The public health leader says, ‘Bad news does not get better with time,’ and urges screenings and avoidance of known harmful habits
A conversation no one wants to have
Georges C. Benjamin has spent his career watching preventable deaths pile up. As CEO of the American Public Health Association, he has tracked the data long enough to know that the gap between what people know and what they do about their health can be fatal. Nowhere does that gap feel more urgent, he says, than in Black communities, and nowhere within those communities is it more pronounced than among Black men.
The reluctance to seek care, to get screened, to acknowledge that something might be wrong, is not unique to Black men. But the consequences in this population are compounding in ways that demand a more direct conversation.
What prostate cancer is doing to Black men
Benjamin does not soften the numbers. Black men develop prostate cancer younger than other groups and are far more likely to be diagnosed at an aggressive stage. The reasons are not fully understood, but the pattern is consistent and the window for effective intervention is real.
“You have to get that digital rectal exam, a colonoscopy, oral cancer screening,” Benjamin said. “As you get older, particularly if you are not at ideal body weight, you are at higher risk for heart disease, lung disease and kidney disease.”
The message he returns to again and again is that avoidance does not protect anyone. “Bad news does not get better with time,” he said. Screening exists to catch problems while they are still manageable. Waiting until symptoms are impossible to ignore often means waiting until the options have narrowed considerably.
Benjamin frames the issue in terms that go beyond individual health. “We want to be strong for our significant others and our families,” he said, “but you cannot be there if you are not healthy.” The idea of strength, he argues, needs to include the willingness to show up for preventive care.
How tobacco found its way into Black communities
The tobacco industry’s targeting of Black communities is not a conspiracy theory. It is a documented marketing strategy, and Benjamin traces it with the precision of someone who has studied it for decades.
Menthol was the mechanism. The cooling sensation masked the harshness of smoke and made the product more accessible to younger, first-time users. The industry identified communities of color as a growth market and promoted menthol products through those channels deliberately and successfully.
“Tobacco is the only product that, when used as intended, kills,” Benjamin said. The diseases it causes, lung cancer, heart disease, chronic obstructive pulmonary disease, low birth weight, are well established. What is less discussed is how much of that damage in Black communities was engineered by an industry that understood exactly what it was doing.
Vaping and marijuana: the new unknowns
Vaping arrived with the promise of harm reduction. For some people trying to move away from combustible cigarettes, it has served that purpose. Benjamin acknowledges that. But he is equally clear about what has gone wrong.
“Far too often people end up with dual use,” he said. Beyond nicotine, vaping devices have been used to deliver drugs laced with fentanyl, heroin or cocaine. Users frequently have no idea what they are inhaling.
Marijuana occupies a more complicated space in the public conversation, and Benjamin reflects that complexity. He supports decriminalization. He acknowledges that THC has legitimate medical applications under the right conditions. But he is careful not to let either of those positions slide into a broader endorsement of casual use.
“We really do not understand the long-term impacts,” he said. Smoking marijuana carries the same respiratory risks as smoking tobacco. Research into cognitive effects is still developing, partly because federal controlled substance classifications have restricted scientific access for years. Meanwhile, a commercial industry has grown faster than the science meant to inform it.
“Science is a quest for truth,” Benjamin said. “It is not the end-all. I will tell you what I know today, and if I learn more, I am eager to correct myself.”