Giving Voice to Black Men: Guidance for Increasing the Likelihood of Having a Usual Source of Care.

Black men suffer inequalities in health and health-care outcomes relative to other racial/ethnic groups, requiring well-informed efforts for health promotion. Fewer Black men have a usual source of health care, which may be a contributor to these disparities. Increasing access to and the likelihood of a usual source of care among Black men are important to address health and health-care disparities. In this focus group study, we sought to better understand how Black men think about primary care and usual sources of care. A total of six focus groups were conducted with N = 25 men. Groups were a mix of men with and without a usual source of care. Several themes were identified through analysis of the data regarding factors that contribute to Black men going to the doctor. Themes identified in the data analysis included Lack of Health Insurance as a Barrier to Establishing Usual Source of Care; Family Promoting Health Care Use; Relationship With Doctor, Trust, and Empowerment; Age and Maturity in Health Promotion; and Positive Tone of Messaging. Future research should explore if similar findings are obtained among men in different regions of the United States or between Black men of different backgrounds. Taking a step beyond this research, specifically, future research can also examine the impact of particular health messages/messaging on Black men's health-care-seeking behaviors.

Falling Through the Cracks: Lack of Health Insurance Among Elderly Foreign- and Native-Born Blacks.

Little research examines lack of health insurance among elderly Black immigrants in the US. We use data from the 2008 American Community Survey to describe variation in insurance coverage and conduct multivariate logistic regression analyses of uninsurance. Among elderly Blacks, 1.7% of the US-born were uninsured, compared to 8.4% of the Latin American and Caribbean-born, 23.2% of the African-born, and 9.3% of those born in other regions. In multivariate models, relative to the US-born, the odds of being uninsured were significantly higher among each immigrant group. Among immigrants, the odds of being uninsured were 3.80 times higher among African-born than Latin American and Caribbean-born immigrants net of demographic and socioeconomic controls. This difference was explained by the inclusion of either year of immigration or length of residence. Relative to Latin America and Caribbean-born immigrants, the odds of being uninsured were significantly higher among immigrants from "other" regions only in the model that included the immigration-related variables. This suppression effect was evident when either length of residence or citizenship was controlled. Recently-arrived, elderly Black immigrants fall through the cracks of insurance coverage. Results are discussed in relation to public and private safety net options.