On April 3, 2020, the Centers for Disease Control (CDC) made a statement encouraging all Americans to wear cloth face coverings upon leaving their homes. In response, Black men have expressed their concern about such a recommendation. Their concern is based in that wearing masks could expose them to racial profiling and harassment from law enforcement officers. An example of such concern can be seen in the Twitter posting of Aaron Thomas, a Black man living in Ohio: “I don’t feel safe wearing a handkerchief or something else that isn’t CLEARLY a protective mask covering my face to the store because I am a Black man living in this world. I want to stay alive but I also want to stay alive.” Such a tweet has been reposted more than 18,000 times since its original posting. Based on his statement, Thomas has decided to not wear a mask so that he can “stay alive.”
This concern has not been unwarranted. A month before the CDC provided its recommendation, two Black men posted a video of themselves on YouTube being escorted out of a Walmart in Wood River, Illinois by a police officer for allegedly “wearing surgical masks.” One of the men stated that: “[The policeman] followed us from outside, told us that we cannot wear masks. This police officer just put us out for wearing masks and trying to stay safe.” The chief of the Wood River police, Brad Wells, stated later in a news release that the police officer in the video “incorrectly” told such men that a city law prohibited the wearing of masks. Chief Wells went on to state: “This statement was incorrect and should not have been made. The city does not have such an ordinance prohibiting the wearing of a mask. In fact, I support the wearing of nonsurgical mask or face covering when in public during the COVID-19 pandemic period.” As a result of the two men filling a complaint, Chief Wells told The Washington Post that an internal investigation of the incident has begun with the assistance of the local NAACP branch.
Georgia Senator, Nikema Williams, wrote a letter to the state’s governor urging him to temporarily suspend the mask laws. She explains why in her letter, stating that her husband, who is African American, 6’3”, and weighs 300 pounds: “was telling [her] how uncomfortable it was to wear a mask in stores because folks get intimidated and look at him like he’s up to no good.”
Black men have also experienced racial profiling when not wearing a mask. In April of 2020, a video from Philadelphia filmed a Black man being removed with force by four police officers one day after the city’s transportation authority required all riders of buses, trolleys, and trains to wear face coverings. After the incident, the transportation authority made an announcement deeming face coverings no longer required for riders.
Therefore, it has been found that both Black men who follow and do not follow the CDC recommendation to wear a face covering have experienced episodes of harassment. Blacks are already at an increased risk of contracting the virus, but now Black men in particular are faced with the dilemma to wear a mask to save their lives from either racial profiling or the raging COVID-19 pandemic.
Like several senators, the NAACP has also made a statement urging states to indefinitely stop their mask laws. Marc Banks, the NAACP’s national press secretary, stated: “No person should be fearful of engaging in lifesaving measures due to racialism.”
Melanye Price is a political science professor at Texas’ Prairie View A&M University. She tells The New York Times that the well-intentioned recommendation to wear masks or bandanas actually can put African Americans at greater risk of racial profiling. According to Kevin Gaines, a professor of civil rights and social justice at the University of Virginia, Black men are already being profiled by the police on a regular basis, but wearing masks heightens such risks of profiling. The initial assumption is not made that Black men are wearing masks to protect themselves and those around them from the threat of the virus. However, in contrast, it is assumed that they are engaging in some type of ill will like stealing or other crimes.
As a result of the risks of racial profiling, some Black men have changed their style of dress in an effort to appear less threatening. STAT correspondent Usha Lee McFarling reports that Black men have attempted to “tone down their appearance to lower suspicion.” Examples of such “toning down” comes in the form of wearing college T-shirts and “dressing like prospects, not suspects.” This has even been found in their choice of mask colors and patterns, choosing floral prints or plain white masks over others.
Vickie Mays, a professor of heath policy and management at UCLA, has been attempting to track situations in which Black men wearing masks have suffered harassment. Mays tells STAT that Black men should wear masks despite the risk of racial profiling in order to, foremost, protect their health. However, she suggests that such masks not be dark in color or “ominous looking.” Instead, she suggests they be bright in color or have traditional African prints. Mays also urges health officials to swiftly procure professionally-made masks for Black communities just as they would any other commodity like food or water as this population has been reportedly experiencing greater rates of COVID-19 infection than non-minority groups.
Community and faith-based education programs have long been proven successful in reaching black communities. As an African American woman and advanced practice nurse, I have participated in many projects and studies to identify effective approaches to increase awareness, prevention, and treatment of health issues that impact my racial/ethnic group. After serving as a nurse expert for several successful community faith-based programs focused on various health issues, I worked with a local organization, in which I am a member, to address prostate cancer awareness and screening among black men in two counties in Virginia.
Prostate cancer is the second most common cancer in men, and, despite being treatable when detected early, is one of the leading causes of cancer death among men of all races, according to the Centers for Disease Control and Prevention. Prostate cancer rates among black men are significantly higher than any other race, with more than 150 new diagnoses annually per 100,000 men in the United States. Clinical progression of prostate cancer is known to be more aggressive in black men as compared to white men. However, black men are less likely than their white counterparts to engage in shared decision making (SDM) with their health care provider about the benefits and risks of the gold-standard prostate specific antigen (PSA) test. Due to the increased risk for prostate cancer among black men, screening is recommended at earlier ages than the general population.
The Education Program
Over a one-year period, I was a nurse researcher for a prostate health education program that examined whether participants had an increased awareness about key issues of prostate cancer, following a culturally targeted education program, and whether participants were more likely to engage in SDM with their health care provider about prostate cancer screening. Their knowledge was assessed through pre- and post-test surveys that addressed three topics:
Increase in knowledge about prostate cancer screening
Increase in intentions to have an SDM conversation with a physician about prostate cancer screening within 12 months
Participation in an SDM conversation with a physician about prostate cancer screening within three months after the educational program
The program worked with 438 black men over the age of 40 who were recruited primarily through churches, as well as social media and community, civic, and social activities. Participants needed to be able to speak and understand English and reside in either Prince William or Stafford County in Virginia. Religious beliefs serve as a fear reducer and motivator for increased prostate cancer screening behaviors among black men, demonstrating the importance of faith and spirituality in the black community. Programs were implemented at 12 black churches, and prayer and scripture were included before and after each program session.
It’s important to ensure that programs are meeting the needs of the community. As a result, a community advisory board was developed for this program, which included key stakeholders such as nurses, physicians, ministers, local hospital representatives, prostate cancer survivors. and community advocates for black men’s health issues.
After the pretest to assess black men’s existing knowledge about prostate cancer, an educational session began with a five to 10-minute personal testimony by a black prostate cancer survivor, followed by an engaging question-and-answer session. The men then watched a short National Cancer Institute video clip, “Prostate Cancer Survivor: An African-American Man’s Perspective.” Next, two physicians who specialize in urology taught a two-hour information session that focused on prostate cancer statistics, prevention, screening, early detection, and quality of life. Last, there was another question-and-answer session, which was followed by the post-test. Contrary to previous community and faith-based programs, this one included a second post-assessment three months after the initial program to evaluate whether patients had an SDM conversation with their physician about prostate cancer screening.
The Program Results
The results showed that educating black men about prostate cancer through a community and faith-based program increased their general knowledge of prostate cancer and its treatment by 40.2%, improved their intention to have an SDM conversation with their health care provider by 17.8%, and impacted whether an SDM conversation took place within three months of the program by more than 80%. Although the results are encouraging, it’s important to note that the black men in this program were predominantly middle class and the majority were employed full-time and possessed private health insurance. Additional programs of this nature should be conducted with those without health insurance and with lower levels of household income.
The Importance of Research
Nurses can play a vital role in helping community and faith-based organizations develop and execute programs to address health disparities. The program I was a part of is an example of how community partnerships can implement a successful health education program. Doctoral programs, like Walden University’s PhD in Nursing, train nurses to become effective researchers and scholars to tackle complex health care questions and issues. It’s critically important for research to be conducted, especially in developing culturally appropriate models for diverse communities, so more contributions toward reducing health disparities can be made available to effect positive social change.
