The Challenging Health Care Issues Affecting Older African Americans

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.

Empower patients with culture-specific strategies for promoting health, treating disease, and preventing violence!Current reports show that Black Americans have the highest death rate of all racial and ethnic groups. They suffer disproportionately from a number of fatal diseases, including hypertension, diabetes, and certain cancers. Moreover, violence takes far too high a toll, especially among young Black men. Clearly a different approach to health education and promotion is needed to end this tragic waste of valuable human lives. Health Care in the Black Community: Empowerment, Knowledge, Skills, and Collectivism proposes an innovative model for health professionals working in the Black community.Traditional Western medicine focuses on sickness, the isolated individual, and the material world. However, the Afrocentric values of many Black people emphasize wellness, the community, and the spiritual world. By basing health care approaches on the community's positive values of holistic healing and mutual assistance, Health Care in the Black Community suggests practical, effective strategies for promoting physical and emotional wellness. This comprehensive and informative book offers a solid intellectual framework as well as practical advice. Health Care in the Black Community: identifies deeply held African-American cultural traditions and attitudes offers specific suggestions for combining health care priorities with respect for cultural concerns shows how to gain compliance by involving patients in their own care and drawing on community strengths discusses the impact of specific problems such as low self-esteem, infertility, HIV/AIDS, and violence on Black families develops strategies for preventing family violence by helping family members define and identify emotions shares programs and ideas for enhancing the physical and mental health of elderly Black people identifies ways to overcome the drawbacks of early parenthood Health Care in the Black Community offers health care professionals-- policymakers, practitioners, researchers, and educators in the fields of social work, health care, and cultural studies--successful methods, models, and suggestions to help improve health care in Black communities.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.

Today, nearly one of every eight Americans is 65 or older, and by 2030, over 20% of the population will be in this age group. Are you prepared to work with this vastly diverse—and rapidly growing—population? This single source is designed to help social service professionals provide effective services to America’s vastly diverse and rapidly growing elderly population. Diversity and Aging in the Social Environment explores the impact of race/ethnicity, gender, sexual orientation, and geographic location on elders’ strengths, challenges, needs, and resources to provide you with a more complete understanding of the issues elders face. In order to be more responsive to older adults, social workers and other human service professionals need to enhance their knowledge of the aging population and the factors that impact the way seniors interact with society, organizations, community resources, neighborhoods, support networks, kinship groups, family, and friends. Diversity and Aging in the Social Environment examines differences in race, ethnicity, geographical location, sexual orientation, religion, and health status to help current and future human service professionals provide culturally competent services to the diverse range of elderly people they serve. In addition, it addresses the wide disparity that exists for older Americans in terms of income and assets, number of chronic conditions, functional and cognitive impairment, housing arrangements, and access to health care. This book provides a context for the examination of diversity issues among older adults by describing and discussing several theoretical perspectives on aging that highlight important aspects of diversity. Next, you’ll find thoughtful examinations of: issues and challenges faced by lesbian, gay, bisexual, and transgender elders—and the strengths they bring into later life the impact of gender, race, and sexual orientation on prevalence rates, risk factors, methods of disease contraction, and mortality rates among older adults with HIV/AIDS—along with a discussion of the psychosocial issues they face diverse characteristics of custodial grandparents—and the influence of the caregivers’ gender, race, age, and geographic location on methods of care and available caregiver support differences in caregiver characteristics, service utilization, caregiver strain, and coping mechanisms among several racial/ethnic groups of adults who care for elderly, disabled, and ill persons cultural/religious factors that influence interactions between health care personnel and Japanese-American elders the relationship between acculturation and depressive symptoms among Mexican-American couples life challenges facing Jewish and African-American elders—with a look at each group’s coping mechanisms differences in religious/spiritual coping skills among Native American, African-American, and white elders psychological well-being and religiosity among a diverse group of rural elders