| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
LETTER |
Vence L. Bonham is with the National Human Genome Research Institute, Bethesda, Md. Sherrill L. Sellers is with the University of Wisconsin, Madison. Harold W. Neighbors is with the University of Michigan, Ann Arbor.
Correspondence: Requests for reprints should be sent to Vence L. Bonham, JD, National Human Genome Research Insititute, Bldg 31, Room 4B25, 31 Center Dr, Bethesda, MD 20892-2152 (e-mail: bonhamv{at}mail.nih.gov).
My coauthors and I are pleased that our brief research report stimulated Griggs and Mallinger’s letter to the editor and has provided the authors an opportunity to elaborate on our conclusions. That "African Americans who are less healthy have somehow failed to overcome barriers to achieve good health" was not a finding or a subtle conclusion of our study. Our perspective is more nuanced and recognizes the multiple factors that contribute to health. Our main point is that structural barriers in combination with personal characteristics are integral to understanding the disparities in health for African American men.
Certainly, because our study design was cross-sectional, it is logically plausible that those with good health are motivated and active. Our speculations in this area stem from a long tradition of studies conceptualized within a stress and coping model.1–4 Within that context, it is more reasonable to view John Henryism as a psychosocial mechanism intervening between exposures and health outcomes. Our attention to the health consequences of high John Henryism in African Americans of high socioeconomic status responds to James’s call for research among those who are energetically engaged in path-breaking managerial positions formerly denied African Americans.5
The behavioral responses (such as John Henryism) of African American men to discrimination cannot be fully appreciated unless they are grounded within the sociohistorical context of racism in the United States.5 In fact, a main goal of research on John Henryism is to understand the benefits and costs of coping efforts employed to overcome the structural barriers to upward mobility against which African Americans struggle. In short, to argue that individual coping efforts contribute to health in no way implies that those with poor health are to blame because they do not possess "positive characteristics." Rather, our point is just the opposite.
Specifically, our argument is that it is plausible and indeed very likely that the poor health of African American men is increased by a persistent striving against real structural obstacles, such as racism and discrimination, that for multiple reasons, such as individuals’ coping strength and strength of opposing unjust forces, cannot be overcome. This interactive perspective, we think, provides a more comprehensive scenario than the either/or dichotomy that Griggs and Mallinger seem to imply. Clearly, behavioral efforts such as John Henryism work in combination with race-based obstacles.7
In summary, this is certainly not "the same old song." Yet it is not a new song either. Rather, it is a familiar theme that is too easily misunderstood and simplified by those unwilling to take a broader, more complicated view of how behavior and structural conditions interact to produce differential health outcomes. Our point is that these findings deserve further study so that we might develop public health strategies to improve the health of all African American men.
References
1. James SA, Keenan NL, Strogatz, DS, Browning SR, Garret JM. Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt County Study. Am J Epidemiol. 1992;135:59–67.
2. Strogatz DS, Croft JB, James SA, et al. Social support, stress, and blood pressure in black adults. Epidemiology. 1997;8:482–487.[ISI][Medline]
3. Light KC, Brownley KA, Turner JR, et al. Job status and high-effort coping influence work blood pressure in women and blacks. Hypertension. 1995;25:554–559.
4. Sellers SL, Neighbors HW. Goal-striving stress, social economic status, and the mental health of black Americans. Ann N Y Acad Sci. 1999;896:469–473.
5. James SA, Thomas PE. John Henryism and blood pressure in black populations: a review of the evidence. Afr Am Res Perspect. 2000;6(3):1–10.
6. Williams DR, Neighbors HW, Jackson JS. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2003;93:200–208.
7. Williams DR. The health of men: structured inequalities and opportunities. Am J Public Health. 2003;93:724–731.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
