The My Brother’s Keeper White House Initiative and the MBK Alliance call for public and private efforts to help boys and young men of color achieve milestones at the same rate as others in the United States. This blog series discusses strategies that could be effective in meeting those goals.
None of the six milestones in the My Brother’s Keeper initiative addresses health issues, yet access to health care—reproductive health care, in particular—is essential to achieving the six milestones. Health is a prerequisite for ensuring that young men gain a good foothold on the ladder to success. The current system of providing reproductive health information and services, however, works against some of the young people who need these services the most.
Boys and young men of color (BYMOC) suffer from substantial inequities in sexual and reproductive health. More than half of births to black men between 2006 and 2010 were reported to have been unintended, while that number is below 35 percent for white men. Young, unintended fatherhood can make a successful transition to adulthood much more difficult and can make it harder for BYMOC to be the best fathers they can be.
BYMOC also suffer from higher rates of sexually transmitted diseases. Thirty-two percent of new HIV cases in the United States in 2014 were found in African American men. Rates of gonorrhea, chlamydia, and syphilis are higher for men of color than for white men, and rates of gonorrhea and syphilis are even higher than for black women. There is evidence that these inequities are because of structural factors as well as differences in behavior and beliefs.
Although publicly subsidized sexual and reproductive health care exists in many communities, it is still disproportionately directed toward women. Most men ages 15 to 44 need family planning services, but only a small number receive health care that includes contraceptive advice or counseling about sexually transmitted infections. This is the case despite substantial research on men’s sexual and reproductive health needs and advocacy for including men in sexual and reproductive health care.
Some barriers to providing sexual and reproductive health services to men have been surmounted. For example, there are now clinical guidelines for providing this care. But clinics that provide sexual and reproductive health services have a long way to go to become welcoming to BYMOC. An important next step is for these clinics to adopt practices and procedures that are both culturally competent and gender competent to serve BYMOC.
These factors are essential for success: staff training, the proper clinic environment, and targeted outreach. In-service training for staff that emphasizes sexual and reproductive health for young men is important; so is including male staff of color, particularly among staff members who are the first point of contact for young men.
Changes to the clinic environment are also important. One strategy that has proven successful is special clinic hours just for men. Even when this is impossible, there are other steps clinics can take to make BYMOC feel more at home. Clinics typically display health education brochures around the waiting room, and these should include brochures that focus on male issues and that feature pictures of BYMOC. Posters and other decorations should also feature young men of color. Men’s rooms should not be three floors away. Forms that are used by both clients and staff should be gender neutral and include questions that apply to young men as well as young women.
Of course, culturally competent staff and a welcoming environment are of no use if male clients of color don’t come through the door. Outreach is essential. Clinics should make sure that recreation centers and other places where BYMOC congregate have flyers, posters, and other information about clinic services for men. They should also make efforts to persuade local programs in areas such as workforce development to include programming in sexual and reproductive health or make BYMOC aware of services available elsewhere. A parallel strategy is “in-reach,” that is, encouraging young female clients to bring their partners along to clinic appointments, where they can find out about services for themselves.
There is a groundswell of support and effort to provide better sexual and reproductive health care to men. As these activities proceed, we must focus on culturally competent service and targeted outreach and in-reach to BYMOC. Only then will the sexual and reproductive health inequities they endure be ameliorated, which will reduce another barrier to boys and young men of color achieving their important life goals.