African American College Students' Perceptions of Psychosocial Factors Influencing Racial Disparities in Health.
Objective: This study examined African American college students' perceptions of psychosocial factors that influence racial disparities in health. Methods: We conducted focus groups in two Alabama Black Belt Counties from June to August 2005. Data were collected using a standardize discussion guide, augmented by prompts for clarification. Results: Principal component factor analysis with varimax rotation was used to identify patterns or the dimensionality of psychosocial factors identified by the students. Principal component factor analysis identified three patterns that accounted for more than 64% of the variance of psychosocial factors influencing racial disparities in health. Our findings indicate that many African American college students perceived racism/discrimination targeted at African Americans, mistrust of whites and of medical and public health institutions among African Americans, poverty and lack of health insurance as major psychosocial factors influencing racial disparities in health. Conclusion: Findings from this exploratory study indicate the potential influence of psychosocial variables on racial health disparities deserves further attention. In order to make measurable progress in eliminating racial disparities in health or closing the gap by 2010, policy makers, program planners, and medical practitioners must consider the broader context of racism, mistrust of whites among African Americans and health insurance issues. Government and health care professionals need to work with African Americans and obtain the trust of their communities by addressing current perceived racism within the health care system. In addition, there remains a desperate need for health initiatives that target areas of persistent rural poverty, many of which are also home to concentrated racial/ethnic minority populations. INTRODUCTION Despite tremendous progress in the use of preventive and life-saving medical technologies in America, racial and ethnic disparities in health persist. For example, mortality rates for stroke, heart disease, and HIV/AIDS are higher for African Americans than for whites. Disparities in health status between black and white Americans are so well documented and are of growing concern to policy makers (U.S. Department of Health and Human Services 2000). In response to President Clinton's Initiative on Race, The Department of Health and Human Services is paying attention to racial disparities in the nation's health. One of the ambitious major goals of Healthy People 2010, the nation's health policy for the Twenty-First Century, is to eliminate racial and ethnic disparities in health by the year 2010. This unprecedented effort will require a major national commitment to identifying and addressing the underlying causes of higher levels of diseases and disability in the African American communities. In other words, identifying and understanding social factors (psychosocial variables) that help African Americans obtain needed health care or that hinder them from doing so is an important goal for social science researchers interested in the U.S health care system and eliminating racial disparities in health. Efforts to understand racial disparities in health should focus not only in terms of individual characteristics but also on social factors that sustain the disparities. In this paper, we provide insights on rural African American college students' perceptions of the psychosocial factors influencing racial disparities in health beyond those found in the biomedical model. This is because the role of psychosocial factors in helping or hindering individuals in obtaining needed health care has not received much attention in research on health disparities. Moreover, African American college students' perceptions about psychosocial variables influencing racial differences in health and access to health care can help shape public opinions and influence the actions of policy makers in eliminating racial disparities in health by 2010. …