Black Fathers in Contemporary American Society: Strengths, Weaknesses, and Strategies for Change

7. FATHERLESSNESS IN AFRICAN AMERICAN FAMILIES: PRIMARY, SECONDARY, AND TERTIARY PREVENTION

125 Chapter 7 FATHERLESSNESS IN AFRICAN AMERICAN FAMILIES: PRIMARY, SECONDARY, AND TERTIARY PREVENTION WORNIE L. REED The increasing rate of father absence in the homes of many African American children presents numerous challenges. It may be instructive to examine the different approaches that are used to address this issue. I will use a public health model to examine the problematic nature of the ways many programs approach the issue of African American fathers and families—specifically, how the public health intervention-prevention framework is used to analyze various approaches to address “fatherlessness” and the potential successes and failures of some of these approaches. This analysis is informed by my experience as an evaluator for some of these programs and my participation in various forums on the issue. The public health framework first defines a health issue in terms of its nature, extent, and distribution in a geographically defined area and then develops approaches to the problem using three levels of prevention: primary prevention, secondary prevention, and tertiary prevention. Tertiary prevention is applied to individuals who already have the problem; attempts are made to ameliorate or remedy the problem. In disease, tertiary prevention is medical treatment of the affected individual. For example, persons with heart disease are treated to keep them from becoming sicker. Secondary prevention is given to individuals who are at risk of having the problem, addressing the at-risk status of specific individuals . In the example of heart disease, secondary prevention strategies are aimed at persons at risk of developing heart disease because they smoke, have high blood pressure, or have a family history of the disease. 126 BLACK FATHERS IN CONTEMPORARY AMERICAN SOCIETY Primary prevention is aimed at the general population. It seeks to prevent individuals from acquiring the at-risk status as well as the actual condition. In the example of heart disease, primary prevention may consist of educational measures such as warning the general public about the risk factors of smoking, hereditary factors, and poor diet. My use of this model does not mean that I am defining fatherlessness as a public health issue. Rather, I am using the public health prevention-intervention model as a framework for discussing the fatherlessness issue. The problem here is “fatherlessness”—African American families and homes without resident fathers and the status of being an absent father. On average all children suffer when they spend parts of their child and teenage years without their father in the family (McLanahan and Bumpass 1988; McLanahan and Sandefur 1994; Jaynes and Williams 1989; Dawson 1991; Angel and Angel 1993; Zill and Schoenborn 1990). Children who grow up in a household with only one biological parent are worse off, on average, than children who grow up in a household with both of their biological parents, regardless of whether the parents are married when the child is born, and regardless of whether the resident parent remarries (McLanahan and Sandefur 1994). Compared with teenagers of similar background who grow up with both parents at home, adolescents who have lived apart from one of their parents during some period of childhood are twice as likely to drop out of school or have a child before age twenty, and they are one and a half times as likely to be idle—out of school and out of work—in their late teens and early twenties (McLanahan and Sandefur 1994). Does this mean that single motherhood and absence of the father are therefore the root cause of poor child outcomes, such as school failure and juvenile delinquency? Of course not. Although living with just one parent increases a child’s risk of experiencing all of these negative outcomes, it is not the only or even the major cause. Growing up with a single parent is just one among many factors that put children at risk of failure, just as lack of exercise is only one among many factors that put people at risk for heart disease. Many individuals who do not exercise never suffer a heart attack, and many children raised by single mothers grow up to be quite successful. However, fatherlessness does put many children at risk, and African American children suffer more than the general population of children because on average they tend to have more fatherlessness and fewer resources to counter the overriding effects of fatherlessness . Even among two-parent families, African American children experience more of these negative...