In the U.S., African Americans make up the second largest minority group after the Latino/Hispanic population. Despite the declining death rate for African Americans, younger African Americans are suffering or dying from numerous health issues characteristically associated with older white Americans, (CDC, 2020). They are also more likely than whites to have high blood pressure between the ages 35-64. At 18 to 49, black Americans are twice as probable as whites to die of heart disease (CDC, 2020). There are also outstanding ethnic and racial variances in infant mortalities. African American babies are 2 times more likely to die in their first year than white infants.
Racial prejudices and practices at individual and institutional levels have led to the differential health treatment of minority groups. These disparities have heavily impacted the health status of African Americans. Some contributing factors of these health disparities include geographical factors, inadequate access to health coverage, health provider and patient communication difficulties, stereotyping from providers, cultural barriers, housing, income, toxic substance exposure, education, access to drugs, occupational hazards, access to healthy foods, just to mention a few. The uptake and application of health information is a crucial factor in disease prevention. Despite this fact, fewer African Americans have a high school diploma (72.5%) in comparison with non-Hispanic whites (87.2%) and fewer blacks (18.6%) compared to whites (32.5%) have a bachelor’s degree. Poor people are associated with poor health outcomes and are more likely to suffer from heart disease, obesity, diabetes and low birth weight. Since 2000, African American income has been on the decline and constitutes to African Americans being the poorest ethnic group. Housing quality affects health and blacks reside in some of the lowest-quality housing areas in the country. African Americans living in mostly segregated surroundings have a higher chance of cardiovascular disease (Kershaw et. al, 2015). Access to nutritious food is an issue for poor black communities. Significantly fewer supermarkets are located in black neighborhoods than in white ones. The food offered in black neighborhoods is often of lower quality or les fresh. This is a contributing factor to the high rates of obesity and diabetes in poor black communities. Culture also influences the dietary preferences for black people. Soul-food, which is consumed in many social functions, typically involves lots of fatty meats and fried foods and is responsible for numerous health issues for African Americans (Lee, 2018). It is reported that only 20% of African Americans eat vegetables and fruits more than five times a day, the least of any ethnic or racial group in the U.S. (Di Noia et. al, 2016). These are just but a few of the nutritional challenges experienced by African Americans.
Socioeconomic factors are key influences to health-related disparities. The level of education signifies knowledge about dietary recommendations concerning which foods are nutritious and healthy, while a person’s income impacts his or her ability to afford healthy foods. As noted earlier, African Americans are poorer and less educated in comparison with other minority ethnic groups. America’s health system puts emphasis on the treatment-based activities, thereby putting prevention measures, health promotion and education as secondary needs. The African American community experiences higher rates of illnesses that can be prevented by physical examinations and immunizations therefore putting them at a disadvantage. Margaret Heckler tabled to Congress in 1984 a review of the health disparities suffered by minority groups in America. Three decades later, African Americans still continue to suffer unacceptable health discrepancies and are powerless to instill policies and actions that could eradicate said disparities (Noonan et. al, 2016). Cultural factors in minority populations influence health behavior and dietary preferences. Generally, African-Americans are more comfortable with large body sizes which may work against the efforts towards healthy eating. Black adults are linked with the highest rates of obesity compared to other ethnic minorities (Petersen et. al, 2019). Many African Americans do not have a regular doctor compared to whites. Seeing a regular doctor facilitates the procurement of health care services when needed and is related to better prevention, diagnosis and treatment of chronic diseases. African Americans also report less interactions with health care givers and unsatisfactory levels of care. Low quality patient-doctor interactions are linked to poor health outcomes. The role of the church and faith in African American lives promotes the members’ welfare by being involved in their education and health. PSA’s on television and radio, posters and ads in newspapers, and flyers and brochures distributed in target venues are some other health promotion avenues explored by African Americans (Graham et. al, 2018).
One approach towards ensuring an effective care plan to the African American community would be to create a church walking program coupled with educational seminars about life style diseases. Physical activity has been proven to reduce and prevent the risk factors associated with preventable chronic lifestyle diseases such as obesity, mental stress, high blood pressure and bad cholesterol, which are prevalent in African Americans. Walking is preferred as the method of exercise since it is free, accessible, cheap, the risk for injury is low, no special equipment is needed and the frequency, intensity and time can easily be self-regulated. This eliminates most barriers identified for African Americans to participate in healthy activities. A church-based walking program is an effective health promotion prevention approach because of the wide-reaching impact the church has in African American culture. Furthermore, scheduled walking groups, walking times and group sessions would encourage participation and consequentially the adoption and maintenance of a healthy lifestyle. Given the association between physical inactivity and chronic lifestyle diseases, promoting a walking culture could help not only prevent the onset of said diseases in the African community, but would lessen its morbidity. During the educational seminars incorporated into the program, health educators could take advantage and teach the participants skills that help detecting and managing these chronic diseases in their early stages. This can be in the form of encouraging for the testing of high blood pressure, advocating for a healthy body mass index, improving the lipid profile and blood screenings for these conditions. By using these methods and combining a healthy lifestyle change, the probability to improve health outcomes greatly increases. Additionally, the advocacy of nutritious diets would be a tertiary preventative approach for people with chronic lifestyle diseases. Nutritional complements such as herbal medicines, fish oil and mind-body techniques have shown promise in alleviating chronic diseases.
When creating a care plan for a minority group, cultural practices should be taken into consideration. These include social inequality domains such as race and ethnicity, socioeconomic status, environmental factors, disability and literacy. Demographical factors such as gender, education and income should also be considered. Psychosocial and cultural factors should also not be ignored. These include convenience of buying nutritious food, less guilt about overfeeding, social eating experiences, perception of physical exercises, learned behaviors and larger bodies normalization. Leininger’s transcultural theory that involves comprehending different cultures in regard to nursing and care-illness provision to provide effective and meaningful health care services to individuals with respect to their cultural practices (McFarland, 2019), would be a great fit for adequate health promotion for the black community. This is because African Americans like most ethnic minorities suffer discrepancies that are unique to their circumstances, behaviors, values and beliefs, and have an impact on their overall health status. Subsequently, a model that addresses these differences is needed in providing efficacious care services with beneficial health outcomes for the black community.

African Americans tend to face a high mortality rate compared to the White Americans. This is due to health disparities such as chronic conditions and preventive screenings. Cultural, socioeconomics and educational factors create health barriers that result to lower health behavior scores.

References

Allan S. Noonan, H. E.-M. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev 37. Retrieved from https://doi.org/10.1186/s40985-016-0025-4

Center for Disease Control and Prevention. (2020). African American Health. Retrieved from https://www.cdc.gov/vitalsigns/aahealth/index.html

Center for Disease Control and Prevention. (2020). African American Health: Creating Equal Opportunities for Health. Retrieved from
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Jennifer Di Noia, D. M.-E. (2016). Differences in Fruit and Vegetable Intake by Race/Ethnicity and by Hispanic Origin and Nativity Among Women in the Special Supplemental Nutrition Program for Women, Infants, and Children, 2015. Preventing Chronic Diseases. Retrieved from https://www.cdc.gov/pcd/issues/2016/16_0130.htm

Kiarri N Kershaw, T. L. (2015). Neighborhood-level racial/ethnic residential segregation and incident cardiovascular disease: the multi-ethnic study of atherosclerosis. Circulation, 131(2), 141–148. Retrieved from https://doi.org/10.1161/CIRCULATIONAHA.114.011345

Lee, L. (2018). Nutrition and the African-American diet. Sampson Independent. Retrieved from https://www.clintonnc.com/features/lifestyle/27515/nutrition-and-the-african-american-diet

Louis F Graham, L. S. (2018). Outreach strategies to recruit low-income African American men to participate in health promotion programs and research: lessons from the Men of Color Health Awareness (MOCHA) project. American journal of men’s health, 12(5), 1307–1316.

McFarland, M. R. (2019). Leininger’s Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future. Journal of Transcultural Nursing. Retrieved from https://doi.org/10.1177/1043659619867134

Renwick, T. (2015). Income and Poverty Data. U.S Census Bureau. Retrieved from https://www.pdx.edu/prc/sites/www.pdx.edu.prc/files/01_Renwick_Income_Poverty.pdf

Ruth Petersen, L. P. (2019). Racial and Ethnic Disparities in Adult Obesity in the United States: CDC’s Tracking to Inform State and Local Action. Preventing Chronic Diseases. Retrieved from https://www.cdc.gov/pcd/issues/2019/18_0579.htm