Skip to main content

Predictors of Health-Related Quality of Life Among African American Men

Abstract

African American men have the lowest life expectancy of any ethnic gender group in the USA. Furthermore, these men endorse having a lower health-related quality of life (HRQoL) than any other group. There have been recent calls from national organizations to improve HRQoL—a multidimensional indicator of health strongly associated with mortality and morbidity. Following these calls, there have been widespread efforts implemented to improve HRQoL among the US population, though no known effort has been implemented that is tailored to the unique experiences of African American men. Health promotion efforts that are not tailored to the unique preferences and experiences of these men are likely to produce limited results. Formative research conducted among African American men is needed in order to design and implement an effective HRQoL-promoting intervention for African American men. The present study constitutes such formative research and was conducted with a sample of 211 African American men. Hierarchical regressions were performed to understand the role of literature-derived predictors of HRQoL among these men. Results found that depression, stress, and physical activity were found to be significant predictors of HRQoL among these men. This is the first known study to examine predictors of HRQoL among African American men—a group that disproportionately experiences health disparities and low HRQoL, though for who few successful health promotions exist. The findings from this study have implications for those seeking to design and implement HRQoL-promoting interventions among African American men.

This is a preview of subscription content, access via your institution.

Data Availability

Data collected from this study are available upon request to the corresponding author.

Code Availability

Not applicable.

References

  1. Pathak EB. Mortality among Black men in the USA. J Racial Ethn Health Disparities. 2018;5:50–61.

    PubMed  Article  Google Scholar 

  2. National Center for Health Statistics. Health, United States, 2014: with special feature on adults aged 55–64. Hyattsville: National Center for Health Statistics; 2015.

    Google Scholar 

  3. Forrest CB, Blackwell CK, Camargo CA. Advancing the science of children’s positive health in the National Institutes of Health Environmental Influences on Child Health Outcomes (ECHO) Research Program. J Pediatr. 2018;196:298–300.

    PubMed  PubMed Central  Article  Google Scholar 

  4. Slabaugh SL, Shah M, Zack M, et al. Leveraging health-related quality of life in population health management: the case for healthy days. Popul Health Manag. 2017;20(1):13–22.

    PubMed  PubMed Central  Article  Google Scholar 

  5. Hays RD, Sherbourne CD, Mazel RM. The rand 36-item health survey 1.0. Health Econ. 1993;2(3):217–27.

    CAS  PubMed  Article  Google Scholar 

  6. Centelmo J, Gordon S, Stefanacci RG. Impact of quality of life on clinical pathways. J Clin Pathways. 2016;2(6):23–5.

    Google Scholar 

  7. Healthy People 2020. Foundation health report measure: health-related quality of life and well-being. 2010. https://www.healthypeople.gov/sites/default/files/HRQoLWBFullReport.pdf. Accessed 16 Sept 2021.

  8. Brown DS, Thompson WW, Zack MM, Arnold SE, Barile JP. Associations between health-related quality of life and mortality in older adults. Prev Sci. 2013;16(1):21–30.

    Article  Google Scholar 

  9. Kaiser Family Foundation. Men reporting poor mental health status, by race/ethnicity. https://www.kff.org/disparities-policy/state-indicator/men-reporting-poor-mental-health-by-raceethnicity/. Accessed 28 May 2020.

  10. Kaiser Family Foundation. Men who report fair or poor health status, by race/ethnicity. https://www.kff.org/disparities-policy/state-indicator/mens-self-reported-fair-or-poor-health-status-by-raceethnicity/. Accessed 29 May 2020.

  11. Kang K, Gholizadeh L, Inglis SC, Han HR. Interventions that improve health-related quality of life in patients with myocardial infarction. Qual Life Res. 2016;25(11):2725–37.

    PubMed  Article  Google Scholar 

  12. Zhang XP, Norris SL, Chowdhury FM, Gregg EW, Zhang P. The effects of interventions on health-related quality of life among persons with diabetes - a systematic review. Med Care. 2007;45:820–34.

    PubMed  Article  Google Scholar 

  13. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life. Med Care. 2003;41(5):582–92.

    PubMed  Google Scholar 

  14. Kumanyika SK, Espeland MA, Bahnson JL, et al. Ethnic comparison of weight loss in the trial of nonpharmacologic interventions in the elderly. Obes Res. 2002;10(2):96–106.

    PubMed  Article  Google Scholar 

  15. Kumanyika S. Ethnic minorities and weight control research priorities: where are we now and where do we need to be? Prev Med. 2008;47(6):583–6.

    PubMed  Article  Google Scholar 

  16. West DS, Elaine Prewitt T, Bursac Z, Felix HC. Weight loss of black, white, and Hispanic men and women in the diabetes prevention program. Obesity. 2008;16(6):1413–20.

    PubMed  Article  Google Scholar 

  17. Centers for Disease Control and Prevention. A closer look at African American men and high blood pressure control: a review of psychosocial factors and systems-level interventions. https://www.cdc.gov/bloodpressure/docs/African_American_Executive_Summary.pdf. Accessed 20 May 2021.

  18. Centers for Disease Control and Prevention. National diabetes surveillance system. https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html. Accessed 20 May 2021.

  19. US Department of Health and Human Services. Stroke and African Americans. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=28. Accessed 20 May 2021.

  20. Jack L, Toston T, Jack NH, Sim M. A gender-centered ecological framework targeting Black men living with diabetes: integrating a “masculinity” perspective in diabetes management and education research. Am J Mens Health. 2010;4(1):7–15.

    PubMed  Article  Google Scholar 

  21. Gilbert KL, Ray R, Siddiqi A, et al. Visible and invisible trends in Black men’s health: pitfalls and promises for addressing racial, ethnic, and gender inequities in health. Annu Rev Public Health. 2016;37:295–311.

    PubMed  PubMed Central  Article  Google Scholar 

  22. Hankerson SH, Suite D, Bailey RK. Treatment disparities among African American men with depression: implications for clinical practice. J Health Care Poor Underserved. 2015;26(1):21–34.

    PubMed  PubMed Central  Article  Google Scholar 

  23. Griffith DM, Cornish EK, Bergner EM, Bruce MA, Beech BM. “Health is the ability to manage yourself without help”: how older African American men define health and successful aging. J Gerontol B Psychol Sci Soc Sci. 2018;73(2):240–7.

    PubMed  Article  Google Scholar 

  24. Taylor TR, Mohammed A, Harrell JP, Makambi KH. An examination of self-rated health among African-American men. J Racial Ethn Health Disparities. 2017;4(3):425–31.

    PubMed  Article  Google Scholar 

  25. Brown DR, Carroll DD, Workman LM, Carlson SA, Brown DW. Physical activity and health-related quality of life: US adults with and without limitations. Qual Life Res. 2014;23(10):2673–80.

    PubMed  PubMed Central  Article  Google Scholar 

  26. Bize R, Johnson JA, Plotnikoff RC. Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007;45(6):401–15.

    PubMed  Article  Google Scholar 

  27. Amarantos E, Martinez A, Dwyer J. Nutrition and quality of life in older adults. J Gerontol A Biol Sci Med Sci. 2001;56(Spec No 2):54–64.

    PubMed  Article  Google Scholar 

  28. De Frias CM, Whyne E. Stress on health-related quality of life in older adults: the protective nature of mindfulness. Aging Ment Health. 2015;19(3):201–6.

    PubMed  Article  Google Scholar 

  29. Daly EJ, Trivedi MH, Wisniewski SR, et al. Health-related quality of life in depression: a STAR*D report. Ann Clin Psychiatry. 2010;22(1):43–55.

    PubMed  Google Scholar 

  30. Newton RL, Griffith DM, Kearney WB, Bennett GG. A systematic review of weight loss, physical activity and dietary interventions involving African American men. Obes Rev. 2014;15(4):93–106.

    PubMed  Article  Google Scholar 

  31. James DCS. Cluster analysis defines distinct dietary patterns for African-American men and women. J Am Diet Assoc. 2009;109(2):255–62.

    PubMed  Article  Google Scholar 

  32. Otiniano AD, Gee GC. Self-reported discrimination and health-related quality of life among Whites, Blacks, Mexicans and Central Americans. J Immigr Minor Health. 2012;14(2):189–97.

    PubMed  Article  Google Scholar 

  33. Taylor RJ, Miller R, Mouzon D, Keith VM, Chatters LM. Everyday discrimination among African American men: the impact of criminal justice contact. Race Justice. 2018;8(2):154–77.

    PubMed  Article  Google Scholar 

  34. Watkins DC, Walker RL, Griffith DM. A meta-study of black male mental health and well-being. J Black Psychol. 2010;36(3):303–30.

    Article  Google Scholar 

  35. Huff C, Tingley D. “Who are these people?” Evaluating the demographic characteristics and political preferences of MTurk survey respondents. Res Politics. 2015;2(3):1–12.

    Article  Google Scholar 

  36. Paolacci G, Chandler J. Inside the Turk: understanding mechanical Turk as a participant pool. Curr Dir Psychol Sci. 2014;23(2):184–8.

    Article  Google Scholar 

  37. Buhrmester M, Kwang T, Gosling SD. Amazon’s mechanical Turk: a new source of inexpensive, yet high-quality, data? Perspect Psychol Sci. 2011;6(1):3–5.

    PubMed  Article  Google Scholar 

  38. Casler K, Bickel L, Hackett E. Separate but equal? A comparison of participants and data gathered via Amazon’s MTurk, social media, and face-to-face behavioral testing. Comput Hum Behav. 2013;29(6):2156–60.

    Article  Google Scholar 

  39. Smith NA, Sabat IE, Martinez LR, Weaver K, Xu S. A convenient solution: using MTurk to sample from hard-to-reach populations. Ind Organ Psychol Perspect Sci Pract. 2015;8(2):220–8.

    Article  Google Scholar 

  40. Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000;19(6):586–92.

    CAS  PubMed  Article  Google Scholar 

  41. Reitzel LR, Nguyen N, Strong LL, Wetter DW, McNeill LH. Subjective social status and health behaviors among African Americans. Am J Health Behav. 2013;37(1):104–11.

    PubMed  PubMed Central  Article  Google Scholar 

  42. The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28(3):551–8.

    Article  Google Scholar 

  43. Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res. 1987;36(2):76–81.

  44. Zhang W, O’Brien N, Forrest JI, et al. Validating a shortened depression scale (10 item CES-D) among HIV-positive people in British Columbia, Canada. PLoS One. 2012;7(7):e40793.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  45. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.

    CAS  PubMed  Article  Google Scholar 

  46. Xu F, Cohen SA, Lofgren IE, et al. Relationship between diet quality, physical activity and health-related quality of life in older adults: findings from 2007–2014 National Health and Nutrition Examination Survey. J Nutr Health Aging. 2018;22(9):1072–9.

    CAS  PubMed  Article  Google Scholar 

  47. Wippold GM, Tucker CM, Roncoroni J, Henry M. Impact of stress and loneliness on health-related quality of life among low income senior African Americans. J Racial Ethn Health Disparities. 2021;8(4):1089–97.

    PubMed  Article  Google Scholar 

  48. Wang J, Sereika SM, Styn MA, Burke LE. Factors associated with health-related quality of life among overweight or obese adults. J Clin Nurs. 2013;22:2172–82.

    PubMed  PubMed Central  Article  Google Scholar 

  49. Tucker CM, Wippold GM, Smith TM, et al. Association of health self-empowerment with health-promoting behaviors among chronically ill African American and Non-Hispanic white adolescents. J Health Care Poor Underserved. 2014;25(4):2019–31.

    PubMed  Article  Google Scholar 

  50. Tucker CM, Smith TM, Wippold GM, et al. Impact of a university-community partnership approach to improving health behaviors and outcomes among overweight/obese hispanic adults. Am J Lifestyle Med. 2016;11(6):479–88.

    PubMed  PubMed Central  Article  Google Scholar 

  51. Tucker CM, Wippold GM, Williams JL, et al. A CBPR study to test the impact of a church-based health empowerment program on health behaviors and health outcomes of Black adult churchgoers. J Racial Ethn Health Disparities. 2017;4(1):70–8.

    PubMed  Article  Google Scholar 

  52. Vickers SM, Fouad MN. An overview of EMPaCT and fundamental issues affecting minority participation in cancer clinical trials: enhancing minority participation in clinical trials (EMPaCT): laying the groundwork for improving minority clinical trial accrual. Cancer. 2014;7(7):1087–90.

    Article  Google Scholar 

  53. Gansler T, Jin M, Bauer J, et al. Outcomes of a cancer clinical trial matching service. J Cancer Educ. 2012;27(1):11–20.

    PubMed  Article  Google Scholar 

  54. Nicholson LM, Schwirian PM, Groner JA. Recruitment and retention strategies in clinical studies with low-income and minority populations: Progress from 2004–2014. Contemp Clin Trials. 2015;45(Pt A):34–70.

    PubMed  Article  Google Scholar 

  55. Litman L, Robinson J. Conducting online research on Amazon mechanical Turk and beyond. Thousand Oaks: SAGE Publications Inc; 2020.

    Google Scholar 

  56. Levay KE, Freese J, Druckman JN. The demographic and political composition of mechanical turk samples. SAGE Open. 2016;6(1).

  57. Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S454-466.

    Article  Google Scholar 

  58. Torres ER, Sampselle CM, Neighbors HW, Ronis DL, Gretebeck KA. Depressive symptoms and walking in African-Americans. Public Health Nurs. 2015;32(5):381–7.

    PubMed  Article  Google Scholar 

  59. Vimalananda VG, Palmer JR, Gerlovin H, et al. Depressive symptoms, antidepressant use, and the incidence of diabetes in the Black women’s health study. Diabetes Care. 2014;37(8):2211–7.

    PubMed  PubMed Central  Article  Google Scholar 

  60. Wippold GM, Nmezi N, Williams JL, Butler J, Hodge TM. An exploratory study to understand factors associated with health-related quality of life among uninsured/underinsured patients as identified by clinic providers and staff. J Prim Care Community Health. 2020;11.

  61. Wippold GM, Roncoroni J. Hope and health-related quality of life among chronically ill uninsured/underinsured adults. J Community Psychol. 2020;48(2):576–89.

    PubMed  Article  Google Scholar 

  62. Wippold GM, Tucker CM, Kroska EB, Hanvey GA. Perceived socioeconomic status and health-related quality of life (HQoL) among urban adults: evaluating the protective value of resilience. Am J Orthopsychiatry. 2021;91(1):20–6.

    PubMed  Article  Google Scholar 

Download references

Funding

Funding for the present study was provided by the University of South Carolina. Dr. Wippold was also funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under award number K23MD016123.

Author information

Authors and Affiliations

Authors

Contributions

Conceptualization: Wippold

Methodology: Wippold

Formal analysis and investigation: Wippold and Frary

Writing – original draft preparation: Wippold and Frary

Writing – review and editing: Wippold and Frary

Revisions – Wippold and Frary

Funding acquisition: Wippold

Resources: Wippold.

Corresponding author

Correspondence to Guillermo M. Wippold.

Ethics declarations

Ethics Approval

Approval was obtained from the ethics committee at the University of South Carolina (No. 00104987). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Not applicable.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wippold, G.M., Frary, S.G. Predictors of Health-Related Quality of Life Among African American Men. J. Racial and Ethnic Health Disparities (2021). https://doi.org/10.1007/s40615-021-01151-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40615-021-01151-z

Keywords

  • Male
  • African American
  • Health-related quality of life
  • Health promotion