Social Environment Plays Key Role in Men’s Health

Social environment may be an important determinant of health behaviors among African American and white men, according to a new study.

The researchers, led by Roland J. Thorpe Jr, PhD, an assistant professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health and director of the Program for Men’s Health Research at the Johns Hopkins Center for Health Disparities Solutions, found that African American and white men who live in racially integrated communities and who have comparable incomes have far fewer differences when it comes to behaviors that contribute to poor health-such as physical inactivity, smoking, and drinking-compared with African American and white men overall in the United States.

“Understanding racial differences in behaviors that affect men’s health is an important step toward reducing health disparities among U.S. men,” said Dr Thorpe Jr. “But it’s critical that we move beyond making these comparisons solely based on national-level data in order to consider the role of confounding factors such as socio-economic status and segregated living environments.”

The researchers compared data from the 2003 National Health Interview Survey (NHIS), including 1551 African American men and 8904 non-Hispanic white men, with data from a smaller survey of 381 African-American men and 247 non-Hispanic white men living in Baltimore.

In the national sample, a larger proportion of African American men (33%) than white men (22.7%) had incomes under $35,000 and a smaller proportion of African American men had incomes over $75,000 (12.8%) compared with white men (24.4%). The survey did not account for or include data on residential segregation.

A smaller proportion of African American men had health insurance, identified as current drinkers, and reported heart disease than their white counterparts; a larger proportion of African American men in the national sample were physically inactive; were obese; and reported fair/poor health, hypertension, and diabetes.

In the Baltimore sample, a larger proportion of African American men than white men had health insurance, and there were no differences between African American and white men with respect to being physically inactive; being a current smoker; being a current drinker; being obese; or reporting fair/poor health, hypertension, diabetes, or heart disease.

After adjusting for age, marital status, insurance, income, educational attainment, poor or fair health, and obesity status, African American men in the national survey had greater odds of being physically inactive, reduced odds of being a current smoker, and reduced odds of being a current drinker. In the Baltimore sample, African American and white men had similar odds of being physically inactive, being a current smoker, or being a current drinker.

“The fact that economic disadvantage is so often a part of the experience of minorities in the US has made it difficult to estimate the relative effects of race and socioeconomic status on behaviors that impact health,” said Dr Thorpe. “But our comparison of national data from the NHIS with data from the EHDIC (Baltimore) study provides a more nuanced picture of the factors underlying these behavioral differences and suggests that the disparities found at the national level may be a function of social and environmental differences. These findings bring us a step closer to understanding and improving the health of minority men in this country.”