Friday, December 12, 2014

Guest Post: Men’s Health: A Case for Violence Prevention Programs for African American Youth by Byron Hunter

Byron Hunter PhD Student Department of Health Studies Texas Woman's University
Pictured: Bro. Byron Hunter, MPH, FACHE
Alpha Phi Alpha Fraternity, Inc.
Matt Lauer and Al Roker grew beards in the month of November in solidarity and support of Men’s Health Month. While much of the focus was one the general population of men, special attention for young African American men should be of particular interest as much attention has been placed on the health and wellness of the population in light of recent events is Ferguson, MO. There are profound social issues for some members of the population and there is a great need for social programs for at-risk youth. 

African Americans represent 14% of the U.S. population (44,456,009) yet have the widest gaps in health care compared to other racial and ethnic groups. Individuals experience alarming rates of heart disease, diabetes, HIV/AIDS, STDs, and cancer.  Early health education and prevention activities among this population, particularly youth and young adults, is paramount to improve health and outcomes in later life.  Among the population, the health and wellness of young African American men is of particular concern. According to the US Census there are 7.4 million African American males between ages 10-34 (U.S. Census Bureau, 2010). 

Several Key public health issues among young African American men include HIV/AIDS, lack of health insurance, and violence (Battle, 2002). HIV/AIDS: African Americans continue to be disproportionately affected by HIV infection. In 1999, AIDS was the leading cause of death for African American males between the ages of 25 and 44 years (U.S. Department of Health and Human Services, 1999).  Ten years later, the estimated rate of new HIV infections among African Americans (68.9) was 7.9 times as high as the rate in whites (8.7) (Center for Disease Control & Prevention, 2014). Of all of the new HIV infections among African Americans, 51% were among men who have sex with men (MSM) (CDC, 2014).  Lack of health insurance: Nearly 4 out of 10 young African American men lack health insurance (The Henry J. Kaiser Family Foundation, 2006).  Violence: Among 10 to 24 year olds, homicide is the leading cause of death for African Americans; the second leading cause of death for Hispanics; and the third leading cause of death American Indians and Alaska Natives. 

Of the aforementioned health issues violence among young African American men is of
Pictured: Bro. Garland Thompson, MCD
Alpha Phi Alpha Fraternity, Inc.
prominent concern. Inner city African American youth are at risk for interpersonal violence and aggression. Statistics reveal that homicide is the leading cause of death for African Americans age 10 to 24 year olds (Centers for Disease Control & Prevention, 2014). Additionally, among youth and young adults age 15 to 24 years killed by firearms in the US, 60 percent are African American or Hispanic (Teplin, McClelland, Abram, & Mileusnic, 2005). Many young African American men particularly those in urban settings live by the ‘Code of the Street’, in which they exert extra masculinity to intimidate peers to establish credibility (Stewart, Schreck, & Simons, 2006). Problems with violence are worsened by ill relationships between police and young African American men. Reports indicate that the likelihood of police contact (including stops) for African America men in urban settings is higher than in any other ethnic group (Meares, 2008). 


In addition to violence, there is a great need to educate youth and young adults about bullying. The Centers for Disease Control and Prevention (CDC) defines bullying as any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated (CDC, 2014). Up to 25% of U.S. students are bullied each year and as many as 160,000 students stay home from school on any given day because they are afraid of being bullied (Hardy, 2005). Boys are more likely to be involved in physical or verbal bullying, while girls are more likely to be involved in relational bullying (Wang, Iannotti, & Nansel, 2009). African-American adolescents are more likely to be involved in physical, verbal or cyber bullying but less victimization (Wang, Iannotti, & Nansel, 2009). Bullying can result in physical injury, social and emotional distress, and even death (CDC, 2014). Victimized youth are at increased risk for depression, anxiety, sleep difficulties, and poor school adjustment (CDC, 2014). 

In the U.S. homicide is the leading cause of death for young men age 10 to 24. According to the Centers for Disease Control and Prevention (CDC) the firearm homicide rate among males ages 10 to 24 years was highest for Non-Hispanic Blacks with 48.4 deaths per 100,000 populations (CDC, 2013). In the state of Texas homicide rates have decreased from 16.7 per 100,000 population in 1994 to 6.5 per 100,000 population in 2010, yet for African-Americans males age 10 to 24 homicide continues to be the leading cause of death (30.2 per 100,000 compared to 6.9 per 100,000 population white males and 11.0 per 100,000 population Hispanic males) (CDC, 2013). Homicide rates are perpetuated by social-economic problems and ongoing programs are needed to address these issues to reduce homicides and other crimes. 

The literature suggests that the physical and social environment such as poverty, access to firearms and drugs, urbanization, disadvantaged neighborhoods, poor social support (parents, teachers, classmates, and close friends) and inadequate education and school systems plays a large role in determining and individuals potential for engagement in violence behavior (Reese, Vera, Thompson & Reyes, 2001; Li, Nussbaum, and Richards, 2007; McMahon, Coker & Parnes, 2013). Of these, poverty is of cited as the most significant factor of particular importance considering 20% of individuals living in poverty are under the age of 18 and African-Americans represent 26% of these individuals (Reese, Vera, Thompson and Reyes, 2001). Vowell and Mary (2000) suggest that many inner-city African American youth feel strained by society and are unable to achieve their fullest potential because of competitive disadvantages, economic resources and limited opportunities. As a result, they reject normative structures and may engage in risky behaviors including drugs, alcohol, or violent behavior. 

Reese, Vera, Thompson & Reyes (2001) suggest that most teen experiences are interrelated, for example, experimentation with drugs and alcohol are usually tied together, and therefore, programs should approach violence prevention strategies from a multifactorial viewpoint. The literature further suggests that programs examine emotional support, improve communication skills, coping skills, eliminate gang activity, and that bolster child and parent relationships simultaneously may be possible strategies to manage violence. 

Pictured: Bro. Adam Whitaker, M.Ed.
Alpha Phi Alpha Fraternity, Inc.
Violence continues to threaten the health and wellness of African American youth. The literature suggests environmental and social factors play a key role in predicting violent behavior. Members of the target population are often excluded from intervention development and there are significant gaps in participant involvement in strategy and design. It is important to involve individuals in planning interventions and to empower them to take control of their health. Informed violence prevention strategies may be accomplished through implementing techniques such as Community Based Participatory Research (CPBR) or peer education, which encourage discussion and active participant engagement. 

References

Battle, S. F. (2002). Health Concerns for African American Youth. Journal of Health & Social Policy, 15(2), 35-44. 

Center for Disease Control & Prevention (2014). HIV among youth. Retrieved from: http://www.cdc.gov/hiv/risk/age/youth/index.html?s_cid=tw_std0141316 

Centers for Disease Control & Prevention (2014). Youth Violence: facts at a glance. Retrieved from: http://www.cdc.gov/violenceprevention/pdf/yv-datasheet-a.pdf 

Hardy, D (2005). In the mix: stop bullying take a stand. Public Broadcast Service. Retrieved from: http://www-tc.pbs.org/inthemix/educators/lessons/bullying_guide.pdf 

Li, S. T., Nussbaum, K. M., & Richards, M. H. (2007). Risk and protective factors for urban African-American youth. American Journal of Community Psychology, 39(1-2), 21-35. 

McMahon, S. D., Coker, C. and Parnes, A. L. (2013). Environmental stressors, social support, and internalizing symptoms among African American youth. Journal of Community Psychology, 41: 615–630. 

Meares, T. (2008). Legitimacy of police among young African-American men. The Marquette Law Review 92, 651. 

Reese, L. R. E., Vera, E. M., Thompson, K., & Reyes, R. (2001). A qualitative investigation of perceptions of violence risk factors in low-income African American children. Journal of clinical child psychology, 30(2), 161-171. 

Stewart, E. A., Schreck, C. J., & Simons, R. L. (2006). “I ain't gonna let no one disrespect me” does the code of the street deduce or increase violent victimization among African American adolescents?, Journal of Research in Crime and Delinquency, 43(4), 427-458. 

Teplin, L. A., McClelland, G. M., Abram, K. M., & Mileusnic, D. (2005). Early violent death among delinquent youth: a prospective longitudinal study. Pediatrics, 115(6), 1586-1593. 

The Henry J. Kaiser Family Foundation (2006). Young African American Men in the United States: race, ethnicity, & healthcare fact sheet. Retrieved from: http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7541.pdf 

U.S. Census Bureau (2010). Age groups and sex. Retrieved from: http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_SF2_QTP1&prodType=table 

Vowell, P. R., & May, D. C. (2000). Another look at classic strain theory: Poverty status, perceived blocked opportunity, and gang membership as predictors of adolescent violent behavior. Sociological Inquiry, 70(1), 42-60. 

Wang, J., Iannotti, R. J., & Nansel, T. R. (2009). School bullying among adolescents in the United States: Physical, verbal, relational, and cyber. Journal of Adolescent Health, 45(4), 368-375. 

Byron Hunter, MPH, FACHE, is a PhD Student in the Department of Health Studies at Texas Woman’s University in Denton, TX. All correspondence should be sent to bhunter3@twu.edu. Pictured individuals are members of Alpha Phi Alpha Fraternity, Incorporated, which is the first Greek-lettered Fraternity for African American. The fraternity’s headquarters is in Baltimore, MD and the organizations aims are ‘Manly Deeds, Scholarship, and Love for all Mankind.’ The organization leads violence prevention and other training programs for inner-city youth and young adults. 

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