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April 15, 2002

Healthy communication

By Eric Rangus


“I don’t want to bore you,” Torrance Stephens began, although the possibilities of that happening are quite slim considering the quality of his subject matter and the energetic way in which he discusses it. “But I could take the top 10 causes of death over the last 15 to 20 years, and you’d see African American men at the top of probably all the categories,” said Stephens, research assistant professor of behavioral sciences and health education in the Rollins School of Public Health.

Prostate cancer, high blood pressure, diabetes, HIV/AIDS and other diseases afflict black men at rates disproportional to those of the remainder of the U.S. population.

Stephens’ primary research interest is African American men’s health, and through his work he has sought ways to improve their quality of life.

“Until we start to focus on this population,” Stephens said, “we’re going to continue to see such problematic rates in all acute and chronic infections, as well as other problematic health outcomes, such as violence, and HIV and AIDS.”

Two of the primary means to improve African American men’s health—everyone’s health, for that matter—are education and communication. It’s not as easy as it appears, either, with a health care system than is becoming increasingly bureaucratic.

“The days of the professional doctor inculcating information into the passive patient are over,” Stephens said. “Nowadays, although we have all these hospitals and advances in technology, we still have people going to doctors and hospitals late, at the very end of a problem.

“Once they’re in, they are rushed through an assembly line: Go to this window here to pay your money. This window to check your insurance card. This window to have your vitals taken. A lot of people—particularly those in minority communities—are turned off by that. I think we need to make sure that we empower individuals to be proactive about their own health care and their own health behavior.”

Recently, Stephens’ research has veered toward a specific population of men—those who are in prison. In many ways, these men are the most vulnerable to disease. They rarely practice proper health habits, Stephens said, not necessarily because they don’t care, but they just have never learned how to properly protect themselves.

Not only has Stephens studied men in American prisons, but he also has taken his research abroad.

In June, Stephens along with Ronald Braithwaite, a professor in the Rollins school, and several peer educators, will travel to Kwazulu Natal, a rural area in eastern South Africa, to begin a program in that country’s prisons to provide inmates with basic health care skills in order to help reduce their risk of infectious disease. It is modeled after a study Braithwaite and Stephens performed in Georgia prisons.

“One reason it is important to work with prison populations, not only overseas but here, is because nine times out of 10 these individuals will be reintegrated into the community,” Stephens said. “So it’s very important that we give these individuals the capacity to reduce the likelihood of spreading infectious diseases among their communities.”

And some of the diseases Stephens will be dealing with are quite frightening. The number of South Africans infected with HIV/AIDS, for instance, has reached pandemic proportions. The infection rate in the prison population, of course, is difficult to determine, but the chances that it is higher than the general populace are good. Not only must health care professionals deal with HIV, but also tuberculosis, hepatitis and several diseases rarely seen in the U.S. but deadly in Africa, like malaria, beriberi and cholera.

One of the most important aspects of this effort is the peer educators—former prisoners who are HIV-positive. Part of the study’s point is to determine whether the message to prisoners about practicing better health care is more successfully delivered by an HIV-positive former inmate, a regular inmate or a traditional health educator.

Stephens is still interpreting data from his previous work, but he said that among the prisoners he has educated though various programs, the rates with which they have returned to prison have fallen as well as IV drug use, needle sharing and sexual contact among prisoners has dropped.

This will be the third consecutive summer Stephens has traveled to South Africa. In all, he’s been to the continent nine times. The first was in 1992 when he spent 13 months in Nigeria doing postdoctoral work leading a child survival and maternal health care project.

“I really love Nigeria,” Stephens said. “There was a genuine appreciation for trying to implement health care services in rural areas by the Nigerian population. It showed me that we don’t always have to go over there with a ‘know-it-all’ attitude. People can solve their own problems.”

Since joining the Emory faculty in 1997, Stephens has written or cowritten nearly 40 articles, chapters or book reviews. He most certainly is interested in his work, but he writes for another reason—he likes it. And he writes much more than just academically tinged pieces.

“Maybe one day I’ll find a publisher for the all the books I’ve already completed,” he said. Sixteen books of verse, novels and short stories, he estimated. Some of them are at home; others he keeps in the office.

“It’s what I do to keep sane,” he said.

The writing bug bit Stephens while he was an undergraduate at Morehouse College in the mid-1980s. One of his roommates told him that Spelman College was sponsoring a playwriting contest and was offering $500 to the winner. The only thing was that the play had to be submitted in two weeks.

Six days later, Stephens cranked out a play. He turned it in and took second place.

“I have dreams of being the greatest literary figure of all time,” Stephens laughed. “Delusions of grandeur, of course.”

Writing and raising his 9-year-old son, Thabiti, keeps Stephens, a single father, busy outside the classroom. Like many fathers, Stephens has coached his son’s teams in basketball and baseball—something he’s done for five years.

Of the two sports, baseball is his favorite because of the lessons the children can learn.

“The reason I like coaching, particularly baseball, is you have to learn to work with other people,” Stephens said. “I think baseball is the best teacher of that. You can’t play every position and you can’t bat every time. And, if you lose, there is a tomorrow.”