Examining the Perceptions, Preferences, and Practices That Influence Healthy Aging for African American Older Adults

This study explored the healthy aging and health promotion perceptions, preferences, and practices of a purposive sample of African American older adults who resided in two communities in the south. An ecological framework was used to capture environmental factors, perceptions regarding access to health promotion resources, and health behavior preferences and practices. A mixed-method approach was used. Health supporting amenities were mapped, focus groups were conducted, and demographic information was obtained. The data were merged to create consolidated themes. The results indicated that health promotion amenities were available, but with some limitations. Convenient access to transportation strongly affected ability to use resources. Older adults were interested in preserving their health and independence, but some had difficulty staying motivated to maintain a healthy lifestyle. They wanted easier access to amenities. Implications for best practice include attention to culturally responsive outreach, motivating with social support and incentives, and developing community-based culturally compatible programming.

Elder abuse and neglect in African American families: informing practice based on ecological and cultural frameworks

Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.

Chronic illness self-care and the family lives of older adults: a synthetic review across four ethnic groups

The purpose of this paper is to integrate the literature on family and social ties among older ethnic minority men and women with the literature on chronic illness self-care among elders in these groups, in order to increase understanding of social influences on self-care behavior, raise questions for future research, and inform culturally appropriate interventions to maximize the health-promoting potential of social relationships. The paper presents demographic and chronic illness prevalence information, and then summarizes literature about patterns of chronic illness self-care behaviors for older African-Americans, Latinos, Asian-Americans, and American Indians in the U.S. For each group, the sociological literature about residential, cultural, and socioeconomic patterns, family lives, and other social ties is then reviewed, and the self-care literature that has accounted for these patterns is discussed. Finally, six themes are outlined and related questions are identified to further illuminate the social context of older adults' chronic illness self-care.

Rural African American clergy: an exploration of their attitudes and knowledge of Alzheimer's disease

Rural African American clergy's ability to recognize Alzheimer's Disease (AD) and their capacity to provide support to elders with this illness has been neglected in the literature. Using a mental health literacy framework, the purpose of this research was to explore rural African American clergy knowledge and beliefs of AD. In-depth interviews were conducted with 9 African American clergy who oversaw churches in central Kentucky. Although few had direct experience with providing pastoral care to elders with AD, all clergy were literate and aware of the need for additional training. This study seeks to further clarify the role of African American clergy and their understanding of AD to inform the future development of appropriate interventions and establish better collaborative community treatment relationships.

Developing comprehensive health care for an underserved population

An especially vulnerable population is the disadvantaged and underserved older adult population residing in urban communities. This article describes a hospital-sponsored program in an urban community developed to improve access to health promotion and chronic disease control services for older adults. As part of the newly designed service, the hospital also sought to change its image from simply that of a "hospital" to that of a "community setting" dedicated to serving the comprehensive needs of older adults.

The Black-White Perception Gap and Health Disparities Research

Reducing and eliminating racial and ethnic health disparities has become a national research priority. This research agenda requires new research frameworks that encompass the social determinants of health and the translation pathways of these social contexts into physiological morbidity. Within these sociobiological research frameworks, identity and emotions are seen as crucial links in the causal pathways from stressors to biological responses. In this country, the lived social reality of African American individuals is experienced through the color of their skin. Their identity is bound with the racial inequities of our society. It has been suggested that the emotions of anger and frustration resulting from this institutionalized racial discrimination are an emotional causative pathway to the pathophysiology contributing to the health disparities experienced by African Americans. However, as much as we espouse the concept of cultural competency in health care, until recently, there has been very little honest dialogue about how race and racism influences health. This article will explore the Black-White cultural perception gap and attempt to provide insight on the relationship to African American health and implications for health disparities research.

"The rock always comes first": drug users' accounts about using formal health care

Illicit drug use remains a significant public health threat. The issues surrounding drug use are recognized by public health professionals as important for several reasons. The incidence and prevalence of drug use persists in spite of the extensive societal, interpersonal, and individual consequences. In addition, the chronic health issues and health care costs associated with drug use continue to spiral. A wide variety of quantitative studies have examined the extent of health care problems, access, cost, and health care satisfaction among illicit drug users. While these studies offer important information through survey formats, fewer studies focus on subjective constructions of health care management from the users' perspective. This article examines the elements of the decision-making process involved in accessing formal health care among chronic and injecting street drug users. Twenty-eight in-depth interviews provide the data for this analysis, which is part of a large quantitative study of 1,479 injecting and chronic drug users and nondrug users in Miami, Florida. By exploring the elements of health care access through the eyes of the drug users, researchers and treatment professionals may gain insights into new ways to improve health care access for this at-risk population.