Considering intersections of race and gender in interventions that address US men's health disparities.

Although gender, racial and ethnic differences in health in the USA are well documented, it is less clear how race and gender intersect to produce large and consistently poor health outcomes for men of colour, particularly Black American men. This paper will illustrate how race and gender intersect at multiple levels to shape men's health and health behaviours, and function as fundamental social determinants of health. The paper will conclude by discussing the need to attend to the role of male gender in pathways and processes underlying racial health disparities, and the challenges of developing health promotion interventions for Black American men.

Psycotherapy, managed care, and the economy of interaction.

This paper examines the disclosure over the value of long-term psychotherapy in a managed-care system. Many managed-care companies define extended psychotherapy as superfluous. Those who defend psychotherapy respond that the restrictions imposed by managed care are misguided and potentially harmful. After briefly discussing the relevant literature, the points of contention between psychotherapy and managed care are examined from the perspective of narrative literary theory. The analysis highlights the contrasting narrative assumptions implied about the importance of the clinical interaction. Pointing out each side's use of point-of-view, narrative structure, and informational exchange, it is posited that beneath arguments that often focus on the commodities of time and money lie larger, conceptual differences. These stealthily serve to undermine the possibility of a rational debate. The paper concludes by asserting that psychotherapy and managed care assume incommensurate narratives of interaction when discussing the value of therapy. The terms of discourse must be expanded in order to account for the philosophical differences described. Several ways this might be accomplished are proposed.