Purpose: The current analyses assess the prevalence, severity and risk factors for reduced physical health among African Origin men in outpatient substance abuse treatment.

Methods: Subjects were participants in the African Men In Recovery (AMIR) program, an outpatient substance abuse treatment program. AMIR clients were of African Origin, 18 years or older, substance abusers, at risk for HIV/AIDS and able to receive outpatient services. A total of 188 clients completed a brief intake assessment, including demographic, alcohol and drug use, and HIV risk measures. Instruments evaluating physical and mental health and social support were administered to 122 clients who volunteered for an in-depth assessment following intake. Data analyses were conducted in two phases. First, descriptive statistics were generated for the sample, and the prevalence and severity of health symptoms were evaluated. Second, bivariate and multivariate analyses were conducted to identify risk factors for physical health severity. Pearson correlation analyses were used to assess the relationship between total health severity and client characteristics. In addition, three multivariate regression models were constructed for the dependent variables of total health severity, pain symptom severity and non-pain related symptom severity. Independent variables significant in bivariate analyses or considered to be clinically relevant were entered into the models.

Results: At baseline, 77.9% of subjects reported being bothered by at least one physical health symptom in the four weeks before entering treatment. The mean number of symptoms reported was 3.75 (SD 4.0). The most frequently reported pain symptoms were arm/leg/joint pain 47.1%, back pain 41.3% and headaches 34.7%. Other frequently reported symptoms included nausea/gas/indigestion 34.7%, constipation/loose bowels/diarrhea 32.0% and shortness of breath 31.9%. Approximately thirty percent (28.5%) of subjects reported either fair or poor health upon entry into treatment. The following variables were found to be significantly associated (p<.05) with increased physical health symptoms in bivariate analyses: barriers to accessing services (r=.311), panic syndrome (r=.392), lifetime (yrs.) alcohol use (r=.197), utilization of health services (r=.194), depression symptoms (r=.353) and physical or sexual victimization (r=.292). In multivariate models, lifetime (yrs.) alcohol use, barriers to accessing services, depression symptoms and panic syndrome were identified as significant predictors (p<.05) of reduced physical health.

Implications for Practice: Current literature points to the heavy health burden experienced by substance abusers, but does not thoroughly examine such issues among substance abusers of African Origin. Racial disparities in the United States are wide between black and white populations and are particularly evident among African American men. The current analyses highlight the physical health burden experienced by substance abusers of African Origin and identify client characteristics predictive of reduced physical health. The identification of risk factors will assist social workers to better address the health burden experienced by substance abusers of African Origin.