1. African Americans

2. Culture
O 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)

3. Culture continued
O 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)

4. Religious Practices
O 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)

5. 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)

6. Diet
O 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)

7. Diet continued
O 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)

8. Myths
O 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)

9. Symptom Management
O 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 medication
O 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)

10. Illness Beliefs
O 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)

11. 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)

12. 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)

13. Health Practices
O 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)

14. Culturally Appropriate African
American
Geriatric 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

15. 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.

16. 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.

17. References
O 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.

18. References
O 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.

19. Questions or Comments?