There are quite a few variables that play into this (heart disease) as well as diabetes and other conditions (HIV) in the African American community (and other minority communities as well).
1. One must ask if it is culturally normative behavior to seek preventative care. Frequently, poverty is a major deterrent to preventative care and poorer folks are seen most frequently AFTER a condition has had a chance to worsen (and when the outcome of treatment may not be as good), the individual showing up for medical care when the symptoms can no longer be managed at home. So is it that African Americans are seen later in their disease progression because of race, poverty, or some combination of both?
2. What has been the collective cultural experience of the medical system? If Blacks in the US have recollection of (or have heard stories of) the Tuskegee Experiment (wherein African American males with syphilis were allowed to go untreated even after the advent of penicillin in order to measure the effects of syphilis when untreated), that would seem to be a major deterrent to trusting the medical community. During Tuskegee, even Black doctors in the public health system were co-opted, further eroding trust in the medical establishment. The movie, Ms. Ever’s Boys (1997), was a fairly recent recounting of the tale that individuals who are now adults may have seen. The movie served to further inform members of the community who may have otherwise been unaware of the Tuskegee Experiment.
3. What is the cultural tradition for natural or traditional remedies? If I am a member of a group of people with healers (religious or otherwise) as elders of my group, what is the likelihood that I will seek medical care from expensive folks I don’t really trust and who may not be a part of my cultural tradition?
4. Further, if my thoughts/concerns about my health is in any way associated with the level or depth of my faith (in my world view), might that not also be a deterrent to me seeking medical care? I might think I need to talk to my pastor or pray more often or more plaintively. If my condition worsens, might that not be interpreted as an indictment of my faithfulness rather than a worsening of my condition because a doctor didn’t intervene?
5. If my cultural tradition shares a fatalistic view of the world, might I also accept my illness, without intervention, in a different way than someone else who has a different world view? If I am worried about my son being arrested just for being Black or my daughter being shot in a drive-by shooting on her way to school, how likely am I going to be to seek out medical care for something I can’t even imagine or am I more likely to worry about the many horrible things I CAN imagine?
6. If I live in a matriarchal culture (because there are absent father figures in many households and strong moms and grandmothers holding the ship together), I might come to expect that Mom is going to make sure the kids get care first and Mom’s healthcare might wait until it may be too late to intervene.
7. Finally, what is my source of health information? Do I get my information from TV or the magazines that I read? Do they inadvertently support any of the above beliefs I may already hold? Are they an accurate source of health information? If I have already lived longer that the relatives I have know, might I forgo medical care if I have already beaten why I perceive as “the odds?”
Composing members:
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