According to Him: Barriers to Healthcare among African-American Men

Presented in part at the 23rd Annual Meeting of the Society of General Internal Medicine, May 4-6, 2000, Boston, MA. Objectives: We sought to elicit barriers to health and primary healthcare use among African-American men residing in a low-income, urban area. Methods: We conducted a qualitative study of African-American men using focused group interviews. A purposive sampling technique was used to recruit 8 select subgroups: adolescents (age 16-18), trauma survivors, HIV-positive men, homeless men, men who have sex with men (MSM), substance abusers, church affiliated men and a mixed sample (N=71). Focus groups were moderated by trained, African-American male focus group leaders. Results: Qualitative analysis of focused group transcripts yielded 2 major categories-intrinsic barriers and extrinsic barriers. Within the intrinsic barriers category, 5 subcategories emerged: lack of health awareness, fear, healthcare as needed, medical mistrust and fatalism. Extrinsic barriers included cost/benefit, clinic experience, and cultural and linguistic differences. Participants also offered solutions to address key barriers. Conclusions: African-American men identified key intrinsic and extrinsic barriers to health and primary healthcare, including lack of health awareness and providers' cultural and linguistic differences. These barriers constitute important areas of future research and intervention to address African-American men's health and willingness to seek healthcare.