Disentangling Race and Social Context in Understanding Disparities in Chronic Conditions among Men

Abstract

Disparities in men's health research may inaccurately attribute differences in chronic conditions to race rather than the different health risk exposures in which men live. This study sought to determine whether living in the same social environment attenuates race disparities in chronic conditions among men. This study compared survey data collected in 2003 from black and white men with similar incomes living in a racially integrated neighborhood of Baltimore to data from the 2003 National Health Interview Survey. Multivariable logistic regression models estimated to determine whether race disparities in chronic conditions were attenuated among men living in the same social environment. In the national sample, black men exhibited greater odds of having hypertension (odds ratio [OR]=1.58, 95 % confidence interval [CI] 1.34, 1.86) and diabetes (OR=1.62, 95 % CI 1.27-2.08) than white men. In the sample of men living in the same social context, black and white respondents had similar odds of having hypertension (OR=1.05, 95 % CI 0.70, 1.59) and diabetes (OR=1.12, 95 % CI 0.57-2.22). There are no race disparities in chronic conditions among low-income, urban men living in the same social environment. Policies and interventions aiming to reduce disparities in chronic conditions should focus on modifying social aspects of the environment.

The Role of Marital Status in Physical Activity Among African American and White Men

“…Also, research has reported that a supportive built environment may facilitate one’s ability to achieve recommended levels of physical activity (Giles-Corti & Donovan, 2002; Mozaffarian et al, 2012). However, there is substantial racial segregation that exists in the United States that may affect the built environment of many African American men (Griffith, Schulz, Johnson, & Herbert, 2010; Thorpe et al, 2008; Thorpe et al, 2013c; Thorpe et al, 2015). For instance, compared with White men, African American men are more likely to live in neighborhoods with more constrained access to resources in their built environments that promote physical activity (Marshall et al, 2007; Taylor, Poston, Jones, & Kraft, 2006; Wilson, Kirtland, Ainsworth, & Addy, 2004).…”

Racial Composition Over the Lifecourse: Examining Separate and Unequal Environments and the Risk for Heart Disease for African American Men

“…49 Following the cumulative burden model of risk suggests that the aggregate effect of institutional or systematic discrimination 50 as exhibited by patterns of racial residential segregation can have the potential to prevent AA men from escaping the deleterious effects of environments that may provide less access to health promoting resources. 11,12,13 Factors such as psychosocial factors, stress, coping strategies, measures of discrimination and personality characteristics were not measured in this study, but are important factors to assess when considering the effects of specific social contexts, as well as events, in the lives of AA men and their contribution to risk for hypertension.…”

“…10 These factors are often unaccounted for in the study of AA men's health. -Gilbert et al However, these factors need to be explored to better explain the complexity of AA men's health profile as well determining how this profile is structured by social and physical environments [11][12][13] and policies that negatively shape health outcomes and health behaviors (eg, access and use of health care services), 14,15 especially related to cardiovascular disease. 16 The epidemiological profile of AA men is the result of several intersecting factors 13 that begin to reveal a more complex and concerning story of racialized and gendered experiences for this population.…”

Geography, Race/Ethnicity, and Physical Activity Among Men in the United States

“…As such, the social and environmental conditions in which men live must be considered in explaining these important differences in physical activity behaviors ( Wilson-Frederick et al, 2014 ). A growing body of literature has identified associations between the social, environmental, and geographic conditions in which people live and health disparities ( Bleich, Thorpe, Sharif-Harris, Fesahazion, & LaVeist, 2010 ; Fang, Madhavan, Bosworth, & Alderman, 1998 ; Gaskin, Price, Brandon, & LaVeist, 2009 ; Kelley, Bowie, et al, 2016 ; LaVeist et al, 2008 ; LaVeist, Thorpe, Galarraga, Bower, & Gary-Webb, 2009 ; Robert, 1998 ; Roux et al, 2001 ; Thorpe, Bell, et al, 2015 ; Thorpe, Bowie, Wilson-Frederick, Coa, & LaVeist, 2013 ; Thorpe, Kelley, et al, 2015 ; Thorpe, Kennedy-Hendricks, et al, 2015 ). Geographic characteristics are particularly important to examine when interpreting disparities in physical activity, as substantial residential segregation by race/ethnicity exists in the United States, which contributes to variation in access to health-promoting resources such as places to participate in physical activity ( Headen, 2005 ; LaVeist, 2005 ; LaVeist, Gaskin, & Trujillo, 2011 ; Williams & Collins, 2001 ).…”