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Purpose – This chapter discusses health disparities among African Americans living in urban spaces within the United States.

Approach – This chapter provides an overview of health disparities in morbidity and mortality related to maternal and child health (maternal mortality rate, infant mortality, and low birth weight).

Practical implications – This chapter describes research and interventions that strive to increase our ability to understand and reduce health disparities. Eliminating health disparities not only is beneficial to these affected groups but also offers the opportunity to improve the health of the entire U.S. population.

Originality/value – This chapter adds to our understanding of the correlates of health disparities for African American women and children as well as successful interventions that have proven effective in ameliorating these disparities.

W.E.B. DuBois, in his 1903 collection of writings entitled The Souls of Black Folk, describes what he calls “The Veil,” which succinctly sums up the deadly and adverse experiences of African Americans in the US. With DuBois contemplations of a Veil under which US Blacks alone live and die as context, this paper takes a look at the modern condition of African Americans in the US, whether they continue to exist within DuBois Veil in modern times (twentieth and twenty-first centuries), and if so, to what extent. As a routine examination and inspection of the condition of Blacks in the US, focus is placed on black lives lost, beginning with an appraisal of their size in the US population overtime, and in comparison with other racial and ethnic groups in the US. US census data, health data collected from the Centers for Disease Control and Prevention, and crime data collected from the Federal Bureau of Investigation are examined to construct a composite of the condition of contemporary Blacks in the US as compared to other groups in the US, focusing attention specifically on the rates at which their lives are lost compared to others through infant mortality, low fertility rates, abortion, and high rates of homicide. This analysis concludes with a look at death from homicide before, during, and after the post-1990s drop in the crime rate.

This chapter depicts the burden of suicidal behavior among African American males. It describes the public health approach to preventing suicidal behavior among African American males. This approach includes assessing and describing the problem; identifying causes or risk and protective factors; developing and evaluating programs and policies; and implementing and disseminating findings and activities. The chapter provides a review of the epidemiology of fatal and non-fatal suicidal behavior; a summary of what is known about the risk and protective factors of the problem; and a descriptive analysis of the circumstances associated with suicides among young African American males is presented. Lastly, the authors give a summary of evidenced-based prevention programs which could be applied in preventing male suicidal behavior.

The COVID-19 pandemic has impacted every community across the globe, but the global COVID-19 data show that the United States remains the most affected country where well over 666,000 people died, and approximately 40 million citizens became ill due to the virus' spread by mid-2021 (CDC, 2021). It is also noteworthy that extreme racial disparities in rates of COVID-19 cases and deaths are high in the United States, specifically among African American population. This situation is particularly evident among African American population in Alabama's Black Belt. Subsequently, COVID-19, racial disparities, and health inequalities have become central to the national and regional conversation. This chapter examines the associations between COVID-19, social determinants of health, and the systematic health disparity in African American population in Alabama's Black Belt region using Geographic Information Systems and the concept of uneven spatial development. Understanding the relationship between COVID-19 and these disparities within a spatial context vital to developing pathways to overcome the pandemic's effects and combat the systemic discrimination in this region. The derived policy recommendation could apply to other regions experiencing social inequality and health disparity.

Prostate and colorectal cancer (CRC) rates are disproportionately high among African‐American men. The purpose of this paper is to describe the development of an intervention in which barbers were trained to educate clients about early detection for prostate and CRC.

Working with an advisory panel of local barbers, cancer survivors and clients, educational materials are developed and pilot tested through use of focus groups and cognitive response interviews.

The advisory panel, focus groups, and interviews provide key recommendations for core content, intervention structure, and evaluation strategies. The men suggest a variety of things they want to know about prostate cancer, however the perceived need for CRC information is much broader, suggesting a knowledge gap. The men prefer print materials that are brief, use graphics of real African‐American men, and provide a telephone number they can call for additional information.

Community involvement is key in developing a well‐accepted and culturally‐relevant intervention.

The paper usefully describes the process of developing and pilot testing educational materials for use in an intervention in which barbers would be trained as community health advisors, to educate their clients about CRC screening and informed decision making for prostate cancer screening.

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an area's racial and class composition and its environmental conditions, has led to the rise of an environmental justice movement. However, few studies have connected these two sets of findings to ask whether social disparities in health outcomes are due to local environmental disparities. This chapter investigates whether the association between racial and socioeconomic composition and multiple health conditions across New York City zip codes is partly mediated by neighborhood physical, built, and social environments.

There is a peculiar problem in the US that is proving to challenge core values that undergird our laws, interpersonal interactions, and challenge the civil rights of many. American society believes in harsh sentences for committing crimes without a system for rehabilitation from crime and absent from resources from a community level to prevent crimes. As crime has declined since the 1990s, policing behavior has grown to a level that reflects a disregard for humanity resulting in police-involved shootings, also known as “justifiable homicides” or deaths by legal intervention. This peculiar problem reifies old notions of racial inferiority and racial profiling that stem from a long history of lynchings in America, and highlights a broken legal system that shows bias toward poor communities and communities not of the racial and ethnic majority. When laws support one racial or ethnic group and those with resources, other communities become invisible and subjected to state-sanctioned violence that allows some police agencies and police officers to engage in behaviors that do not reflect their training foster an overwhelming sense of fear in these communities. We have observed that when communities fear the police and the larger society disbelieves the negative interactions with police, residents have begun to capture police encounters with community members on social media. Despite the video footage that has been collected documenting abuse of power, some police have been granted impunity for their actions, which further fuels fear in these communities. What we propose are ways to frame and solve negative police encounters with communities through an understanding of: (1) racial biases; (2) racial and gender consciousness; (3) ways to provide more equitable policing practices; (4) the enforcement of legal remedies for those who abuse power; and (5) the prevention of acts of discrimination by holding individuals culpable who informally police Black males. We believe these strategies aid in addressing the historical legacy of these behaviors and moves multiple systems and disciplines toward integrated solutions to eliminate “justifiable homicides.”

Suicide is a public health crisis that differentially affects racial and ethnic groups. Suicide is a public health crisis that differentially affects racial and ethnic groups. American Indians had the highest per capita suicide rates (11.1 for females and 33.4 for males) followed by White Americans (8.0 for females and 29.8 for males; Centers for Disease Control, 2019). There is an emerging focus on racial/ethnic disparities in suicide prevention research. Prior studies suggest that more accepting attitudes toward suicide are associated with elevated suicide risk status. As such, this study aims to examine the association between racial/ethnic identity and three attitude domains: the right to die, interpersonal gestures and resilience.

General linear models were used to compare racial/ethnic groups in right to die, interpersonal gestures and resilience attitudes.

Participants who identified as Native American or Black were more likely than participants who identified as White, Bi/Multi-racial and Hispanic to hold attitudes supporting interpersonal motivations for suicide. Participants who identified as Black were more likely than participants who identified as White to hold right to die attitudes. Participants who identified as Black were more likely than White participants to report not viewing suicide as an option. These results suggest that racial/ethnic identity impacts attitudes toward suicide. People who identify as Native American or Black may be more likely to see suicide as acceptable for interpersonal reasons despite those who identify as Black being less likely to see suicide as an option. This study has implications for suicide prevention programs and interventions within racial/ethnic communities. Focusing interventions on attitudes supporting interpersonal motivations for suicide may increase effectiveness within Native American and Black communities.

This study aimed to fill a gap in suicide prevention research by examining associations between racial/ethnic identity and responses to a multidimensional attitude toward suicide measure. No prior study has compared attitudes across multiple domains and racial/ethnic groups.

This chapter provides an introduction to the volume and reviews some issues related to provision of health care services to racial and ethnic minorities and other underserved population. In addition to this review of some of the material on underserved populations and what has often been called in the US “health care disparities” concerns, this chapter also serves as an introduction to the volume. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.