Unfortunately, there are inequalities for different groups in modern society in access to services and participation in political, social and cultural life. Some of these groups did not take advantage of the potential of previously implemented social policies and programs, while others cannot be realized due to the historical context. Thus, ethnicity can be seen as a factor in the natural exclusion of certain groups or populations.
Previous development strategies in the health sector tended to ignore ethnicity. However, recently more attention is paid to various kinds of minorities, which allows the development and implementation of treatment measures. The purpose of this essay is to analyze the African American community as an ethnic American minority. In the scope of this research, an analysis of the health situation is needed to explore possible methods of health promotion prevention, taking into account the unique, including cultural, needs of this group.
Description of the Ethnic Minority and Current Health Status
After China and India, the United States is the third most populous country, with 332 million inhabitants in 2021 (“U.S. and world population clock,” 2021). A multicultural and multiracial population makes it the first country of immigration in the world. In the context of population, minorities are usually defined as non-white people belonging to either a racial group or ethnicity. Today, the African-American community is in the second position with 13% of the population (“QuickFacts United States,” n.d.). Unfortunately, the life expectancy of black Americans is four years shorter than that of whites, according to federal health officials (“Table 15,” 2017).
Thus, the African American community has an apparent health status problem, which hints that there are some obstacles to providing them with medical care. As further studies show, the main issues with the health sector of this group are associated precisely with the presence of racial prejudices.
Health Disparities Existing for This Group and Nutritional Challenges
There are many health disparities inherent to the population. For example, it has already been proven that African Americans have more postoperative complications than white Americans due to more common comorbidities (Nafiu et al., 2020). At the same time, these disorders exist among healthy children without chronic disease or other risk factors. The research found that African American children were 3.43 times more likely to die within thirty days after a surgical operation than white children (Daley, 2020). Another significant disparity is nutritional challenges, which come from cultural practices and decreased access to a healthy lifestyle.
Many studies relate the prevalence of obesity and hypertension to the so-called “soul food diet,” which is inherent to African American culture (Msora-Kasago, 2021). With all these factors considered, the analyzed ethnic minority faces fundamental challenges in nutrition, resulting in a variety of health issues in the long-term perspective.
The Barriers to Health
As a rule, African Americans find it more difficult to access health care. In addition to the cost of health insurance, they face discrimination caused by racist prejudice. These preconceptions have negative consequences on their management by health personnel. Even the algorithms are unfavorable, as in decision support software often used by healthcare organizations. In addition to culture, the economy has a significant influence in this case. The rate of people living below the poverty line was 11.8% in the whole of the American territory in 2018. This rate peaks at 20,8% for the black population against 10.1% for non-Hispanic whites (“Income and poverty,” 2019). The unemployment rate is also twice as high among the black population.
According to national origin or ethnic-racial affiliation, inequalities in healthcare and health inequalities are closely linked to economic disparities. Ethnic discrimination observed in the area of work and discrimination in access to housing is all factors that perpetuate precarious living conditions, which in turn constitute barriers to access to care. Likewise, ethnic and racial discrimination is likely to determine “risky” health behavior. As has been shown in the context of cervical cancer screening, a prevention strategy can generate differentiated opportunities according to ethnic groups (World Health Organization, 2020). Thus, in African Americans, economic and social factors are closely intertwined, making it difficult to obtain skilled health care.
Health Promotion Activities
Evaluation of the preventive measures most frequently used by the group often involves cultural studies. In the context of the African American community, it is worth noting that faith and the communities based on it are critical elements of culture (Maxwell et al., 2020). As practice shows, in the absence of conventional methods, the role of medical institutions in this context is occupied by the church and other similar communities.
Studies have shown that 83 percent of African American church leaders have conducted at least one health activity in the past year (Maxwell et al., 2020). However, despite such activities, it does not have significant support and funding, so it cannot fully implement this function. Consequently, research suggests combining public health and faith-based organizations (Holt et al., 2017). Combining the key features and benefits of both approaches will provide the most effective results.
Health Promotion Prevention Approach
The most effective way, in this context, may be to implement health promotion prevention within faith-based communities. Since the economic, political and social situation cannot be changed quickly, it is necessary to use the resources that are already available. Currently, most African Americans trust the church, and preventive measures are already being implemented in this institution. Therefore, it is much easier to use an existing base than to build something from scratch. Given the current assurance in the church, a plan can be created on its basis that considers all three levels of health promotion prevention (“EPHO5,” n.d.).
At the primary level, educational measures regarding diet and general health requirements can be implemented. At the second level, church workers can explain the importance of referring to specialized services when symptoms are present. In the context of the third level, the church can help specific individuals address their diseases. The second and third levels, however, require cooperation with public services for maximum efficiency.
Cultural Beliefs and Practices and Health Promotion
When implementing assistance programs, it is necessary to consider the long history of racism. In addition, certain religious and cultural biases affect the perception of information. A close bond with the church can manifest itself in a reluctance to resort to medication, even when needed (O’Rourke & McDowell, 2018). Therefore, when implementing health promotion prevention practices, it is necessary to be extremely careful about the topic of religion so as not to cause rejection.
To most culturally competently implement these programs, you can use the Campinha-Bacote Model. The advantage of this approach in this context is a four-component system that includes cultural awareness, skill, knowledge, and encounter (Albougami et al., 2016). This allows one to most effectively avoid contradictions and collisions in communication, ultimately leading to more effective plan implementation.
Thus, as an ethnic group, African Americans are in a rather disastrous position in health care due to the presence of significant barriers. Overcoming them is quite difficult due to prejudices based on a long history of racism. However, there is an opportunity to introduce health promotion prevention practices based on existing cultural characteristics, particularly the close spiritual connection of African Americans with the church. Nevertheless, without using particular models and the development of cooperation between spiritual and public centers, the implementation of health promotion prevention can be undermined. Therefore, it is imperative to research African American culture in detail and fix current problems based on the culture of this minority.
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Table 15. Life expectancy at birth, at age 65, and at age 75, by sex, race, and Hispanic origin: United States, selected years 1900–2016. (2017). Centers for Disease Control and Prevention. Web.
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