The Nature of the Disparity

Bowie State University is located in Prince George's County in Maryland, which is adjacent to Washington, DC. Prince George is a county with a diverse population and geographical make-up. Residents possess a valuable array of talents, interests, dedication to education, and commitment to community. Nationally, Prince George's County ranks in the top 2% of highest income and the top 4% of persons with incomes $100,000 or more. According to the 2000 census, over 800,000 people reside in Prince George's County, of which over 70% are non-whites. Despite the impressive statistics regarding high earners in the area, and from the 2000 census, 9 percent of persons living in the County were in poverty. Eleven percent of related children under 18 were below the poverty level, compared with 9 percent of people 65 years old and over. Six percent of all families and 12 percent of families with a female householder and no husband present had incomes below the poverty level. Sixteen percent of the households in Prince George's County received means-tested public assistance or noncash benefits. Disparity of this nature provides a compelling backdrop for a study of minority men's health issues and a valuable opportunity to reach men with messages of wellness, especially as issues of health disparity reach the national stage. This project will focus on the five major health concerns facing minority males in central Maryland, as identified by the Whitman-Walker Clinic of Maryland: HIV/AIDS, heart disease and hypertension, cancers, diabetes, and hepatitis.

It is well documented that male wellness is driven by paradigms entrenched in culture and economics. Access to health care, while an important factor in the wellness of minority men, is often overshadowed by the reluctance of men to visit a doctor absent illness. The benefits of early detection of illnesses like prostate cancer at times do not reach minority communities due to reversible attitudes regarding health and wellness. Additionally, the health of minority males is impacted by high-risk behavior that can be driven by socio-economic factors but that can be modified by exposure to health education, access, and other interventions. The US Department of Health and Human Services details in a July 2000 report Community Health Status Report the state of men's health in minority communities. The report contends that half of all deaths can be attributed to substance abuse and a sedentary lifestyle. It identifies the leading causes of death in minority males as heart disease, cancers, diabetes, HIV/AIDS, and respiratory disease.

While exposing men to health education and other preventative measures is challenging across the nation, in central Maryland the lack of such measures is catastrophic. A recent community health assessment published by Whitman-Walker Clinic of Suburban Maryland provides statistics on HIV/AIDS in the region. In Prince George's County, 83% of all new HIV infections can be found in African-Americans. In white and non-Hispanics, 1997 saw 25 new infections, 1998 saw 18, and 1999 saw 10. During the same period, black and non-Hispanics saw numbers alarmingly higher, 225, 190, and 200. While nearly 25% of the County's population is white and only 7% Hispanic, the quantity of new infections in Hispanics was almost equal to that of whites during the period, 8 to 10 in 1999.

In recent years, the documenting of health disparities across the nation has received new attention. In Maryland, the Cigarette Restitution Fund Program is spending over $80 million during the next 10 years on programs to combat cancer and end the ravages of tobacco-related diseases, and is especially interested in the ways cancer and cigarette smoking effect minorities disproportionally to whites. In March 2001, the National Health Resources and Services Administration published strategies and activities for the elimination of health disparities in the United States. The publication describes HRSA's overarching goal of 100% access to health care and the eliminating of health disparities. The issue remains at the forefront of national health concerns.

The problem is no less an issue in Maryland. The Secretary of Maryland's Department of Health recently in a message about Public Health Week outlined observations about the disparities in health and wellness in Maryland, stating, "African-Americans are disproportionately affected by health problems than are whites." A March 2001 report from the agency provides alarming data on the health disparities in the African-American community and whites in Maryland (http://mdpublichealth.org/ohp/pdf/factsheet.pdf).

• In general, African-Americans in Maryland experience higher overall cancer incidence and mortality rates than whites and African-Americans are diagnosed with advanced stages of cancer in higher proportions than whites.
  
  
• African-American men in Maryland have more than three times the death rate from prostate cancer when compared to white men.
  
  
• Maryland has the third highest colorectal cancer mortality rate in the nation; African-Americans have both higher incidence and mortality rates than whites.
  
  
• White men in Maryland have been experiencing decreasing mortality rates from prostate cancer while mortality rates for African-American men have been increasing.