcohol consumption. Religious behaviors (e.g., service attendance) were found to have direct, unmediated effects on health behaviors. Findings have implications for church-based health promotion in African American communities such as education or support groups. PMID:23143382

The South African fertility decline: Evidence from two censuses and a Demographic and Health Survey.

PubMed

Moultrie, Tom A; Timaeus, Ian M

2003-11-01

Inadequate data and apartheid policies have meant that, until recently, most demographers have not had the opportunity to investigate the level of, and trend in, the fertility of South African women. The 1996 South Africa Census and the 1998 Demographic and Health Survey provide the first widely available and nationally representative demographic data on South Africa since 1970. Using these data, this paper describes the South African fertility decline from 1955 to 1996. Having identified and adjusted for several errors in the 1996 Census data, the paper argues that total fertility at that time was 3.2 children per woman nationally, and 3.5 children per woman for African South Africans. These levels are lower than in any other sub-Saharan African country. We show also that fertility in South Africa has been falling since the 1960s. Thus, fertility transition predates the establishment of a family planning programme in the country in 1974.

Differences in Problems Paying Medical Bills between African Americans and Whites from 2007 and 2009: the Underlying Role of Health Status.

PubMed

Wiltshire, Jacqueline C; Elder, Keith; Allison, Jeroan J

2016-06-01

Although the proportion of people reporting problems paying medical bills has declined in the aftermath of the Great Recession, it is unclear if this decline has been caused by self-rationing of care, particularly among disadvantaged groups. We examined African American-White differences in problems paying medical bills prevalence along with factors which may account for observed differences. We used cross-sectional data from 2007 (N = 13,064) and 2010 (N = 11,873) waves of the nationally representative, Health Tracking Household Survey. Logistic regression analyses, accounting for complex survey design and weights, were performed to compute population-based estimates. Overall, the prevalence of problems paying medical bills was 18.3 % in 2007 and 19.8 % in 2010. African Americans more frequently reported having problems paying medical bills than Whites. Among African Americans, problems paying medical bills decreased from 30 % in 2007 to 25 % in 2010, which was largely explained by fewer problems reported by those in poor/fair health. Problems paying medical bills significantly declined from 44 % in 2007 to 33 % in 2010 for African Americans in poor/fair health, but remained almost constant for those in good health and very good/excellent health. Our findings suggest that African Americans in poor health may be rationing or forgoing necessary care as a result of the recession, which could increase existing health disparities and future health spending. Efforts to reduce racial/ethnic disparities may depend on the extent to which the lingering effects of the Great Recession are mitigated.

Change in motor function and adverse health outcomes in older African-Americans.

PubMed

Buchman, Aron S; Wilson, Robert S; Leurgans, Sue E; Bennett, David A; Barnes, Lisa L

2015-10-01

We tested whether declining motor function accelerates with age in older African-Americans. Eleven motor performances were assessed annually in 513 older African-Americans. During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/year (Estimate, -0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p's<0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African-Americans. Copyright © 2015 Elsevier Inc. All rights reserved.

Change in Motor Function and Adverse Health Outcomes in Older African Americas

PubMed Central

Buchman, Aron S.; Wilson, Robert S.; Leurgans, Sue E.; Bennett, David A.; Barnes, Lisa L.

2015-01-01

Objective We tested whether declining motor function accelerates with age in older African Americans. Methods Eleven motor performances were assessed annually in 513 older African Americans. Results During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/yr (Estimate, −0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p’s <0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. Conclusions The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African Americans. PMID:26209439

Skeletal Health among African Americans with Recent Onset Rheumatoid Arthritis

PubMed Central

Curtis; Arora, T; Donaldson, M; Alarcon, GS; Callahan, LF; Moreland, LW; Bridges, SL; Mikuls, TR

2009-01-01

Background African Americans with rheumatoid arthritis (RA) may be at increased fracture risk. We applied the World Health Organization (WHO) fracture risk assessment tool (FRAX) and National Osteoporosis Foundation (NOF) guidelines to a cohort of African Americans with early RA to identify which patients were recommended for osteoporosis treatment. Methods Risk factors and bone mineral density (BMD) were assessed in acohort of African Americans with RA. The WHO FRAX tool estimated ten-year fracture risk. Patients were risk-stratified using FRAX without BMD to identify which individuals might be most efficiently targeted for BMD testing. Results Participants (n = 324) had a mean age of 51 years and included 81% women. There were no associations of RA disease characteristics with BMD. The proportion of patients recommended for osteoporosis treatment varied from 3% to 86%, depending on age and BMI. Ten-year fracture risk calculated with BMI only was generally the same or higher than fracture risk calculated with BMD; adding BMD data provided the most incremental value to risk assessment in patients 55–70 years of age with low/normal BMI and in those ≥ 70 years of age with BMI > 30 kg/m2. Conclusions A high proportion of African Americans with RA were recommended for treatment under 2008 NOF guidelines. FRAX without BMD identified low risk patients accurately. Systematic application of FRAX to screen high risk groups such as RA patients may be used to target individuals for BMD testing and reduce the use of unnecessary tests and treatments. PMID:19790118

Images of sexual stereotypes in rap videos and the health of African American female adolescents.

PubMed

Peterson, Shani H; Wingood, Gina M; DiClemente, Ralph J; Harrington, Kathy; Davies, Susan

2007-10-01

This study sought to determine whether perceiving portrayals of sexual stereotypes in rap music videos was associated with adverse health outcomes among African American adolescent females. African American female adolescents (n = 522) were recruited from community venues. Adolescents completed a survey consisting of questions on sociodemographic characteristics, rap music video viewing habits, and a scale that assessed the primary predictor variable, portrayal of sexual stereotypes in rap music videos. Adolescents also completed an interview that assessed the health outcomes and provided urine for a marijuana screen. In logistic regression analyses, adolescents who perceived more portrayals of sexual stereotypes in rap music videos were more likely to engage in binge drinking (OR 3.8, 95% CI 1.32-11.04, p = 0.01), test positive for marijuana (OR 3.4, 95% CI 1.19-9.85, p = 0.02), have multiple sexual partners (OR 1.9, 95% CI 1.01-3.71, p = 0.04), and have a negative body image (OR 1.5, 95% CI 1.02-2.26, p = 0.04). This is one of the first studies quantitatively examining the relationship between cultural images of sexual stereotypes in rap music videos and a spectrum of adverse health outcomes in African American female adolescents. Greater attention to this social issue may improve the health of all adolescent females.

It's a Matter of Trust: Older African Americans Speak About Their Health Care Encounters.

PubMed

Hansen, Bryan R; Hodgson, Nancy A; Gitlin, Laura N

2016-10-01

To examine perceptions of older African Americans' encounters with health care providers and ways to enhance trust. Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Four themes emerged: "Added Insult of Ageism," "Alternative Remedies," "Good Providers in a 'Broken' System," and "The Foundation of Trust Is Person Recognition." Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans. © The Author(s) 2015.

Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration.

PubMed

Scott, A J; Wilson, R F

2011-01-01

African Americans living in rural USA experience multiple health disparities as a result of both race and rural geography. An increasing literature suggests that social determinants of health, the social contexts in which people live their lives, are key contributors to these health disparities. Ecological theory provides a valuable conceptual framework for exploring social determinants of health in communities, but few US rural health community-based studies have utilized this approach, or engaged ecological theory to explore rural contexts. This exploratory study blended a community-based, qualitative approach with ecological theory with the objective of identifying potential social determinants of health among African Americans in a rural community in the Deep South, from the perspectives of participants. In-depth interviews were conducted with rural, Deep South African Americans participants who were purposefully sampled to incorporate a range of perspectives. Interview guides structured around five ecological levels (individual, relational, environmental, structural, and superstructural) were used to frame interviews. Iterative content analysis of interview transcripts and field notes identified potential social determinants of health. An 'editing' approach to content analysis was used. Data and analysis quality was tested by triangulation at the level of the researcher, and by member checking with community members. Potential determinants of health were identified at all five levels of the ecological framework. At the individual level, lack of engagement with personal health and health promotion was a recurring theme. Participation in preventive health activities and education was minimal, even when offered in community settings. At the relational level, lack of social capital emerged as another potential social determinant of health, with estrangement between the younger and elder generations as one source, and fractiousness among churches (key institutions

Living Arrangements during Childrearing Years and Later Health of African American Mothers

ERIC Educational Resources Information Center

Fothergill, Kate E.; Ensminger, Margaret E.; Green, Kerry M.; Thorpe, Roland J.; Robertson, Judy; Kasper, Judith D.; Juon, Hee-Soon

2009-01-01

Using longitudinal data from the Woodlawn Project (N = 680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health…

Church and spirituality in the lives of the African American community.

PubMed

Giger, Joyce Newman; Appel, Susan J; Davidhizar, Ruth; Davis, Claudia

2008-10-01

The African American church is held in the highest esteem by most African Americans. Although the influence of the African American church has been underestimated by physicians and nurses, it could be pivotal in optimizing health status among African Americans. Because of this influence, health care practitioners, including nurses, are now recognizing the important role that the African American church plays in improving the health status of individuals in the African American community. This article illuminates the health and health care concerns of the African American community by considering the traditional lack of equal access for this population and the role that the church can play in not only offering church-based health care services but also improving the health status of church congregations. Future roles of the African American church for improved health status are also suggested.

Getting mad but ending up sad: the mental health consequences for African Americans using anger to cope with racism.

PubMed

Pittman, Chavella T

2011-01-01

Anger is a common reaction to stressful life events. However, little is known about anger’s use and efficacy as a coping strategy for racism. Is anger a coping strategy for racism that improves mental health? Or does anger operate in an opposing way, deteriorating mental health? The analyses for this research focused on a probability sample of African Americans who reported experiences of acute (n = 246) or chronic (n = 120) racial discrimination in a survey interview. General linear model results revealed that using anger to cope with racial discrimination negatively affected the general well-being and psychological distress of African Americans. These findings raise concerns about the effectiveness (or lack therefore of) of anger as a common coping mechanism for racism, given the deleterious effects it may have on African Americans’ mental health.

Oral Cancer in African Americans: Addressing Health Disparities

ERIC Educational Resources Information Center

Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.

2008-01-01

Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…

Practitioners' Perceptions of Culturally Responsive School-Based Mental Health Services for Low-Income African American Girls

ERIC Educational Resources Information Center

Harper, Erin; Kruger, Ann Cale; Hamilton, Chela; Meyers, Joel; Truscott, Stephen D.; Varjas, Kris

2016-01-01

School-based mental health practitioners are positioned to address low-income urban African American girls' mental health needs through culturally responsive services. Despite the importance of culturally reflective practice, it is understudied. We asked school-based mental health practitioners (N = 7) to reflect on barriers and facilitators to…

[The regulatory regime and the health insurance industry in Brazil].

PubMed

Costa, Nilson do Rosário

2008-01-01

This paper analyzes the regulatory regime for health insurance and prepayment schemes in Brazil. It describes the ideas that have influenced the creation of the Agência Nacional de Saúde Suplementar-ANS (National Agency of Supplementary Health) in 2000, showing that the independent agency model was a direct result of the privatization process and of the induction of new competition mechanisms in a natural state monopoly. The paper concludes that the prepayment firms in Brazil are facing a new institutional environment as refers to their market entry or exit conditions.

A Qualitative Examination of Health Barriers and Facilitators Among African American Mothers in a Subsidized Housing Community.

PubMed

Cotter, Elizabeth W; Hamilton, Natia S; Kelly, Nichole R; Harney, Megan B; Greene, LaShaun; White, Kelly A; Mazzeo, Suzanne E

2016-09-01

Although African American families are at particular risk for obesity and its associated health comorbidities, few interventions have directly targeted low-income members of this group living in subsidized public housing. Using a consensual qualitative research approach, we conducted 11 interviews with African American mothers living in two public housing communities to enhance understanding of their perceived barriers and facilitators to health. Five primary domains emerged, including barriers (access, financial, personal, and neighborhood concerns), resources (personal and community), current behaviors (diet, physical activity, and program participation), definition of health (mental well-being, physical well-being, and health behaviors), and needs/interests in programming (health behavior-specific programs, non-health-related programs, child-focused programming, and qualities of programs and their leaders). Results demonstrate the complex interaction among social, environmental, and personal factors on health behaviors for this priority population, and highlight the need for community members' involvement in the development of community-based obesity prevention programming. © 2016 Society for Public Health Education.

Clues to the Blues: Predictors of Self-Reported Mental and Emotional Health Among Older African American Men.

PubMed

Mitchell, Jamie A; Watkins, Daphne C; Shires, Deirdre; Chapman, Robert A; Burnett, Janice

2017-09-01

The mental health needs of aging African American men have been overlooked and few studies have distinguished between more severe clinically diagnosable mental health challenges and less severe emotional states for this population. African American men may not identify with or internalize the terminology of "depression" despite exhibiting the symptom criteria. This exploratory cross-sectional study examined correlates of "downheartedness" as an alternative indicator of emotional health. The authors examined the self-reported responses of 1,666 older African American men on a baseline questionnaire from a larger longitudinal study. Demographic, physical, mental and emotional health, and health system factors were examined as possible correlates of downheartedness. The mean age of participants was 73.6 years and 74.8% of men described themselves as "downhearted and blue" most or all of the time while only 18.5% of them reported feeling moderate to severe anxiety or depression. When other factors were controlled, mobility problems (odds ratio [ OR] = 2.36), problems getting health care ( OR = 2.69), having a doctor who never listens ( OR = 2.18), physical or mental problems that interfere with social activities ( OR = 1.34), accomplishing less due to physical health ( OR = 1.35), and accomplishing less due to mental/emotional health ( OR = 1.57) were all associated with greater odds of being downhearted. The current findings indicate that this sample more closely identified with language accurately describing their emotional health state (i.e., downhearted) and not with clinical mental health terminology (i.e., depression) that may be culturally stigmatized.

The Context for Choice: Health Implications of Targeted Food and Beverage Marketing to African Americans

PubMed Central

Grier, Sonya A.; Kumanyika, Shiriki K.

2008-01-01

Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions. We conducted a systematic review of studies published in June 1992 through 2006 (n = 20) that permitted comparison of food and beverage marketing to African Americans versus Whites and others. Eight studies reported on product promotions, 11 on retail food outlet locations, and 3 on food prices. Although the evidence base has limitations, studies indicated that African Americans are consistently exposed to food promotion and distribution patterns with relatively greater potential adverse health effects than are Whites. The limited evidence on price disparities was inconclusive. PMID:18633097

The context for choice: health implications of targeted food and beverage marketing to African Americans.

PubMed

Grier, Sonya A; Kumanyika, Shiriki K

2008-09-01

Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions. We conducted a systematic review of studies published in June 1992 through 2006 (n = 20) that permitted comparison of food and beverage marketing to African Americans versus Whites and others. Eight studies reported on product promotions, 11 on retail food outlet locations, and 3 on food prices. Although the evidence base has limitations, studies indicated that African Americans are consistently exposed to food promotion and distribution patterns with relatively greater potential adverse health effects than are Whites. The limited evidence on price disparities was inconclusive.

African-American patients' preferences for a health center campaign promoting HIV testing: an exploratory study and future directions.

PubMed

Arya, Monisha; Kallen, Michael A; Street, Richard L; Viswanath, Kasisomayajula; Giordano, Thomas P

2014-01-01

In 2006, the US Centers for Disease Control and Prevention recommended routine HIV testing in health care settings and called for HIV testing campaigns targeting African Americans. In a 2011 national survey, 63% of African Americans wanted information on HIV testing. In our study, 176 African Americans were surveyed to determine channels and spokespersons for an HIV testing campaign. Among 9 media channels, the top 3 ranked as "very likely" to convince them to get HIV tested were television, poster, and brochure. Among 10 spokespersons, the top 3 were doctor, nurse, and "real person like me." The media are a cost-effective strategy to promote HIV prevention. Posters and brochures are inexpensive and easy to reproduce for clinical settings. Television campaigns may be feasible in clinics with closed-circuit televisions. Research is needed on campaign messages. An effective health center HIV testing campaign may help mitigate the disproportionate toll HIV is having on African Americans. © The Author(s) 2014.

The TG/HDL-C ratio does not predict insulin resistance in overweight women of African descent: a study of South African, African American and West African women.

PubMed

Knight, Michael G; Goedecke, Julia H; Ricks, Madia; Evans, Juliet; Levitt, Naomi S; Tulloch-Reid, Marshall K; Sumner, Anne E

2011-01-01

Women of African descent have a high prevalence of diseases caused by insulin resistance. To positively impact cardiometabolic health in Black women, effective screening tests for insulin resistance must be identified. Recently, the TG/HDL-C ratio has been recommended as a tool to predict insulin resistance in overweight people. While the ratio predicts insulin resistance in White women, it is ineffective in African American women. As there are no data for African women, we tested the ability of the TG/HDL-C ratio to predict insulin resistance in Black women from South Africa, West Africa and the United States. For comparison, the ratio was also tested in White women from South Africa. Participants were 801 women (157 Black South African, 382 African American, 119 West African, 143 White South African, age 36 +/- 9y [mean +/- SD]). Standardized scores were created from log-transformed homeostasis model assessment-insulin resistance values from each population. Participants in the upper third of their population distribution were classified as insulin-resistant. To predict insulin resistance by the TC/HDL-C ratio, area under the receiver operating characteristic (AUC-ROC) curve was used and criteria were: 0.50 for no discrimination and > or = 0.70 for acceptable. Seventy-one percent of the Black women were overweight vs 51% of White women (P<.01). In overweight White women, AUC-ROC curve for prediction of insulin resistance by TG/HDL-C was 0.76 +/- 0.06, but below the 0.70 threshold in each group of overweight Black women (Black South African: 0.64 +/- 0.06, African American: 0.66 +/- 0.03, and West African: 0.63 +/- 0.07). Therefore, TG/HDL-C does not predict insulin resistance in overweight African American women and this investigation extends that finding to overweight Black South African and West African women. Resources to identify effective markers of insulin resistance are needed to improve cardiometabolic health in women of African descent.

Positivity and indicators of health among African Americans with diabetes.

PubMed

Steinhardt, Mary A; Dubois, Susan K; Brown, Sharon A; Harrison, Louis; Dolphin, Kathryn E; Park, Wonil; Lehrer, H Matthew

2015-01-01

To examine the utility of the positivity ratio to distinguish differences in psychological and physiological health in African Americans with type 2 diabetes. Study participants (N = 93) were recruited through radio and church announcements and grouped by their positivity ratio. Multivariate analyses showed flourishing individuals had the highest resilience and lowest depressive symptoms and HbA1c (A1C), whereas depressed individuals recorded the lowest resilience and highest depressive symptoms and A1C. Small to large effect sizes were reported. Further support for the utility and generalizability of the positivity ratio was provided. Cultivating positive emotions may improve the health of individuals with type 2 diabetes.

Socioeconomic Status, Occupational Characteristics, and Sleep Duration in African/Caribbean Immigrants and US White Health Care Workers

PubMed Central

Ertel, Karen A.; Berkman, Lisa F.; Buxton, Orfeu M.

2011-01-01

Study Objectives: o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant–white difference in sleep duration. Design: Cross sectional Setting: Four extended care facilities in Massachusetts, United States Participants: 340 employees in extended care facilities Measurements and Results: Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: −81.0, −47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (−69.2, −32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (−57.8, −17.6). Conclusions: his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant–white difference in sleep duration in the United States, especially among health care workers. Citation: Ertel KA; Berkman LF; Buxton OM. Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immi grants and US white health care workers. SLEEP 2011; 34(4):509-518. PMID:21461330

The rise of the regulatory state in health care: a comparative analysis of The Netherlands, England and Italy.

PubMed

Helderman, Jan-Kees; Bevan, Gwyn; France, George

2012-01-01

In a relatively short time, regulation has become a significant and distinct feature of how modern states wish to govern and steer their economy and society. Whereas the former 'dirigiste' state used to be closely related to public ownership (e.g. hospitals), planning (volume and capacity planning) and centralised administration (e.g. fixed prices and budgets), the new regulatory state relies mainly on the instrument of regulation to achieve its objectives. In this paper, we wish to relate the rise of the 'regulatory state' to the path-dependent trajectories and institutional legacies of discrete European health-care systems. For this purpose, we compared the Dutch corporatist social health insurance system, the strongly centralised National Health Service (NHS) of England and federal regionalised NHS system of Italy. Comparing these three different health-care systems suggests that it is indeed possible to identify a general trend towards the rise of the regulatory state in health care in the last two decades. However, although the three countries examined in this paper face similar problems of multilevel governance of networks of third-party payers and providers, each system also gives rise to its own distinct regulatory challenges. © Cambridge University Press 2012

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context.

PubMed

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

PubMed Central

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

Reliability and Validity of Brief Measures of Oral Health-Related Knowledge, Fatalism, and Self-Efficacy in Mothers of African American Children

PubMed Central

Finlayson, Tracy L.; Siefert, Kristine; Ismail, Amid I.; Delva, Jorge; Sohn, Woosung

2006-01-01

Purpose Low-income African American children experience high rates of dental caries compared to the general population. Knowledgeable and efficacious caregivers can play an important role in caries prevention. This study developed and evaluated four brief measures reflecting mothers’ potentially modifiable cognitions associated with African American children’s oral health: (1) knowledge about appropriate bottle use (KBU); (2) children’s oral hygiene (KCOH); (3) oral health-related fatalism (OHF); and (4) oral health-related self-efficacy (OHSE). Methods Questions were selected based on reviews of the health promotion and oral health literature, with input from low income African American caregivers of young children. Reliability and validity were evaluated using survey and dental examination data from 719 low-income African American mothers and their children ages 1–5 years. Results Alpha reliabilities ranged from .76 – .91. KCOH was significantly associated with mothers’ oral health perceptions and children’s caries status. OHSE was significantly positively correlated with children’s brushing frequency and with mothers’ subjective perceptions of children’s oral health, which was in turn significantly associated with children’s caries status. Conclusions Results support the reliability and validity of the new measures. If confirmed by further research, these measures can be used to develop tailored educational and cognitive-behavioral interventions to reduce oral health disparities. PMID:16435644

Transformative Learning Intervention: Effect on Functional Health Literacy and Diabetes Knowledge in Older African Americans

ERIC Educational Resources Information Center

Ntiri, Daphne W.; Stewart, Merry

2009-01-01

This study evaluated the effect of a transformative learning (TL) intervention on functional health literacy and diabetes knowledge in older African Americans. Twenty participants from senior community centers completed a six-session intervention. The short-form Test of Functional Health Literacy in Adults (s-TOFHLA), Literacy Assessment for…

Functional disability and health-related quality of life in South Africans with early rheumatoid arthritis.

PubMed

Hodkinson, B; Musenge, E; Ally, M; Meyer, P W A; Anderson, R; Tikly, M

2012-10-01

The severity and predictors of functional disability and health-related quality of life (HRQoL) in a cohort of South Africans with early rheumatoid arthritis (RA) were investigated. Changes in the Health Assessment Questionnaire Disability Index (HAQ) and the 36-Item Short Form Health Survey (SF-36) following 12 months of traditional disease-modifying anti-rheumatic drugs (DMARDs) were studied in previously DMARD-naïve adults with disease duration ≤ 2 years. The majority of the 171 patients were female (82%), Black Africans (89%) with a mean (SD) symptom duration of 11.6 (7.0) months. In the 134 patients seen at 12 months, there were significant improvements in the HAQ and all domains of the SF-36 but 92 (69%) still had substantial functional disability (HAQ > 0.5) and 89 (66%) had suboptimal mental health [SF-36 mental composite score (MCS) < 66.6]. Multivariate analysis showed that female sex (p = 0.05) and high baseline HAQ score (p < 0.01) predicted substantial functional disability at 12 months. Unemployment (p = 0.03), high baseline pain (p = 0.02), and HAQ score (p = 0.04) predicted suboptimal mental health, with a trend towards a low level of schooling being significant (p = 0.08). Early RA has a broad impact on HRQoL in indigent South Africans, with a large proportion of patients still showing substantial functional disability and suboptimal mental health despite 12 months of DMARD therapy. Further research is needed to establish the role of interventions including psychosocial support, rehabilitation programmes, and biological therapy to improve physical function and HRQoL in this population.

Residential segregation, health behavior and overweight/obesity among a national sample of African American adults.

PubMed

Corral, Irma; Landrine, Hope; Hao, Yongping; Zhao, Luhua; Mellerson, Jenelle L; Cooper, Dexter L

2012-04-01

We examined the role of residential segregation in 5+ daily fruit/vegetable consumption, exercise, and overweight/obesity among African Americans by linking data on the 11,142 African American adults in the 2000 Behavioral Risk Factor Surveillance System to 2000 census data on the segregation of metropolitan statistical areas (MSAs). Multi-level modeling revealed that after controlling for individual-level variables, MSA Segregation and Poverty contributed to fruit/vegetable consumption, MSA Poverty alone contributed to exercise, and MSA Segregation alone contributed to overweight/obesity. These findings highlight the need for research on the built-environments of the segregated neighborhoods in which most African Americans reside, and suggest that neighborhood disparities may contribute to health disparities.

A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California.

PubMed

Knight, B G; Silverstein, M; McCallum, T J; Fox, L S

2000-05-01

A sociocultural stress and coping model to explain emotional distress among caregivers of family members who have dementia across ethnic and cultural groups is presented and explored in a sample of 41 African American and 128 non-African American caregivers. In this sample, African American caregivers reported lower levels of burden but equal levels of depression and anxiety. In the structural equation model, previous reports that African Americans' lower appraisal of caregiving as burdensome resulted in lower levels of emotional distress were confirmed. However, in this model, this pathway was counterbalanced by a tendency of African American caregivers to use emotion-focused coping and, therefore, increase emotional distress. African American caregivers were also younger and in poorer health, factors which tend to increase both burden and emotional distress outcomes. As suggested by the sociocultural stress and coping model, the influences of ethnic group variables on stress and coping processes are complex and multidirectional.

Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study.

PubMed

McCann, Terence V; Mugavin, Janette; Renzaho, Andre; Lubman, Dan I

2016-08-02

Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities. A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken. Themes and related sub-themes were abstracted from the data, reflecting the young people's, parents' and key community leaders' beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people's and parents' mental health literacy. Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers' cultural competency and perceived trustworthiness, and

Status of national health research systems in ten countries of the WHO African Region.

PubMed

Kirigia, Joses M; Wambebe, Charles

2006-10-19

The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that

Status of national health research systems in ten countries of the WHO African Region

PubMed Central

Kirigia, Joses M; Wambebe, Charles

2006-01-01

Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten

Legal and regulatory capacity to support the global health security agenda.

PubMed

Morhard, Ryan; Katz, Rebecca

2014-01-01

On February 13, 2014, 27 nations, along with 3 international organizations, launched the Global Health Security Agenda (GHSA). The intent of GHSA is to accelerate progress in enabling countries around the world to prevent, detect, and respond to public health emergencies-capacities to be achieved through 9 core objectives. Building national, regional, and international capacity includes creating strong legal and regulatory regimes to support national and international capacities to prevent, detect, and respond to public health emergencies. Accordingly, establishing and reinforcing international and national-level legal preparedness is central to advancing elements of each of the 9 objectives of the GHSA.

Health and Mental Health Policies' Role in Better Understanding and Closing African American-White American Disparities in Treatment Access and Quality of Care

ERIC Educational Resources Information Center

Snowden, Lonnie R.

2012-01-01

Since publication of the U.S. Surgeon General's report "Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General" (U.S. Department of Health and Human Services, 2001), several federal initiatives signal a sustained focus on addressing African American-White American disparities in mental health…

Using Photovoice to Understand Barriers to and Facilitators of Cardiovascular Health Among African American Adults and Adolescents, North Carolina, 2011-2012.

PubMed

Kowitt, Sarah; Woods-Jaeger, Briana; Lomas, Jesse; Taggart, Tamara; Thayer, Linden; Sutton, Sussie; Lightfoot, Alexandra F

2015-10-01

Cardiovascular disease is the leading cause of death in the United States, and mortality rates are higher among African Americans than among people of other races/ethnicities. We aimed to understand how African American adults and adolescents conceptualize cardiovascular health and perceive related barriers and facilitators. This qualitative study was conducted as formative research for a larger study, Heart Healthy Lenoir, which aimed to reduce cardiovascular disease disparities among African Americans in eastern North Carolina, part of the widely-known "stroke belt" that runs through the southeastern United States. Using photovoice, a community-based participatory research method, we conducted eight 90-minute photovoice sessions with 6 adults and 9 adolescents in Lenoir County, North Carolina. Topics for each discussion were selected by participants and reflected themes related to cardiovascular health promotion. All sessions were transcribed and coded using a data-driven, inductive approach. Participants conceptualized cardiovascular health to have mental, spiritual, and social health dimensions. Given these broad domains, participants acknowledged many ecological barriers to cardiovascular health; however, they also emphasized the importance of personal responsibility. Facilitators for cardiovascular health included using social health (eg, family/community relationships) and spiritual health dimensions (eg, understanding one's body and purpose) to improve health behaviors. The perspectives of African American adults and adolescents elicited through this formative research provided a strong foundation for Heart Healthy Lenoir's ongoing engagement of community members in Lenoir County and development and implementation of its intervention to prevent cardiovascular disease.

Nursing contributions to the elimination of health disparities among African-Americans: review and critique of a decade of research--Part III.

PubMed

Underwood, Sandra Millon; Buseh, Aaron G; Canales, Mary K; Powe, Barbara; Dockery, Brenda; Kather, Tiffany; Kent, Nicole

2005-12-01

The excessive burden of disease experienced by African-Americans has long been described by authorities in the public, private, and professional sector as a national health concern. Several reports have been published in the peer-reviewed literature that describe the outcomes of nurse-directed studies aimed at addressing the factors associated with the disparities experienced by African-Americans and these reports were also aimed toward the design of interventions to reduce and/or eliminate them. However, little is known about the scope, quality, and impact of these efforts relative to the promotion of health and the prevention of disease among African-American population groups. This report presents the results of a review, analysis, and critique of reports of outcomes of nursing research aimed toward reducing health-related disparities among African-Americans. These reports were described in a selected group of African-American nursing organizations and journals dedicated to providing a forum for the discussion of issues focused on cultural diversity, transcultural nursing, and multicultural health care issues. Included among the journals were the Journal of the National Black Nurses Association, the Journal of the Association of Black Nursing Faculty, the Journal of Chi Eta Phi Sorority, the Journal of Cultural Diversity, the Journal of Transcultural Nursing, and the Journal of Multicultural Nursing and Health. Results of the review will be reported in three parts. The first part was reported in an earlier edition (Journal of National Black Nurses Association, Volume 15, No. 1), the second part was reported in Volume 16, No 1, of the Journal of National Black Nurses Association, and the third part is reported here. The results of this critique revealed that this body of nursing research provides the profession with a broad base of knowledge and insights. This knowledge is relative to the individual and familial impact of cardiovascular disease, cancer, diabetes

Intimate partner violence and mental health symptoms in African American female ED patients.

PubMed

Houry, Debra; Kemball, Robin; Rhodes, Karin V; Kaslow, Nadine J

2006-07-01

Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n=461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms.

Role of mobile phone technology in health education in Asian and African countries: a systematic review.

PubMed

Sahu, Madhusmita; Grover, Ashoo; Joshi, Ashish

2014-01-01

The objective of this systematic review was to explore the role of mobile phone technologies in delivering health education programs in Asian and African countries. The search engine used was Pubmed during 2008-2011. Randomised controlled trials or controlled studies that improved health outcomes through delivery of health educational interventions using cell phone or text messaging were included in the review. Results showed studies from six Asian and African countries including Philippines, China, Kenya, South Korea, Taiwan and India. Mobile phone technology has shown to improve health outcomes for chronic disease conditions such as diabetes, heart disease and hypertension. Additional conditions include obesity and cardiopulmonary resuscitation guidance. Other studies have shown improvement in self management of breast cancer and post-hospitalisation HIV and pharmaceutical care. Overall results of the present review showed that mobile phone technologies can be a possible solution to improve healthcare outcome.

Health Disparities and Triple-Negative Breast Cancer in African American Women: A Review.

PubMed

Newman, Lisa A; Kaljee, Linda M

2017-05-01

Variation in cancer incidence and outcome has well-documented correlations with racial/ethnic identity. In the United States, the possible genetic and ancestral hereditary explanations for these associations are confounded by socioeconomic, cultural, and lifestyle patterns. Differences in the breast cancer burden of African American compared with European/white American women represent one of the most notable examples of disparities in oncology related to racial/ethnic identity. Elucidating the source of these associations is imperative in achieving the promise of the national Precision Medicine Initiative. Population-based breast cancer mortality rates have been higher for African American compared with white American women since the early 1980s, largely reflecting declines in mortality that have been disproportionately experienced among white American patients and at least partly explained by the advent of endocrine therapy that is less effective in African American women because of the higher prevalence of estrogen receptor-negative disease. The increased risk of triple-negative breast cancer in African American women as well as western, sub-Saharan African women compared with white American, European, and east African women furthermore suggests that selected genetic components of geographically defined African ancestry are associated with hereditary susceptibility for specific patterns of mammary carcinogenesis. Disentangling health care access barriers, as well as reproductive, lifestyle, and dietary factors from genetic contributions to breast cancer disparities remains challenging. Epigenetics and experiences of societal inequality (allostatic load) increase the complexity of studying breast cancer risk related to racial/ethnic identity. Oncologic anthropology represents a transdisciplinary field of research that can combine the expertise of population geneticists, multispecialty oncologists, molecular epidemiologists, and behavioral scientists to eliminate

Exploring African-American and Latino Teens' Perceptions of Contraception and Access to Reproductive Health Care Services.

PubMed

Galloway, Charlotte T; Duffy, Jennifer L; Dixon, Rena P; Fuller, Taleria R

2017-03-01

Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens' 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants' comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Ensuring that teens' beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking among African American Boys

ERIC Educational Resources Information Center

Lindsey, Michael A.; Joe, Sean; Nebbitt, Von

2010-01-01

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to…

How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

PubMed

Lin, Chia-Yen; Yeh, Wei-Ju

2017-12-04

The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad's regulatory focus is promotion focus, viewers' attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents' regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW.

Family-Level Factors and African American Children's Behavioral Health Outcomes: A Systematic Review

ERIC Educational Resources Information Center

Washington, Tyreasa; Rose, Theda; Colombo, Gia; Hong, Jun Sung; Coard, Stephanie Irby

2015-01-01

Background: Considerable prior research targeting African American children has focused on the pervasiveness of problematic behavior and negative risk factors associated with their development, however the influence of family on better behavioral health outcomes has largely been ignored. Objective: The purpose of this review is to examine…

Rhythm experience and Africana culture trial (REACT!): A culturally salient intervention to promote neurocognitive health, mood, and well-being in older African Americans

PubMed Central

Lukach, Alexis J.; Jedrziewski, M. Kathryn; Grove, George A.; Mechanic-Hamilton, Dawn J.; Williams, Shardae S.; Wollam, Mariegold E.; Erickson, Kirk I.

2017-01-01

The Rhythm Experience and Africana Culture Trial (REACT!) is a multi-site randomized controlled intervention study designed to examine the efficacy of using African Dance as a form of moderate-intensity physical activity to improve cognitive function in older African Americans. African Americans are almost two times more likely than Caucasians to experience cognitive impairment in late adulthood. This increased risk may be attributed to lower level and quality of education, lower socioeconomic status, and higher prevalence of vascular diseases, type 2 diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. Fortunately, interventions targeting cardiovascular health (i.e., physical activity) are associated with improved neurocognitive function and a reduced risk for dementia, so African Americans may be particularly suited for interventions targeting cardiovascular health and cognitive function. Here, we describe a randomized intervention protocol for increasing physical activity in older (65–75 years) African Americans. Participants (n = 80) at two study locations will be randomized into one of two groups. The treatment group will participate in African Dance three times per week for six months and the control group will receive educational training on Africana history and culture, as well as information about health behaviors, three times per week for six months. If successful, the REACT! study may transform community interventions and serve as a platform and model for testing other populations, age groups, and health outcomes, potentially identifying novel and creative methods for reducing or eliminating health disparities. PMID:27033674

Lung cancer disparities and African-Americans.

PubMed

Sin, Mo-Kyung

2017-07-01

African-Americans, as historically disadvantaged minorities, have more advanced stages of cancer when diagnosed, lower survival rates, and lower rates of accessing timely care than do Caucasians. Lung cancer incidence and mortality, in particular, are high among African-Americans. The U.S. Preventive Services Task Force recently released an evidence-based lung cancer screening technology called low-dose computerized tomography. High-risk African-Americans might benefit greatly from such screening but not many are aware of this technology. Public health nurses can play a key role in increasing awareness of the technology among African-American communities and encouraging qualified African-Americans to obtain screening. This study discusses issues with lung cancer and smoking among African-Americans, a recently released evidence-based lung cancer screening technology, and implications for public health nurses to enhance uptake of the new screening technology among high-risk African-Americans. © 2017 Wiley Periodicals, Inc.

African American Children and Mental Health. Child Psychology and Mental Health

ERIC Educational Resources Information Center

Hill, Nancy E., Ed.; Mann, Tammy L., Ed.; Fitzgerald, Hiram E., Ed.

2011-01-01

This groundbreaking two-volume set examines the psychological, social, physical, and environmental factors that undermine or support healthy development in African American children while considering economic, historical, and public policies. African American children are at the highest risk for becoming school dropouts, for academic disengagement…

Debate on GMOs health risks after statistical findings in regulatory tests.

PubMed

de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

2010-10-05

We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries.

Debate on GMOs Health Risks after Statistical Findings in Regulatory Tests

PubMed Central

de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

2010-01-01

We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries. PMID:20941377

Self-rated health appraisal as cultural and identity process: African American elders' health and evaluative rationales.

PubMed

McMullen, Carmit K; Luborsky, Mark R

2006-08-01

We explored self-rated health by using a meaning-centered theoretical foundation. Self-appraisals, such as self-rated health, reflect a cultural process of identity formation, whereby identities are multiple, simultaneously individual and collective, and produced by specific historical formations. Anthropological research in Philadelphia determined (a) how African American elders appraise their health, and (b) how health evaluations reflect cultural and historical experiences within a community. We interviewed and observed 35 adults aged 65 to 80, stratified by gender and self-rated health. We validated theme analysis of focused interview questions against the larger data set of field notes and transcripts. Health appraisal reflected a complex process of adaptation and identity. Criteria for health included: independent functioning, physical condition, control and responsibility for health, and overall feeling. Evaluative rationales that shaped health appraisals were comparisons, restricted possibilities for self-evaluation, and ways of handling adversity. Evaluative rationales mitigated undesirable health identities (including low self-reported health) and provided mechanisms for claiming desired health identities despite adversity. Describing the criteria and evaluative rationales underlying self-appraisals of health extends current understandings of self-rated health and illustrates the sociohistorical context of individual assessments of well-being.

Social integration and health insurance status among African American men and women.

PubMed

Williams, Beverly Rosa; Wang, Min Qi; Holt, Cheryl L; Schulz, Emily; Clark, Eddie M

2015-01-01

Using 2010 national data, we investigate the relationship between social integration and health insurance for African American adults. During the previous year 21.6% of men and 19.8% of women lacked continuous health insurance. The effect of marital status, income, and employment on insurance coverage differed by age and gender. Additionally, frequency of church attendance was positively associated with continuous health insurance for women aged 51-64. Spiritual/religious identity was marginally associated with insurance status for men aged 36-50. As provisions of the Affordable Care Act take effect, implementation programs should expand enrollment efforts to include the conjugal unit and the church.

The Role of Game Based Learning in the Health Literacy of African American Adolescent Males

NASA Technical Reports Server (NTRS)

Connell, Judith; Knight, Margaret

2012-01-01

Twenty-first century literacy is more than being able to encode for spelling ability, decode for reading comprehension, and calculate for numeric reasoning. It demands the skills to negotiate the world of technology. Health literacy is lower than general literacy, and general literacy is lower among African American males than the overall population. The authors discuss the prospects of incorporating Game Based Learning approaches into strategies for teaching health literacy. Results of a survey administered to youth to determine their level of involvement in video game playing indicate that key elements must be in place to ensure that a game will be played. These include action, strategy, and entertainment. Future investigation will examine the knowledge level of African American adolescent males of the nexus of certain concepts of climate change and health literacy. Climate change has significant implications for human health. This understanding will produce a scientifically based foundation for curricular and instructional decisions that include GBL. Results of this study will be used to design a video game concept and will contribute to the body of knowledge concerning environmental justice and empower individuals to make informed decisions about their own health and those they influence.

Understanding global health and development partnerships: Perspectives from African and global health system professionals.

PubMed

Barnes, Amy; Brown, Garrett W; Harman, Sophie

2016-06-01

Partnership is a key idea in current debates about global health and development assistance, yet little is known about what partnership means to those who are responsible for operationalising it or how it is experienced in practice. This is particularly the case in the context of African health systems. This paper explores how health professionals working in global health hubs and the health systems of South Africa, Tanzania and Zambia understand and experience partnership. Drawing on semi-structured interviews with 101 professionals based in each country, Washington DC and Geneva between October 2012 and June 2013, the paper makes four key arguments. First, partnership has a legitimating function in global health policy processes for international development institutions, government agencies and civil society organisations alike. Second, the practice of partnership generates idiosyncratic and complicated relationships that health professionals have to manage and navigate, often informally. Third, partnership is shaped by historical legacies, critical events, and independent consultants. Fourth, despite being an accepted part of global health policy, there is little shared understanding of what good partnership is meant to include or resemble in practice. Knowing more about the specific socio-cultural and political dynamics of partnership in different health system contexts is critical to equip health professionals with the skills to build the informal relations that are essential to effective partnership engagement. Copyright © 2016 Elsevier Ltd. All rights reserved.

How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?

PubMed Central

Lin, Chia-Yen; Yeh, Wei-Ju

2017-01-01

The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad’s regulatory focus is promotion focus, viewers’ attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents’ regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW. PMID:29207544

Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol.

PubMed

Watkins, David A; Tulloch, Nathaniel L; Anderson, Molly E; Barnhart, Scott; Steyn, Krisela; Levitt, Naomi S

2016-04-16

People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the current patterns of care delivery and the major barriers and facilitators to health care. We present a systematic review protocol to synthesize studies of healthcare delivery for an important subset of NCDs, cardiovascular and metabolic diseases (CMDs), among African PLHIV. We plan to search electronic databases and reference lists of relevant studies published in African settings from January 2003 to the present. Studies will be considered if they address one or both of our major objectives and focus on health care for one or more of six interrelated CMDs (ischemic heart disease, stroke, heart failure, hypertension, diabetes, and hyperlipidemia) in PLHIV. Our first objective will be to estimate proportions of CMD patients along the "cascade of care"-i.e., screened, diagnosed, aware of the diagnosis, initiated on treatment, adherent to treatment, and with controlled disease. Our second objective will be to identify unique barriers and facilitators to health care faced by PLHIV in African countries. For studies deemed eligible for inclusion, we will assess study quality and risk of bias using previously published criteria. We will extract study data using standardized instruments. We will meta-analyze quantitative data at each level of the cascade of care for each CMD (first objective). We will use meta-synthesis techniques to understand and integrate qualitative data on health-related behaviors (second objective). CMDs and other NCDs are becoming major health concerns for African PLHIV. The

Help-Seeking Attitudes among African American College Students

ERIC Educational Resources Information Center

So, Dominicus W.; Gilbert, Stefanie; Romero, Sergio

2005-01-01

Traditionally, African American students display a low-rate of seeking mental health treatment. Issues such as mistrust of White therapists, attitudes toward mental health problems, and African American spirituality affect their help-seeking behavior. The present study examined a sample of 134 African American students at a Historically Black…

"You Have to Approach Us Right": A Qualitative Framework Analysis for Recruiting African Americans into mHealth Research

ERIC Educational Resources Information Center

James, Delores C. S.; Harville, Cedric, II; Efunbumi, Orisatalabi; Babazadeh, Ida; Ali, Sheriza

2017-01-01

Background: Despite the high ownership of smartphones, African Americans (AAs) remain underrepresented in health research and specifically mobile health (mHealth) research. This may be due to ineffective recruitment efforts. Purpose: To explore strategies for recruiting AAs into mHealth research and examine how these strategies may vary by gender…

Exploring African-American and Latino Teens’ Perceptions of Contraception and Access to Reproductive Health Care Services

PubMed Central

Galloway, Charlotte T.; Duffy, Jennifer L.; Dixon, Rena P.; Fuller, Taleria R.

2017-01-01

Purpose Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens’ 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. Methods As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Results Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants’ comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Conclusions Ensuring that teens’ beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. PMID:28235437

African Americans and Mathematics Outcomes on National Assessment of Educational Progress: Parental and Individual Influences

ERIC Educational Resources Information Center

Noble, Richard, III; Morton, Crystal Hill

2013-01-01

This study investigated within group differences between African American female and male students who participated in the 2009 National Assessment of Educational Progress mathematics assessment. Using results from participating states, we compare average scale scores of African American students based on home regulatory environment and interest…

Mapping South African allied health primary care clinical guideline activity: establishing a stakeholder reference sample.

PubMed

Dizon, Janine Margarita; Grimmer, Karen; Machingaidze, Shingai; McLaren, Pam; Louw, Quinette

2016-10-10

Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant. South African government websites were searched for structures of departments and portfolios, and available CPGs. Professional AH association websites were searched for CPGs, purposively-identified key informants were interviewed, and CPGs previously identified for priority South African primary care conditions were critiqued for AH therapy involvement. Key informants described potentially complex relationships between players who may be engaged in South African AH CPGs, in both public and private sectors. There were disability/rehabilitation portfolios at national and provincial governments, but no uniformity in provincial government organisation of, or support for, PHC AH services. There were no AH primary care therapy CPGs on government websites, although there was 'clinical guidance' in various forms on professional association websites. Only two CPGs of priority South African PHC conditions included mention of any AH therapy (physiotherapy for adult asthma and chronic obstructive pulmonary disease). A comprehensive and wide-reaching stakeholder reference framework would be required in order to capture the heterogeneity of AH primary care CPG activity in South Africa. This should involve the voices of national and purposively-selected provincial governments, academic institutions, consultants, public sector managers and clinicians, private practitioners, professional associations, and private sector

Rhythm experience and Africana culture trial (REACT!): A culturally salient intervention to promote neurocognitive health, mood, and well-being in older African Americans.

PubMed

Lukach, Alexis J; Jedrziewski, M Kathryn; Grove, George A; Mechanic-Hamilton, Dawn J; Williams, Shardae S; Wollam, Mariegold E; Erickson, Kirk I

2016-05-01

The Rhythm Experience and Africana Culture Trial (REACT!) is a multi-site randomized controlled intervention study designed to examine the efficacy of using African Dance as a form of moderate-intensity physical activity to improve cognitive function in older African Americans. African Americans are almost two times more likely than Caucasians to experience cognitive impairment in late adulthood. This increased risk may be attributed to lower level and quality of education, lower socioeconomic status, and higher prevalence of vascular diseases, type 2 diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. Fortunately, interventions targeting cardiovascular health (i.e., physical activity) are associated with improved neurocognitive function and a reduced risk for dementia, so African Americans may be particularly suited for interventions targeting cardiovascular health and cognitive function. Here, we describe a randomized intervention protocol for increasing physical activity in older (65-75years) African Americans. Participants (n=80) at two study locations will be randomized into one of two groups. The treatment group will participate in African Dance three times per week for six months and the control group will receive educational training on Africana history and culture, as well as information about health behaviors, three times per week for six months. If successful, the REACT! study may transform community interventions and serve as a platform and model for testing other populations, age groups, and health outcomes, potentially identifying novel and creative methods for reducing or eliminating health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

Multiple health risk perception and information processing among African Americans and whites living in poverty.

PubMed

Hovick, Shelly R; Freimuth, Vicki S; Johnson-Turbes, Ashani; Chervin, Doryn D

2011-11-01

We investigated the risk-information-processing behaviors of people living at or near the poverty line. Because significant gaps in health and communication exist among high- and low-income groups, increasing the information seeking and knowledge of poor individuals may help them better understand risks to their health and increase their engagement in health-protective behaviors. Most earlier studies assessed only a single health risk selected by the researcher, whereas we listed 10 health risks and allowed the respondents to identify the one that they worried about most but took little action to prevent. Using this risk, we tested one pathway inspired by the risk information seeking and processing model to examine predictors of information insufficiency and of systematic processing and extended this pathway to include health-protective action. A phone survey was conducted of African Americans and whites living in the southern United States with an annual income of ≤$35,000 (N= 431). The results supported the model pathway: worry partially mediated the relationship between perceived risk and information insufficiency, which, in turn, increased systematic processing. In addition, systematic processing increased health-protective action. Compared with whites and better educated respondents, African Americans and respondents with little education had significantly higher levels of information insufficiency but higher levels of systematic processing and health-protective action. That systematic processing and knowledge influenced health behavior suggests a potential strategy for reducing health disparities. © 2011 Society for Risk Analysis.

Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

PubMed Central

2012-01-01

A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions. PMID:22838941

Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent.

PubMed

Nwaka, Solomon; Ochem, Alexander; Besson, Dominique; Ramirez, Bernadette; Fakorede, Foluke; Botros, Sanaa; Inyang, Uford; Mgone, Charles; Adae-Mensah, Ivan; Konde, Victor; Nyasse, Barthelemy; Okole, Blessed; Guantai, Anastasia; Loots, Glaudina; Atadja, Peter; Ndumbe, Peter; Sanou, Issa; Olesen, Ole; Ridley, Robert; Ilunga, Tshinko

2012-07-27

A pool of 38 pan-African Centres of Excellence (CoEs) in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI), through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i) it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii) it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii) it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions.

Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions' participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. © The Royal Society of Medicine.

Research and its governance in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey

PubMed Central

Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-01-01

Summary Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions’ participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. PMID:24914129

Projections of 21st Century African Climate: Implications for African Savanna Fire Dynamics, Human Health and Food Security

NASA Astrophysics Data System (ADS)

Adegoke, J. O.

2015-12-01

Fire is a key agent of change in the African savannas, which are shaped through the complex interactions between trees, C4 grasses, rainfall, temperature, CO2 and fire. These fires and their emitted smoke can have numerous direct and indirect effects on the environment, water resources, air quality, and climate. For instance, veld fires in southern Africa cause large financial losses to agriculture, livestock production and forestry on an annual basis. This study contributes to our understanding of the implications of projected surface temperature evolution in Africa for fire risk, human health and agriculture over the coming decades. We use an ensemble of high-resolution regional climate model simulations of African climate for the 21st century. Regional dowscalings and recent global circulation model projections obtained for Africa indicate that African temperatures are likely to rise at 1.5 times the global rate of temperature increase in the tropics, and at almost twice the global rate of increase in the subtropics. Warming is projected to occur during the 21st century, with increases of 4-6 °C over the subtropics and 3-5 °C over the tropics plausible by the end of the century relative to present-day climate under the A2 (low mitigation) scenario. We explore the significance of the projected warming by documenting increases in projected high fire danger days and heat-wave days. General drying is projected across the continent, even for areas (e.g. tropical Africa) where an increase in rainfall is plausible. This is due to the drastic increases in temperature that are projected, which leads to drier soils (through enhanced evaporation) despite the rainfall increases. This will likely impact negatively on crop yield, particularly on the maize crop that is of crucial importance in terms of African food security.

Neighborhood characteristics and mental health among African Americans and whites living in a racially integrated urban community.

PubMed

Gary, Tiffany L; Stark, Sarah A; LaVeist, Thomas A

2007-06-01

Aspects of the environment in which one lives are increasingly being recognized as major contributors to health, yet few empirical studies have focused on mental health. Therefore, we sought to determine if neighborhood characteristics were associated with mental health outcomes among 1408 African-American (59.3%) and white (40.7%) adults living in a socio-economically homogeneous, racially integrated, urban community in Baltimore, MD. Among African Americans and whites, the perception of severe problems in the community was associated with higher levels of stress (approximately 1.8 units higher), anxiety (approximately 1.8 units higher), and depression (OR= approximately 2.0) compared to those who perceived no or few problems (all p<0.05). Community cohesion, the perception that people generally work together, was associated with better mental health among whites only. These findings give further insight into the complex environment of inner-city communities.

Outreach Strategies to Recruit Low-Income African American Men to Participate in Health Promotion Programs and Research: Lessons From the Men of Color Health Awareness (MOCHA) Project.

PubMed

Graham, Louis F; Scott, Lamont; Lopeyok, Erus; Douglas, Henry; Gubrium, Aline; Buchanan, David

2018-04-01

African American men continue to bear a disproportionate share of the burden of disease. Engaging these men in health research and health promotion programs-especially lower-income, African American men who are vulnerable to chronic disease conditions such as obesity and heart disease-has historically proven quite difficult for researchers and public health practitioners. The few effective outreach strategies identified in the literature to date are largely limited to recruiting through hospital clinics, churches, and barbershops. The Men of Color Health Awareness (MOCHA) project is a grassroots, community-driven initiative that has developed a number of innovative outreach strategies. After describing these strategies, we present data on the demographic and health characteristics of the population reached using these methods, which indicate that MOCHA has been highly effective in reaching this population of men.

Achieving Broad Participation in Congregational Health Surveys at African American and Latino Churches

ERIC Educational Resources Information Center

Hawes-Dawson, Jennifer; Derose, Kathryn P.; Aunon, Frances M.; Dominguez, Blanca X.; Felton, Alexandria; Mata, Michael A.; Oden, Clyde W.; Paffen, Sandra

2017-01-01

Congregation-based health program evaluations often rely on surveys, but little documentation is available regarding specific methods and challenges. Here we describe methods used to achieve acceptable response rates (73-79%) in a survey of HIV-related attitudes and behaviors in two African American and three Latino churches in high HIV-prevalence…

Groundwater recharge with reclaimed municipal wastewater: health and regulatory considerations.

PubMed

Asano, Takashi; Cotruvo, Joseph A

2004-04-01

Groundwater recharge with reclaimed municipal wastewater presents a wide spectrum of technical and health challenges that must be carefully evaluated prior to undertaking a project. This review will provide a discussion of groundwater recharge and its management with special reference to health and regulatory aspects of groundwater recharge with reclaimed municipal wastewater. At present, some uncertainties with respect to health risk considerations have limited expanding use of reclaimed municipal wastewater for groundwater recharge, especially when a large portion of the groundwater contains reclaimed wastewater that may affect the domestic water supply. The proposed State of California criteria for groundwater recharge are discussed as an illustration of a cautious approach. In addition, a summary is provided of the methodology used in developing the World Health Organization's Guidelines for Drinking Water Quality to illustrate how numerical guideline values are generated for contaminants that may be applicable to groundwater recharge.

Longitudinal associations between social support and physical and mental health in African American adults

USDA-ARS?s Scientific Manuscript database

African Americans report a greater number of modifiable risk factors, such as overweight/obesity, physical inactivity and poor dietary habits, putting them at increased risk of developing and dying from chronic diseases. These risk factors are also associated with poorer health-related quality of li...

Oral health of Rhodesia African first year student teachers.

PubMed

Ritchie, J

1979-08-01

A basic oral health survey was carried out on a random sample of first year African student teachers attending four teachers' colleges in Rhodesia. The number examined and interviewed was 309. Methods and criteria used are those described in the second (1977) edition of the World Health Organization manual Oral health surveys - Basic methods. Prevalences of dental caries were 31.0% for the 142 male students and 59.5% for the 167 female students. The difference is statistically significant (P less than 0.001). Mean DMFTs were 0.74 for men and 2.02 for women. The prevalences of "intense gingivitis" were 52.8% for male students and 34.7% for female students. This difference also is significant (P less than 0.005). The major treatment requirements are for one-surface fillings and prophylaxis with oral hygiene instruction. Dental service utilization is low. Less than 10% of the sample had obtained dental care in the previous 12 months. The main reason for seeking care was pain. Self-assessments of oral health needs were not valid. The stated desire for fillings is greater than for extractions. A need has been demonstrated for dental health education aimed at the prevention of disease and the encouragement, use and demand for quality care services.

Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

PubMed

Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O

2017-09-01

Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women from one southern state.

PubMed

Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B

2013-09-01

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included.

Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immigrants and US White health care workers.

PubMed

Ertel, Karen A; Berkman, Lisa F; Buxton, Orfeu M

2011-04-01

o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant-white difference in sleep duration. Cross sectional Four extended care facilities in Massachusetts, United States 340 employees in extended care facilities Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: -81.0, -47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (-69.2, -32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (-57.8, -17.6). his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant-white difference in sleep duration in the United States, especially among health care workers.

Fine-mapping and initial characterization of QT interval loci in African Americans.

PubMed

Avery, Christy L; Sethupathy, Praveen; Buyske, Steven; He, Qianchuan; Lin, Dan-Yu; Arking, Dan E; Carty, Cara L; Duggan, David; Fesinmeyer, Megan D; Hindorff, Lucia A; Jeff, Janina M; Klein, Liviu; Patton, Kristen K; Peters, Ulrike; Shohet, Ralph V; Sotoodehnia, Nona; Young, Alicia M; Kooperberg, Charles; Haiman, Christopher A; Mohlke, Karen L; Whitsel, Eric A; North, Kari E

2012-01-01

The QT interval (QT) is heritable and its prolongation is a risk factor for ventricular tachyarrhythmias and sudden death. Most genetic studies of QT have examined European ancestral populations; however, the increased genetic diversity in African Americans provides opportunities to narrow association signals and identify population-specific variants. We therefore evaluated 6,670 SNPs spanning eleven previously identified QT loci in 8,644 African American participants from two Population Architecture using Genomics and Epidemiology (PAGE) studies: the Atherosclerosis Risk in Communities study and Women's Health Initiative Clinical Trial. Of the fifteen known independent QT variants at the eleven previously identified loci, six were significantly associated with QT in African American populations (P≤1.20×10(-4)): ATP1B1, PLN1, KCNQ1, NDRG4, and two NOS1AP independent signals. We also identified three population-specific signals significantly associated with QT in African Americans (P≤1.37×10(-5)): one at NOS1AP and two at ATP1B1. Linkage disequilibrium (LD) patterns in African Americans assisted in narrowing the region likely to contain the functional variants for several loci. For example, African American LD patterns showed that 0 SNPs were in LD with NOS1AP signal rs12143842, compared with European LD patterns that indicated 87 SNPs, which spanned 114.2 Kb, were in LD with rs12143842. Finally, bioinformatic-based characterization of the nine African American signals pointed to functional candidates located exclusively within non-coding regions, including predicted binding sites for transcription factors such as TBX5, which has been implicated in cardiac structure and conductance. In this detailed evaluation of QT loci, we identified several African Americans SNPs that better define the association with QT and successfully narrowed intervals surrounding established loci. These results demonstrate that the same loci influence variation in QT across multiple

Fine-Mapping and Initial Characterization of QT Interval Loci in African Americans

PubMed Central

Avery, Christy L.; Sethupathy, Praveen; Buyske, Steven; He, Qianchuan; Lin, Dan-Yu; Arking, Dan E.; Carty, Cara L.; Duggan, David; Fesinmeyer, Megan D.; Hindorff, Lucia A.; Jeff, Janina M.; Klein, Liviu; Patton, Kristen K.; Peters, Ulrike; Shohet, Ralph V.; Sotoodehnia, Nona; Young, Alicia M.; Kooperberg, Charles; Haiman, Christopher A.; Mohlke, Karen L.; Whitsel, Eric A.; North, Kari E.

2012-01-01

The QT interval (QT) is heritable and its prolongation is a risk factor for ventricular tachyarrhythmias and sudden death. Most genetic studies of QT have examined European ancestral populations; however, the increased genetic diversity in African Americans provides opportunities to narrow association signals and identify population-specific variants. We therefore evaluated 6,670 SNPs spanning eleven previously identified QT loci in 8,644 African American participants from two Population Architecture using Genomics and Epidemiology (PAGE) studies: the Atherosclerosis Risk in Communities study and Women's Health Initiative Clinical Trial. Of the fifteen known independent QT variants at the eleven previously identified loci, six were significantly associated with QT in African American populations (P≤1.20×10−4): ATP1B1, PLN1, KCNQ1, NDRG4, and two NOS1AP independent signals. We also identified three population-specific signals significantly associated with QT in African Americans (P≤1.37×10−5): one at NOS1AP and two at ATP1B1. Linkage disequilibrium (LD) patterns in African Americans assisted in narrowing the region likely to contain the functional variants for several loci. For example, African American LD patterns showed that 0 SNPs were in LD with NOS1AP signal rs12143842, compared with European LD patterns that indicated 87 SNPs, which spanned 114.2 Kb, were in LD with rs12143842. Finally, bioinformatic-based characterization of the nine African American signals pointed to functional candidates located exclusively within non-coding regions, including predicted binding sites for transcription factors such as TBX5, which has been implicated in cardiac structure and conductance. In this detailed evaluation of QT loci, we identified several African Americans SNPs that better define the association with QT and successfully narrowed intervals surrounding established loci. These results demonstrate that the same loci influence variation in QT across multiple

The public health effects of water and sanitation in selected West African countries.

PubMed

Alagidede, P; Alagidede, A N

2016-01-01

This paper examines access to water and improved sanitation target under the Millennium Development Goal 7c (MDG 7c) for six West African countries: Chad, Niger, Nigeria, Mauritania, Sierra Leone and Togo. The article outlines some possible causes for the slow progress in achieving the MDG 7c, examines the public health effects of missing the targets, and charts paths for policy makers to consider in bringing these targets to acceptable levels. The study is based on secondary data analysis of trends in water and sanitation indicators for the six countries from 2000 to 2014. The data are drawn from the World Development Indicators (WDI) of the World Bank, and the World Health Organisation Joint Monitoring Programme (WHO JMP) and WaterAid Africa Wash Map. The performance of each country in the two indicators is presented and judged against the target set under MDG 7c. Forecasts based on the expiry of the MDG's in 2015 and the time required to achieve the targets are carried out. The study showes that while some progress has been made in improved water, sanitation showed slow progress for all the countries between 2000 and 2014. The goal of attaining acceptable sanitation shows that the six West African countries have lagged behind the MDG 7c target and the progress is equally slow. At the current rate of progress if strong public and private sector intervention mechanisms are not instituted across the board, the six West African countries under study would continue to lag behind the rest of the world in terms of access to improved water and sanitation. This has consequences for poverty alleviation and the risk of the re-emergence of neglected tropical diseases. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Powerlessness, destiny, and control: the influence on health behaviors of African Americans.

PubMed

Green, B Lee; Lewis, Rhonda K; Wang, Min Qi; Person, Sharina; Rivers, Brian

2004-02-01

This study assessed the extent to which a belief in fate or destiny might explain certain health behaviors among African Americans. A survey of 1,253 African Americans in Alabama churches was conducted. Fifty-nine percent of the total sample indicated that they believe in fate or destiny. The findings of this study suggest that fate/destiny may influence health decisions. The study found a statistically significant difference between men and women regarding their belief in fate or destiny. Women reported believing in fate and destiny more than men. Surprisingly people with more education (i.e., college or postgraduate) believed in fate and destiny significantly more than high school dropouts and high school graduates. A belief in fate or destiny also varied by income level. Respondents who made more in annual income were more likely to believe in fate and destiny than people who made less. One behavior, breast exam had a statistically significant association with a belief in fate and destiny. Women who reported never having a breast exam were more likely to believe in fate and destiny than women who did not have a belief in fate or destiny. These findings highlight the need for practitioners to examine more closely the definition of fate and destiny and determine how this belief influences or does not influence health behaviors as once believed. The research suggests a closer examination of the role culture plays in health decision making which may be independent of a belief in fate and destiny.

Assessing the role of regulatory bodies in managing health professional issues and errors in Europe.

PubMed

Risso-Gill, Isabelle; Legido-Quigley, H; Panteli, D; Mckee, M

2014-08-01

This paper explores how medical regulatory bodies in nine European countries manage professional issues involving quality and patient safety, to build on limited existing information on procedures for regulating medical professionals in Europe. Twelve vignettes describing scenarios of concerns about standards of physicians were developed, covering clinical, criminal and administrative matters. Medical regulatory bodies in nine European countries were asked what action they would normally take in each situation. Their responses were related to their regulatory mandate. Responses varied greatly across participating countries. Regulators are always involved where patients are at risk or where a criminal offence is committed within the clinical setting. Non-criminal medical issues were generally handled by the employer, if any, at their discretion. Countries varied in the use of punitive measures, the extent to which they took an interest in issues arising outside professional activities, and whether they dealt with issues themselves or referred cases to another regulatory authority or took no action at all. There is little consistency across Europe on the regulation of medical professionals. There is considerable diversity in the range of topics that regulatory bodies oversee, with almost all covering health care quality and safety and others encompassing issues related to reputation, respect and trust. These inconsistencies have significant implications for professional mobility, patient safety and quality of care. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

What Makes African American Health Disparities Newsworthy? An Experiment among Journalists about Story Framing

ERIC Educational Resources Information Center

Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.

2011-01-01

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C "et al." Unintended…

South African HIV self-testing policy and guidance considerations

PubMed Central

Jankelowitz, Lauren; Adams, Siraaj; Msimanga, Busisiwe R.; Nevhutalu, Zwoitwaho; Rhagnath, Naleni; Shroufi, Amir; Devillé, Walter; Kazangarare, Victoria; van der Wiel, Renee; Templeman, Hugo; Conradie, Francesca; Chidarikire, Thato; Gray, Andy

2017-01-01

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education. PMID:29568643

South African HIV self-testing policy and guidance considerations.

PubMed

Venter, Francois; Majam, Mohammed; Jankelowitz, Lauren; Adams, Siraaj; Moorhouse, Michelle; Carmona, Sergio; Stevens, Wendy; Msimanga, Busisiwe R; Allen, David; Balani, Pooja; Nevhutalu, Zwoitwaho; Rhagnath, Naleni; Shroufi, Amir; Devillé, Walter; Kazangarare, Victoria; van der Wiel, Renee; Templeman, Hugo; Puren, Adrian; Tucker, Tim; van Cutsem, Gilles; Conradie, Francesca; Dong, Krista; Chidarikire, Thato; Gray, Andy

2017-01-01

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017-2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

Health literacy and digital media use: Assessing the Health Literacy Skills Instrument – Short Form and its correlates among African American college students

PubMed Central

Rosenbaum, Judith E.; Deane, Amber E.

2018-01-01

Improving health literacy is increasingly seen as a solution to health problems and inequalities. This study assesses how one of the more recent measures of health literacy, the Health Literacy Skills Instrument – Short Form, performs among African American college students, and ascertains if and how media use relates to health literacy. Results indicate that both the use of health-related websites and apps as well as overall time spent with the media were positively, but conditionally, linked to health literacy. However, findings also pointed to the need for further test development. PMID:29942630

It’s a Matter of Trust: Older African Americans Speak About Their Health Care Encounters

PubMed Central

Hansen, Bryan R.; Hodgson, Nancy A.; Gitlin, Laura N.

2015-01-01

Purpose To examine perceptions of older African Americans’ encounters with health care providers and ways to enhance trust. Method Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Results Four themes emerged: “Added Insult of Ageism,” “Alternative Remedies,” “Good Providers in a ‘Broken’ System,” and “The Foundation of Trust Is Person Recognition.” Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Discussion Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans. PMID:25669876

Promoting Health and Behavioral Health Equity in California.

PubMed

Mishra, Meenoo; Lupi, Monica Valdes; Miller, Wm Jahmal; Nolfo, Tamu

2016-01-01

Behavioral health disparities are not usually considered part of the same system of health disparities. However, the California Department of Public Health focused its health equity strategies on reducing behavioral health disparities through its California Statewide Plan to Promote Health and Mental Health Equity. This statewide plan was developed through a community-wide stakeholder engagement and outreach process. In addition, the California Reducing Disparities Project is a prevention and early intervention effort to reduce mental health disparities in underserved populations. This strategic plan represents the voice of several racial/ethnic communities, such as African American, Asian and Pacific Islander, Latino, Native American, as well as lesbian, gay, bisexual, transgender, and queer and questioning communities in California, through 5 strategic planning workgroups. The workgroups were composed of a broad range of stakeholders, including community leaders, mental health care providers, consumer and family members, individuals with lived experience, and academia. This case example highlights the various efforts of California's Office of Health Equity in eliminating behavioral health disparities and promoting mental health equity, as well as discusses the unique statutory and regulatory role of the Office of Health Equity's deputy director.

Can countries of the WHO African Region wean themselves off donor funding for health?

PubMed

Kirigia, Joses Muthuri; Diarra-Nama, Alimata J

2008-11-01

More than 20% of total health expenditure in 48% of the 46 countries in the WHO African Region is provided by external sources. Issues surrounding aid effectiveness suggest that these countries ought to implement strategies for weaning off aid dependency. This paper broaches the following question: what are some of the strategies that countries of the region can employ to wean off donor funding for health? Five strategies are discussed: reduction in economic inefficiencies; reprioritizing public expenditures; raising additional tax revenues; increased private sector involvement in health development; and fighting corruption.

The role of familism in stress and coping processes among African American and White dementia caregivers: effects on mental and physical health.

PubMed

Kim, Jung-Hyun; Knight, Bob G; Longmire, Crystal V Flynn