Cultures differ in ways of defining and managing or treating illness. In this paper I will be discussing the cultural views of African Americans as they pertain to culturally sensitive perspectives on health care. I will be referencing the perspective of the general African American community living in Tennessee as it relates to the importance in this community of the twin institutions of family and church. In the African American community, nuclear family structures are less common and female-headed households are far more prevalent. Usually, extended kinship bonds are used to raise children and it is more common for children to have frequent contact with family members who are not their immediate parents. For an African American child growing up in Tennessee, they are more likely than children in the general population to be influenced by extended kinship bonds with individuals like grandparents, cousins, aunts, or other individuals who are friends of the family and may not be biological relations.
Family is extremely important when discussing health care because it often takes an entire family to come together to support a member of the family who is ill. Because of the differently formed economic networks of many African Americans, it’s not very common to only rely on people who are living in the same household or to only be influenced by people who are in one generation of separation, i.e. parents and children.
Where the extended family and friend network cannot come through for an individual, the church can be a great beacon of support. These cultural differences are important because they will affect a medical patients attitudes about the care that they are receiving and it will help or hinder their ability to understand, cope, and manage with the course of an illness, the meaning of a diagnosis, and the consequences of medical treatment(Coates, L., 2003).
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"Health Issues of African Americans living in Tennessee".
According to the CDC, statewide health in Tennessee is relatively poor when compared to other states. There are also social, cultural, and economic factors which build together to create significant health disparities between African Americans and Caucasians. At all age demographics, African Americans are projected to have shorter life expectancies than their Caucasian counterparts in the state of Tennessee. For example, a Caucasian baby born in 2002 is expected to live 5.2 years longer than an African American baby born in 2002.
For persons with cardiovascular disease or cancer who are over 45 years old, African American males have the highest mortality rates than males from any other racial demographic. Schisms can be seen in infant mortality rates as well. While Tennessee’s overall statewide infant mortality rate is 8.6 deaths for every 1,000 births; the infant mortality rate amongst African Americans is 2.5 times higher than the rate among whites.
This is a good indication that African American mothers may be receiving less care before pregnancy and that they may also be less supported during the birthing process or less aware of potential services that could make delivery easier.
Even though Caucasian women have a much higher natural rate of getting breast cancer, a twelve fold difference actually, the mortality rate for women who are diagnosed with breast cancer is 48% higher for African American women.(Scott, H., 2005) This is very problematic because it is probably a good indication that though African American women are less likely to be diagnosed with breast cancer, once diagnosed, they are much more likely to die from it.
While the top four causes of death for African Americans in Tennessee as recorded in 2004 are quite common throughout the racial spectrums, the prevalence of high blood pressure and type 2 diabetes in African Americans is higher than what has been observed in any other population in the entire world. Shockingly, although high blood pressure is a major problem for many African Americans, 27% of African Americans with high blood pressure are completely unaware that they have high blood pressure and have consequently not sought medical treatment. Of those who are aware that they have high blood pressure, and are in some way seeking treatment, approximately 32% of African Americans are receiving in adequate treatment.
Worse of all, there is the extension of a vicious cycle that is happening because African American women of childbearing age have higher rates of both essential and pregnancy-induced hypertension. This results in adverse results for both the mother and the child, a common result is low birth rate for the child. According to the CDC, research has shown that low birth rate is a risk factor which leads to hypertension, stroke, myocardial infarction in both Caucasian and African American adults. The cycle keeps going and going, exacerbating the health problems of African Americans because African American women continue to give birth to twice as many babies with low birth weight as their Caucasian counterparts.
African American Cultural Beliefs and Myths
The vast majority of African Americans are Christians and many sociologists have written about the importance of the church. Religion is important to many African Americans and God is seen as an all powerful source of both health and illness. Some beliefs which flow from the devout’s belief in God may sound superstitious. Some examples include that health is a gift from God while illness is some way of exacting divine vengeance. Many believe that women are more susceptible to illness during some critical times such as during their monthly menstruation.
Many people view prayer as having efficacy in the treatment of the ill. It is common for prayer cloths to be placed on the bed or gown of a sick person, with the intent that it will help them get better faster. Many African American people are more trusting of their church than of the health care system and the state supported medical apparatus. It’s not uncommon for an African American person to mistrust the hospital so severely that they view it as a place where people go to die. Home remedies are consequently in demand because they are seen as a way to avoid the hospital and the dangers attributed to it while still getting some form of ‘safe’ treatment for a certain disease. While some of these treatments may be seen as not liable to cause harm, nevertheless they are rarely supported by firm science. There are practices which may seem strange to people like putting castor oil and coins on the umbilical cord during deliveries until it falls off to prevent the newly born infant from getting a protruding umbilical area.(Coates, L., 2003)
Recommendations for Medical Providers
Tennessee is and will continue to be a state with a great deal of diversity but unfortunately, separate does not mean equal. It is increasingly important the health providers reflect on the needs and differences of an increasingly heterogeneous patient base(Coates, L., 2003). Medical providers should work on understanding how they are seen and judged by people from different cultures and changing their communication patterns to have more successful interactions with patients from different communities.
Medical providers should work on unpacking their biases, prejudices, and discriminatory behaviors which may make working with various demographic groups challenging or even impossible. A patient should not be seen as a generic ‘adult’ with a disease that needs to be treated, they should rather be fully affirmed in their humanity and it is important to understand that discrimination, poverty, and other oppressive factors will have a profound role on how well a person interacts with their treatment program.
There is a lot of work that needs to be done on the end of medical providers so that they can be trusted as sources of empathy, honestly, warmth, positive regard, and authenticity. Once a medical provider fully expands on their skill set so that they can win the confidence of their various patients from different diverse backgrounds, they will be on a better road to solving major public health problems and making the country an easier place to live for everyone.
- Breedlove, S. M., & Watson, N.V., (2013). Biological Psychology. (7th ed., pp. 49-53). Sunderland, MA: Sinauer Associates, Inc. Publishers.
- Coates, L., (2003). Culture Whisper – Healthcare Reflections: Understanding African Americans, Retrieved from http://www.salemhealth.org
- Scott, H., (2005). View Point Commentaries on the Quest to Improve the Life Changes and the Educational Lot of African Americans ‘ The African American Culture, Retrieved from http://health.state.tn.us/
- Hill, C. E. (2009). Helping skills: facilitating. (3rd ed.). Washington, DC: American Psychological Association
