RESUMO
Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Saúde do Homem/etnologia , Determinantes Sociais da Saúde/etnologia , Fatores Etários , Causas de Morte , Meio Ambiente , Exercício Físico , Identidade de Gênero , Comportamentos Relacionados com a Saúde/etnologia , Acessibilidade aos Serviços de Saúde , Humanos , Expectativa de Vida/etnologia , Masculino , Racismo/etnologia , Fatores Sexuais , Fatores Socioeconômicos , Estados UnidosRESUMO
PURPOSE: Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. METHODS: Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. RESULTS: A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. CONCLUSIONS: Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.