AFRICAN AMERICAN CULTURE

The following cultural patterns may represent many African Americans, but do not represent all people in a community. Each person is an individual, as well as a community member. The term African American generally refers to people descended from Africans who did not come to the US voluntarily—descendants of the four million slaves brought to the US between 1600 and 1800.

Social structure

According to the University of California School of Nursing, in Culture and Clinical Care, many aspects of African American culture today reflect the culture of the general US population. The structure in African American families is often nuclear and extended with non-related “family” members. The family may be matriarchal, although father or mother may take on the decision-making role. For African Americans, women more than men tend to remain unmarried, and more women have been educated at the college level.

In general, the older generation is more conservative, may have a more traditional view of gender roles, and may shun interracial dating and marriage. Elders are respected and often provide care for their grandchildren. Institutionalization of elders has historically been avoided, with sons and daughters taking on the family caretaker role.

Diet

Many African Americans like hearty meals that may include meat, fish, greens, rice, grits, white and sweet potatoes, corn, turnips, eggplant, peanuts, and homemade desserts. Leafy greens may include spinach, collards, mustard, kale, and cabbage. Traditionally, many elders eat a large noon meal on Sunday after church.

Traditional African-American food—sometimes referred to as “soul food”—is diverse and flavorful with origins in Africa, the West Indies, and American southern states. The idea of what soul food is differs greatly among African Americans. Soul food may refer to meals made with fried chicken, pork chops, chitterlings, grits, cornbread, macaroni and cheese, and hushpuppies. Dishes such as hoppin’ John (rice, black-eyed peas, and salt pork), gumbos, jambalyas, fried porgies, and potlikker may all be considered soul food. Okra is the principal ingredient in gumbo, a Creole stew, and is believed to have spiritual and healthful properties. Many of these foods found their way from the south to the north via the Mississippi River. Cajun and Creole cooking, which originated from the French and Spanish in Louisiana, was changed in character and composition by the influence of African cooks.

In 1965, African Americans were more than twice as likely as whites to eat a recommended diet of fruit, vegetables, fat, fiber, and calcium. By 1996, 28 percent of this population was reported to have a poor-quality diet, compared to 16 percent of whites. A poor quality diet often can be attributed to greater access to packaged, processed, and fast foods; the common practice of using fats in cooking; and the high cost of fresh produce and lean meat. And fast foot companies have specifically targeted African American communities as a growing market for their products.

Although many African Americans eat foods such as greens, beans, and rice, which are rich in nutrients, economic issues and deep-rooted dietary habits create challenges for changing behaviors and lowering disease risk in this population. However, through health education and increased awareness of healthy eating practices, African Americans are replacing traditional pork products with turkey, fried foods with baked foods, and starchy vegetables with tomatoes and green vegetables. National programs to improve diet quality and the overall health of African Americans and other minority groups have been initiated. Body and Soul: A Celebration of Health Eating and Living for African Americans offers information targeted to African Americans on eating a health diet rich in fruits and vegetables.

Religion

African Americans often have strong religious affiliations. Many are affiliated with Christian denominations—notably Baptist and Church of God in Christ. Many follow Islam. Maintaining good health is associated with good religious practice. Many churches maintain a health ministry, through which congregations and parish nurses support good health with flu shots, blood pressure checks, and health education. Before the advent of health ministries, African American churches had mission volunteers who attended services and administered to parishioners.

Medical care

African Americans are becoming increasingly health conscious, seeking health screenings and treatments, although health literacy in this population tends to vary by generation. Older African Americans may be suspicious of clinicians, believing their health is personal and up to God’s will. Because they may be reluctant to share personal or family issues, building a trusting relationship is key.

African Americans are affected disproportionately by the leading causes of death in the US, with more morbidity and mortality from premature births, cancer, HIV/AIDS, obesity, and diseases related to obesity, including heart disease, hypertension, stroke, and type 2 diabetes.

* African American men have higher rates of getting and dying from prostate cancer than other men. * Forty-five percent of African American adults in the US are obese. * African Americans are more likely to die from asthma than other populations. * Nearly half of those infected with HIV/AIDS are African American.

Sickle cell anemia is the most common genetically inherited condition in African Americans. They also exhibit a higher incidence of lactose intolerance, periodontal disease, and have common skin problems such as melasma (discoloration of the face) and other pigment disorders. Death and dying

Many older African Americans believe that death is at God’s will, but tend to believe that life support should be continued as long as necessary. A family-centered approach is recommended for conveying serious medical information, seeking consents, and explaining issues such as autopsy and organ donation. Cremation is generally avoided in this community and organ donation may be viewed by some as a desecration of the body. Because of the importance of family in the African American culture, the family should be informed of an impending death so that extended family members who live out of state can be notified.

In the African American community, death is an important aspect of culture, with unique traditions, mourning practices, burial rites, and even the structure of cemeteries. Rather than a time of sadness, death is a time to celebrate that the deceased no longer has to endure the trials of the earthly world. Some present day customs associated with death can be traced back to African roots. Customs have been passed down in the form of expressions, superstitions, religious practices, and music. At the time of death, old beliefs and superstitions are remembered and may be acted upon, such as not burying the deceased on a rainy day or burying the deceased with feet facing east to allow rising on Judgment Day. Coins may be placed on the eyes or in the hands of the deceased, or placed around the grave site as the deceased’s contribution to the community of ancestors.

Culture in context

Culture is essential in assessing a person’s health and well-being. Understanding a patient’s practice of cultural norms can allow providers to quickly build rapport and ensure effective patient-provider communication. Efforts to reduce health disparities must be holistic, addressing the physical, emotional, and spiritual health of individuals and families. Also important is making connections with community members and recognizing conditions in the community.

Get to know your patients on an individual level. Not all patients from diverse populations conform to commonly known culture-specific behaviors, beliefs, and actions. Generalizations in this material may not apply to your patients.

Source: www.stratishealth.org