Our expert answers 3 Questions
I want to provide opportunities through my research for older African American men to express their difficulties in communicating with their health care providers, to feel heard and understood, and get the patient and- family centered care and communication they deserve. I'm also thinking about the role that older African American men play in the medical interactions. I'm concerned that even when they have the health literacy, communication skills, and support to be highly engaged and active patients, they may still be experiencing disparate communication with health providers that impacts their health outcomes. Also, what happens to the many older men who can't speak up and advocate for themselves during medical visits? Some of the projects I'm currently leading include conducting a series of interviews with older African American men about patient-provider communication experiences in primary care, working with older African American cancer survivors on designing tools to help them locate and make use of health information, and identifying communication disparities in kidney transplantation processes for African Americans with end-stage renal disease.
I'm so passionate about the health of older African American men because across socioeconomic levels, this population continues to have a shorter life-expectancy and higher morbidity and mortality than nearly every other racial or ethnic group (including African American women) in the U.S. There are a few outcomes such as prostate cancer and HIV/AIDS for which African American men get the appropriate needed attention, but overall, they are medically underserved and their culturally-specific health disparities are woefully understudied. Interpersonal interactions, like health communication, play a powerful role in perpetuating disparities and I want to uncover the mechanisms that disadvantage older African American men as they are attempting to navigate the complex health care system.
First, health disparities are expensive. If poor patient-provider and family communication plays a significant role in hospital re-admissions, or someone not getting their needed medications or being able to adhere to a treatment recommendation, we should know about it because somewhere down the line, the health care system and we as consumers, will pay for that lack of patient and family centered care. Also, when patients are not satisfied with their care, when they perceive that they are not being communicated with in a respectful manner, they are more reluctant to return for care. Poor communication in health care breeds mistrust, and in order to reduce health disparities and support populations who have historically been mistreated or have reason to mistrust the health care system, we need to thoroughly understand the mechanisms that drive these interactions. There are a number of experts doing research on how to better train medical students, physicians and health care teams on improving their health care communication and reducing implicit bias that often drives poor interactions with African American patients. My concern is the patient, how to empower older African American men to speak up, or have an advocate who can speak up on their behalf, to get the care they deserve.