Date of Award

August 2023

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Kim Litwack

Committee Members

David Pate, Lucy Mkandawire-Valhmu, Jeanne Erickson, Amy Harley


Critical race theory, Quality of life, Racial disparities, Resiliency, Resistance, Symptom Management


AbstractAs Black American men continue to experience the highest premature morbidity and mortality, few studies have centered on the intersection of class (low-income) and race (middle-aged and older Black men) with multiple morbidity from a critical race approach in the Midwest region of the U.S. Middle-aged Black men have 31% higher death rate than their White counterparts. A qualitative study was conducted by a community health nurse in the spring of 2021 in a metropolitan city. Thirty-one, low-income Black American men were interviewed focusing on their understanding and perceptions of their complex comorbidities, symptom management for quality of life, short and long-term health planning using critical race theory. Thematic analysis and reflexivity were utilized for the dissemination of the men’s narrative as they shared their journeys with their resiliency to resist racism and persist to grow old. Two major themes were identified, 1) resiliency to resist oppression and racism, and 2) persistence for quality of life through analyzing the narratives of the participants. The themes were chosen after analyzing the narratives of the participants who identified as low-income Black men with complex co-morbidities and how they understand their health, manage their symptoms for quality of life, and short and long-term health planning. Community health nursing has an important role, with a multidisciplinary approach, to build relationships and trust among this population for higher quality of life and to support this population toward the opportunity to age and grow old. Through further community participative research, advocacy through a collaborative disciplinary approach and policy action, addressing and acting against racism as the root of Black men’s health disparities can be eliminated.

Keywords: Racial disparities, resistance, resiliency, symptom management, quality of life, short- and long-term health plan, critical race theory