Assessing perceptions of and responses to multiple health risks among the southern poor.

Introduction: We explored perceptions of and responses to multiple health risks among people living in poverty in the southern United States.

Methods: We conducted 12 focus groups and interviewed 66 focus group participants in 3 southern US cities (Birmingham, Alabama; Jackson, Mississippi; and Columbia, South Carolina). Thematic analysis was used to identify major themes.

Results: Study participants worried most about chronic health conditions and the costs to treat those conditions. Feelings of threat were influenced by family health history and race. Barriers to health-protective behaviors included time, work, family, apathy, and low response efficacy. Physical activity and checking blood pressure were the health-protective behaviors in which participants most often engaged.

Conclusion: Our results will be useful for the development of interventions that target the southern poor. Intervention messages should address the barriers that poor people face when attempting to engage in health-protective behaviors and should help strengthen people's confidence in their ability to change their behaviors.