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Black Men’s Health: Strength on the Small-Scale

Black men’s health has graduated from the ranks of the underreported—now health activists and professionals of all backgrounds are often familiar, to some degree, with the epidemic of disease morbidity and mortality among black men.

The black men’s health movement finds strength in its ability to unify disparate situations under a set of organizing principles: that black male lives are under attack (whether actively or not), consistent with an unspoken but ubiquitous devaluation of black life.

The contexts and situations where it’s been discussed now receive national attention: from hysteria (probably poorly founded) surrounding the down-low phenomenon during the mid 2000s to the Trayvon Martin case and many others.

By connecting the social response to Trayvon Martin to data on cancer incidence, hypertension and heart disease we get the most activist bang for our buck: we can push every agenda at once and hopefully mobilize resources (intellectual, monetary, cultural) towards averting the loss of life due to preventable illness and illicit behaviors.

Paradoxically, within this approach resides the largest weakness with the black men’s health movement: the overemphasis on consilience and the use of organizing principles in the name of popularizing a movement serves to strip the individual issues of their identity and (I would argue) potency.

For example, the circumstances that created the Trayvon Martin and Cedric Bell cases, both violent deaths of black boys, are not only different from the forces that create epidemic rates of chronic disease but are sufficiently different from each other that their respective discussions and putative solutions are completely different.

Trayvon Martin was killed by a rogue neighborhood vigilante (murdered in the opinion of many, myself included).  Bell, on the other hand, was more than likely killed by a member of his own demographic who was a gang member in Chicago, IL.

These differences become especially relevant when we ask what policies or activities might prevent another Trayvon Martin and another Cedric Bell.

Educating black men in Florida on the evils of gang violence would not have prevented Trayvon Martin’s death; educating Chicago citizens (of all races) on racial sensitivity and profiling would not have prevented Cedric Bell’s. Two different cases; two different solutions; one demographic: black boys killed by gunfire.

Violent crime is not the only paradigm where this paradox applies:  we need to be mindful of the specific dynamics driving discrepancies between blacks and whites in hypertension relative to infectious disease. Even if they do share sources such as poverty or discrimination, their solutions might diverge in several very important ways.

For example, policies aimed at the food industry might affect food access and safety, both related to the diabetes and obesity epidemics.

Responsible sexual behavior, on the other hand, can be addressed through safe sex initiatives, condom use, screening and primary care.

As simple as this sounds, full adoption of this perspective would constitute a change in the status quo in regards to how we discuss health inequities.

This is because the modern health justice movement is defined by our understanding of the social determinants of health and disease—the structural violence that crafts the ecology of health inequities. Indeed, this perspective was a revolutionary discovery, forcing anyone interested in human health to examine how social forces can create a the conditions that breed health inequities

This discovery had political importance: blame-the-victim policies bore the weight of a new burden, novel data communicating that individual behavior is only a part of the explanation for health inequities.

This discovery also had public health importance: structural policies that openly fostered disparate health outcomes, such as the unhealthy content of school lunches, were challenged with a new set of arguments.

But this exclusive aim at structural readjustment has its negatives: It created a public health agenda built entire around addressing underlying social determinants. At its most extreme, the arguments read as follows: if the violence epidemic among black men is influenced by unemployment, then the only way to address violence is to fix unemployment (or so says the dogma).  If the HIV epidemic is influenced by the prison industrial complex (which fosters addiction  and unhealthy sexual behaviors), then we must fix the prison industrial complex in order to fix the HIV epidemic.

These represent well intentioned but tragically nearsighted perspectives on addressing health inequities.  The truth is that the discovery and the solution need not be the same.  I’d even argue that in the case of the broader social determinants and forces crafting illness—poverty, racism, sexism, homophobia—we’re better off adopting ancillary shorter-term foci for our efforts toward improving black men’s health—not at the expense of structural readjustment, but rather, to compliment structural readjustment.

For example, instead of a heavy-handed emphasis on how the economic collapse affected communities of color and insistence that we replace our current economic model with a more just model (a “solution” that should address many health inequities), maybe health justice should shift its focus towards teaching black men how to survive in this economic climate, utilize their existing resources towards good fiscal health.

Thankfully, I am far from alone in this perspective, as several organizations have been thinking similarly for many years. There are, for example, initiatives in several American cities where black barbershops are targeted as healthcare screening hubs.  Similarly, other initiatives, some targeting the black church and other establishments in the black community, utilize similar smaller-scale, community-based approaches towards improving black men’s health.

While these initiatives don’t flex the same ideological muscle of their bigger, stronger and more verbose social determinant relatives, they might be just as effectual and revolutionary.

C. Brandon Ogbunu, Ph.D. is a New York City native, completed his M.Phil (2007) and Ph.D at Yale University (2010) in Microbiology. Academic, pugilist and writer. Connect with Brandon on twitter.

Disclaimer: Health Justice CT provides a public forum for conversations, ideas and collective action. The opinion expressed on this site are those of the authors and do not necessarily reflect the views of HealthJusticeCT or our funder.   

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About Cheekay Brandon

Cheekay Brandon is an academic computational epidemiologist and data scientist. A former amateur boxer, he also studies and writes about health inequities, violence, sports, technology, and futurism. Follow him on twitter: @bigdata_kane

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