Implications of Black men's “Hierarchy of Responsibilities” for health behavior interventions

Health behavior interventions have tended to focus more on Black Americans' food preparation and access to physical activity than where health fits in the context of their lives. Black men's personal health is often considered a low priority until health problems impair more highly valued aspects of their lives or social roles (e.g., provider, father, spouse). Gendered cultural and social demands present unique stressors in the lives of Black men and constrain their opportunities and efforts to prioritize diet and physical activity. This presentation describes data from 14 exploratory focus groups examining factors that influence Black men's eating behaviors and physical activity that were conducted with 110 urban men with a mean age of 55 from Flint and Ypsilanti, Michigan. Thematic content analysis reveals that gendered and cultural responsibilities and roles, which Black men describe as a “hierarchy of responsibilities”, influence how men prioritize employment and family needs over eating a healthy diet and engaging in regular physical activity. Black men were socialized to prioritize work and family roles over their own personal health, and this pattern is reinforced by today's gendered social and cultural norms. While it is critical to overcome knowledge limitations, personal preferences and environmental barriers, these data suggest that interventions designed to improve Black men's eating behaviors and physical activity consider how they cope with chronic life stressors. There are key culturally anchored beliefs and priorities that influence men's willingness to engage in healthy behaviors and constrain their ability to make and sustain lifestyle changes.