Black men are steady, active users of health services, and most devote significant energy to pursuing healthful outcomes for themselves and their families, according to a landmark survey of Black Californians. A key finding of Listening to Black Californians, a report issued in 2022, was that Black men in the Golden State prize good health care and often go to great lengths to obtain it. That determination, however, has not gotten as much attention as it should.
The finding upends an enduring trope that Black men tend to be disengaged from providers and their care. While it is true that Black men experience higher incidence of some chronic diseases than White men (a trend now understood to be a byproduct of systemic racism and economic discrimination), the notion that they are detached patients is a myth, the data show. In fact, Black men are more actively engaged in maintaining or improving the physical and mental health of themselves and their families than is generally recognized, the report said.
The study was conducted for the California Health Care Foundation by Los Angeles-based public opinion research firm Evitarus. In one of the largest investigations of its kind, Evitarus surveyed 3,325 Black Californians, facilitated 18 focus groups, and conducted 100 in-depth interviews. The findings present a fuller, clearer, and welcome picture of the heretofore mischaracterized nexus between Black men and their health care.
According to the study, 92% of Black male respondents have health insurance, 88% have seen a doctor within the past year, and 70% keep up with screenings and preventive care. They track vital measurements like cholesterol, body weight, and blood pressure. Between doctor visits, 78% say they devote “a great deal” or “quite a bit” of effort to reducing stress, and 77% say they strengthen their mental health through activities such as yoga, meditation, exercise, or prayer.
Primary Caregiver
Other data also dispel the myth of the disengaged Black man. In focus groups and in-depth interviews, Listening to Black Californians found repeated instances of Black men playing leading roles caring and advocating for ailing loved ones. Among Black families, 54% report a household member suffering from diabetes or cancer, and 30% have a household member suffering from depression, schizophrenia, or another mental health condition. One Black man from Sacramento cooks; cleans the house; and drives his wife, who suffered a stroke, back and forth to medical appointments. “I’m the primary caregiver for her,” he explained. “It’s certain things that I’m committed to make happen that she would do for me.”
One reason these kinds of commitments are not well reported may be that the work of caregiving is so demanding and emotionally wrenching, many men prefer to keep it private.
As a member of the study’s board of advisers, I worked alongside an impressive panel of physicians and other experts, and I discovered that many health-focused efforts cited in the study are not limited to California.
Although I grew up on the East Coast, the experiences described in the study parallel those of my family. My father was as health conscious as they come. Perhaps it was his history as a track and field champion in high school and college or the time he spent in his later years caring for his own ill father. Throughout his own life, my father was mostly healthy, in part because he saw physicians regularly. He encouraged my mother to do so, but she was less enthusiastic about doctors. When he reached his 60s and his doctor told him he was borderline diabetic, my father controlled the disease by scrupulously watching his diet, keeping his weight down, and remaining physically active. He was with us until the ripe old age of 87.
Lawyer, Health Care Quarterback
Such stories are more common than is recognized by the public or the health care industry. Take Gregory Hodge of Oakland. At 63, he is a well-known figure in the East Bay, recognized for his work as an attorney, nonprofit executive, and former school board member.
Hodge also plays roles within his family and community that in many ways are even more impactful: he’s a health advocate, a caregiver, and a role model. In those jobs, Hodge has often had his hands full managing his loved ones’ health journey. He works to ensure that every member of his large family receives good health care and leads a healthful life. He guides his five children (ages 15 to 37) toward home-cooked vegetarian meals, plenty of physical activity, and regular medical check-ups.
Acting as the hub of his family’s health care is equal parts choice and necessity. When his mother — a retired educator living 2,000 miles away in Hodge’s hometown of Pine Bluff, Arkansas — was diagnosed with Parkinson’s disease, Hodge managed her care by flying back and forth to Arkansas regularly.
When travel was impossible, he worked the phones from California. He arranged his mother’s medical appointments, vetted her medications, found good home care for her, and deciphered insurance complexities. Whenever he or his mother had a question or concern they wanted addressed, Hodge made a point of bringing it directly to her physician. He was not deterred by the enormous investment of time required to help her.
Learning to Speak Up
The burdens of this kind of engagement are many. Listening to Black Californians documented the difficult interactions faced by Black men during even routine encounters with health care providers. It also identified a common skill among effective Black male health advocates: speaking up.
The researchers found that speaking up appears as a top priority. Eighty-one percent of respondents said they put “a great deal” or “quite a bit of effort” into discussing health concerns when they see a doctor, even when unprompted. One 72-year-old Black man in San Francisco who closely watches over his family’s health care said he learned how to raise questions at the doctor’s office. “Sometimes you’d be surprised you can get what you want,” he said. “And there’s nothing wrong with making the request. But a lot of folks are afraid. And so therefore they don’t ask.”
Not long before Hodge set about caring for his mother, his eldest son was involved in a motorcycle crash that nearly cost him his life. He spent six weeks in intensive care at Cedars Sinai in Los Angeles. At the time, he was under-insured. Hodge stepped in to make sure his son got the care he needed, plus vital physical therapy for his long recovery.
“It took a lot of time and effort to get his care right,” says Hodge. “It caused a lot of stress for me and the family.” Hodge said that’s when he adopted two new stress-reducing activities: jogging and meditating.
There is no doubt that Hodge’s experience as a lawyer and nonprofit leader and my father’s experience as a real estate developer and public figure not only enhanced their skills at advocating for family and friends, they also helped them find solutions to their personal health care challenges. But among Black men, this kind of engagement is common across all professions.
For many of these men, a common feature of success is a clear vision of what it means to live a healthful life. “Independence, security, purpose, a strong social network, a good diet, hobbies, freedom from chronic illness — those are things I think everyone needs to thrive,” said Hodge. “I try to model that for my kids. That means alcohol moderation, exercise, cooking our own meals, and no DoorDash. I have run marathons, and I got my scuba diving certificate. I’ve also traveled all over the world — Brazil, Ethiopia, Mexico, Kenya, Jamaica.”
Yet the burdens of caregiving, guiding family members toward healthful living, and navigating the labyrinth of modern health care systems and health insurance are not without costs. And sometimes life just throws a curveball your way. About a year ago, while busy working and caring for family and friends, Hodge experienced a mild stroke. It was a function of aging, his doctor said. Hodge’s family and friends rallied around him. He recovered and said he is as strong as ever. Now he’s planning to learn how to surf. His girlfriend and his children are all healthy, and that assures Hodge they’ll always be there for him, just as he is always there for them.
Kristen Murakoshi is a San Francisco Bay Area–based editorial and commercial photographer specializing in food and farming stories, lifestyle, and portraiture. Her work exists at the intersections of visual storytelling, cultural preservation, and the magic of the sacred and mundane. Read More