Morehouse Research Institute

Fall 2009 – Volume 15, No. 2

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Interpersonal and Attitudinal Factors in Healthcare Utilization among HIV-Infected Urban African American Men
Aaron G. Buseh, Sheryl T. Kelber, Patricia E. Stevens, Robin J. Poedel
University of Illinois at Chicago - pg. 1

This study describes health services utilization patterns and barriers to healthcare analyzing relationships among participant and situational variables. Using a cross sectional design with a sample of 117 HIV-infected African American men aged 21 to 60, a survey was administered to assess: socio-demographic indicators, health care utilization patterns, stigma, and self-efficacy relative to perceived attitudes toward their HIV healthcare providers (AHHCP). Fifty-seven percent reported not seeking health care when needed and 51 percent reported having missed appointments. Results revealed correlations between time spent by healthcare provider (HCP), ability to access care, lack of HCP commitment, and denial of care. Self-efficacy was correlated to the total AHHCP score and its subscales. This study provides important contextual perspectives on healthcare utilization barriers among HIV-infected African men in an urban setting. To reduce access barriers for HIV-infected patients, health care providers must understand better the patients’ perspectives on the difficulties of accessing care and navigating the healthcare system.



Disparities in Health Care among African Americans
Sadia Javaid, Naviar C. Barker, Ali Shahid, Shagufta Jabeen, Rahn Kennedy Bailey
Meharry Medical College – pg 19

Many variables determine the quality of health care received by persons of color in the United States. Differences in disease detection, diagnosis, and management of health care outcomes in African Americans date back to slavery. There are race differences, gender differences, and epidemiological differences in the treatment of African Americans in our health care system. Diseases such as prostate and colorectal cancer, infant mortality, chronic diseases like hypertension and diabetes all are very high among African Americans as compared to white Americans. The high rate of infectious diseases like Pneumonia and AIDS are consistently higher among African Americans. Contributing factors for these occurrences are a lack of regular sources for Primary care, social, financial, cultural, insurance related and linguistic barriers that increases the burden of disease and unresolved disparities in the U.S. healthcare system. Elimination of these healthcare disparities must take place in order to better manage healthcare and provide unbiased equal care and quality of life to all Americans. This article examines factors leading to healthcare disparities and identifies essential tasks to improve the quality of care received by African Americans and other racial minority groups.



Suicide and African Americans: An Overview
Kenneth Osiezaga, Amandeep Kaur, Narviar C. Barker, Rahn Kennedy Bailey
Meharry Medical College – pg 29

Suicide is increasingly becoming a major public health issue. Each year over one million people die by suicide worldwide. The World Health Organization estimates that suicide is the thirteenth leading cause of death worldwide (Gross 2006) and the National Safety Council rates death by suicide eleventh in the United States (Minino and Heron 2006). It is a leading cause of death among teenagers and adults under 35 (Nikola 2006). The rate of completed suicide is higher in men than in women (O’Connor and Noel 2000). It is estimated that workforce-related suicides cost businesses as much as $13 billion annually (Research! America 2008) and for every suicide prevented, the United States could save an average of $3,875 in medical expenses and $1,178,684 in lost productivity (Research! America 2008). Caucasians are twice as likely as African Americans to complete suicide. The rate of suicide is growing faster among African American youth than among Caucasian youth (American Association of Suicidology 2006); it is the third leading cause of death for African Americans aged 15-24 (Centers for Disease Control and Prevention 2007). This is a descriptive study of various dimensions of suicide among African Americans in the past decade with a discussion of prevention and screening tools.


Prostate Cancer in African American Males: Psychological Effects of Diagnosis and Prostatectomy
M. Rehan Puri, Ernest A. Gbadebo-Goyea, Narviar C. Barker, C. Freeman, Rahn K. BaileyMeharry Medical College – pg 41

Prostate cancer is the most common cancer in men regardless of race or ethnicity, but it is more common in African American men than in white men ( American Cancer Society 2008). It is less common in Hispanic, Asian, Pacific Islander, and Native American men. Several studies have reported diminished and poorer quality of life (i.e., disease-specific physical health and functional status) for African American men who have undergone standard treatments for prostate cancer when compared to white men. However, limited research is available on psychological adjustments to prostate cancer and even less is known about racial differences in psychological functioning after treatment. Problems most often reported by African American men after prostate cancer diagnosis or a radical prostatectomy are impotence, sexual dysfunction, erectile dysfunction, urinary frequency and psychological problems related to sadness, worry, nervousness, loneliness, loss, and diminished perceptions of “manhood”. Treatment for prostate cancer requires thoughtful decision making, which often is influenced by patient age at diagnosis, tumor stage, co-morbidities and treatment choice; because the type of treatmen t chosen may lead to adverse effects and modification in sexual behavior, especially after a radical prostatectomy.