African Americans

CultureO African-American culture is rooted in Africa.O Includes various cultural traditions of

African ethnic groups.O It is a both a part of and distinct from

American culture.O A mixture of chiefly sub-Saharan African

and Sahelian cultures.O Values and beliefs that have survived over

time have been incorporated with some elements of the European-American culture.

(Ohio State University, 2010)

Culture continuedO African-Americans participate in a culture

that centers on the importance of family and the church.

O There are extended kinship bonds with grandparents, aunts, uncles and cousins.

O Individuals who are not biologically related may also play an important role in the family system.

O A key member of the family is usually consulted for important health related decisions.

(Ohio State University, 2010)

Religious PracticesO The church is an important support system for

many African Americans.O African-Americans practice a number of religions.O Protestant Christianity is the most popular.O The ethnic group makes up 14% of Muslims in

the United States.O Seven day Adventist, Jehovah Witness, and

Catholicism are also practiced.O A small, but growing number of African-

Americans participate in African traditional religions, such as Voodoo and Santeria.

(Library of Congress, 2013)

Note In Practice…O Preferred Term: Black, Afro-American, Black, Negro, African-American, its

ok to ask

O History of Immigration: slavery in the 18th and 19th century moved eight millions Africans to America. Historical events of emancipation, civil rights movement and crossing class boundaries are important influences. Caribbean and some areas of Africa share some history of slavery.

O Communication: Traditional dialects of Carolinas, Alabama, Louisiana, Black English, Ebonics.

O Literacy assessment: Ask about education. Bickley (2009) recommends handing paperwork upside down to assess literacy.

O Nonverbal assessment: Maintain eye contact to establish trust

O Orientation toward time: flexible time frame, not linear.

(Locks & Boateng ,2008)

DietO Historically, African-American rites revolved

around food.O The society was based on religious

ceremonies, feasting, cooking, and raising food.

O Traditional “soul food” which consists of fried chicken, candied yams, collard greens, corn bread and macaroni and cheese, is often high in fat, sodium and starch.

(Library of Congress, 2013)

Diet continuedO While part of the diet is high in fat,

other parts of it are low in fiber, calcium and potassium.

O Home baked cakes and pies are also common.

O The diet is a contributing factor to obesity, heart disease, and diabetes.

(Library of Congress, 2013)

MythsO All African-Americans adhere to poor

diets and have bad cooking habits.O Have no concern about their health.O Lack nutritional understanding and

health education.(Ohio State University, 2010)

Symptom ManagementO Pain: generally open but there are variations. May

avoid medications for fear of addiction.O Dyspnea: likely to accept oxygen and opiates if

educated. Strong fear of addiction to opiates.O Nausea/Vomiting: may prefer ginger ale and soda

crackers, tea before medicationO Constipation/Diarrhea: openness to reporting.

Older people may become upset if bowels are not moved daily

O Depression: Seldom acknowledge depression; may view as a “tired” state

O Self-care for symptom management: Home remedies may be used first

(Locks & Boateng, 2008)

Illness BeliefsO Causes of Physical Illness- natural

causes, improper die and eating habits, exposure to cold air/winds. Unnatural or supernatural causes: god’s punishment for not living according to God’s will, work of the devil, spell.

O Cause of genetic defect- God’s will. Some variations noted with level of education.

O Sick role- illness means that roles cannot be fulfilled. Attention to family expected but independence maintained.

(Locks & Boateng ,2008)

Illness Beliefs continued…

O Home and Folk remedies- Teas, herbs, warm medicated compresses to chest for colds, cotton balls in nostrils to protect against cold winds; advice/prescriptions from folk healers who are stable and respected resources. Magic, Obeah or Voodoo used in rural areas with African and Caribbean influences.

O Care seeking- both folk and biomedical systems used. Biomedicine highly respected and used for serious illnesses.

(Capers,2005)

How Beliefs hinder their state of health

O Some may prefer self-treatment as giving “God a chance to heal”.

O Older patients may seek care from folk healers, lay advice, home remedies and prayer to treat illness.

(Library of Congress, 2013)

Health PracticesO Concept of Health- Feelings of well-

being, able to fulfill role expectations, free of pain and or excessive stress.

O Health promotion and prevention- Proper diet, proper behavior, exercise and fresh air; protect against cold weather.

O Screening- open and accepting about new health information; application variable

(Height , 2009)

Culturally Appropriate African AmericanGeriatric Care

Important issues for effective geriatric care for African American elders are:O background knowledge of the historical events that

have influenced their lives and attitudes toward health care, and

O knowledge of their health beliefs and practices.O Because of the experience of many African American

elders who grew up with segregated health care and social service systems in which they faced continual discrimination, it is extremely important to show respect to them in clinical settings in order to put them at ease and establish rapport.

O Use respectful titles (e.g., Mr., Mrs.) unless they give the clinician and staff permission to do otherwise

Tammy’s Personal Experiences with African American Culture..

O African Americans are as diverse as there are African Americans. Though there is some commonality in family relationships, spiritual and religious orientation, individuals can be so different because of variations in education, environment and upbringing.

O I had an experience with a Muslim African American who was permitted by his religion to marry more than one wife. He had three. It was hard at first to treat each wife as the “significant other” because of my own cultural beliefs and upbringing. Fortunately, I was able to treat the patient, reassure and relay information to all three wives without incidence.

Sindy’s Personal Experiences with African American Culture..

O As a healthcare provider, I find that helping African-American patients modify recipes for foods they typically eat is valuable in achieving and maintaining adherence to recommended dietary changes.

O Socioeconomic status and education level are important in the meal planning and nutrition education of African-Americans.

ReferencesO Library of Congress(2013) An Illustrated Guide.

African-American History and Culture. Retrieved on September, 9 2013 from http://www.loc.gov/rr/mss/guide/african.html

O Ohio State University. (2010). Cultural Diversity:Eating in America African-American. Retrieved on September, 9 2013 http://ohioline.osu.edu/hyg-fact/5000/pdf/5250.pdf

O Capers , C. (2005). Nursing and the afro-american client. Topics in clinical nursing

O Locks, S. & Boateng, L. (2008). Culture and nursing care. San Francisco; California.

ReferencesO Froehlich, T., Bogardus, S., & Inouye, S. (2010)

Dementia and race: Are there differences between African Americans and Caucasians? Journal of the American Geriatric Society, 49, 477-484.

O Administration on Aging. (2011). Achieving cultural competence: A guidebook for providers of services to older Americans and their families. Retrieved September 11, 2013 from http://aoa.gov/AoAroot/Press_Room/Social_Media/Widget/Statistical_Profile/2011/1.aspx

O Basu, J. (2001). Access to primary care: The role of race and income. Journal of Health and Social Policy, 13(4), 57-73.

Questions or Comments?