When I worked as a research assistant at Mount Sinai and later pursued my master’s degree in public health at Hunter College, one thing guided my work: data. Data helps us understand problems and, ideally, solve them. We often hear statistics about health disparities affecting different communities. One of the most troubling is the disproportionate impact of colorectal cancer on Black men.
According to the New York State Cancer Registry, Black, non-Hispanic New Yorkers die from colorectal cancer at rates about 25% higher than white, non-Hispanic New Yorkers. In New York State alone, more than 1,400 men die from colorectal cancer each year. A researcher might see 1,400 as a statistic. The 11-year-old boy in me sees my father in that number. He died of colon cancer in 1985. No child should have to watch their father wither away from a disease that is largely preventable through screening and early detection.
Much has changed since the 1980s. Screening is now embedded in primary care, with routine recommendations beginning at age 45 for most adults and earlier for those with family history. Colonoscopies and stool-based tests can detect precancerous polyps before they become life-threatening. Despite these advances, Black men continue to die at disproportionately higher rates.
As a Black man, I have heard firsthand why some men delay or refuse screening. “I can’t afford to take a day off work.” “I’m not listening to no white doctors.” “I’m not having anything stuck up me.” These statements reflect real economic pressures, medical mistrust rooted in history, and cultural stigma. When these barriers go unaddressed, families pay the price.
One effective strategy is community-level outreach through trusted messengers. Public health research shows people are more likely to act on health information delivered by trusted messengers. In Black communities, peer educators such as barbers, church leaders, and community health workers have helped increase participation in cancer prevention efforts by breaking down stigma and reframing conversations in culturally relevant ways.
Real Dads Network, a fatherhood advocacy organization partnering with the New York State Department of Health, has implemented a colorectal cancer outreach campaign in East New York, Brooklyn. Trained peer educators — many of them Black men who have undergone colonoscopies themselves — engage men in honest conversations about screening. In one instance, a peer educator reassured a resident that colonoscopy is performed under sedation and explained that non-invasive stool tests are also available. Because the message came from someone who shared his lived experience, the resident became more open to getting screened.
Community outreach alone, however, is not enough. Structural barriers also require policy solutions.
Many Black men, particularly those working in service-sector or hourly jobs, lack sufficient paid time off to schedule preventive medical appointments. Although New York City and New York State have enacted Paid Sick Leave laws, preventive procedures such as colonoscopies are not clearly protected. A 2017 state law allows public employees up to four hours of paid leave annually for cancer screening, but private-sector workers often do not have comparable protections.
This gap forces too many men to choose between their health and their paycheck.
Legislation such as Assembly Bill A00479 — known as “45 Saves Lives” — introduced by Assemblymember Amy Paulin, seeks to address that inequity by allowing employees age 45 and older one paid day off every 10 years to undergo a colonoscopy while protecting them from employer retaliation. The bill reflects growing recognition in Albany that preventive care should not depend on employment class. When policymakers address economic barriers to screening, they make it easier for families to choose health without risking lost wages.
As a 51-year-old Black man, the loss of my father still shapes my life. Colon cancer robbed him of the chance to see me graduate, become a husband, and later a father. I have undergone three colonoscopies since my 40s, all with clean results. Because I was screened, I have been present for my daughter’s milestones, including her high school graduation.
Father’s Day reminds many families to celebrate the fathers and father figures still present in their lives. Preventive screening helps make more of those moments possible.
This Father’s Day, give yourself and your family one of the greatest gifts possible: get screened. As actress Taraji P. Henson said during a public plea to Black men at the 2021 BET Awards, “We see you, kings, and most importantly, we need you.”
Leon Tulton, MPH, is a member of Real Dads Network and has participated in community-based colorectal cancer outreach efforts in East New York, Brooklyn
