Health Guidelines for Ethic Group of Africa as Culture and Nursing Education

Cultural Ethnicity of Africans Culture In Health Education and Nursing

Black /African American Culture as Big Ethnic Group,Ethnic Group Historical Suffering of Africans,Africans Believes About Health and Education,Africans Concepts about Health Care Providers.

Black /African American Culture as Big Ethnic Group

    According to the most recent census survey, members of the black/African American culture make up the second largest ethnic group in the United States. Currently, black Americans constitute 14% of the nation's population. Most of this ethnic population resides in the South (54%), and approximately 19% live in the Midwest, 18% in the Northeast, and 9% in the West. The greatest concentration resides in large metropolitan areas (Rastogi, Johnson, Hoeffel, & Drewery, 2010).

    The cultural origins and heritage of black Americans are quite diverse. Their roots are mainly from Africa and the Caribbean Islands. They speak a variety of languages, including French, Spanish, African dialects, and various forms of English. Depending on the age cohort to which they belong, African Americans may prefer to identify themselves differently as a racial group. 

    For example, members of the youngest generation often refer to themselves by the term African American, whereas middle-aged and older members of this ethnic group usually prefer the term black or black American. Each designation is politically correct according to the US Census Bureau's identification of this ethnic group as black/African American. 

    However, because the diversity of cultural heritage varies within the many black subgroups, nurses and other providers need to be aware of ethnic differences in cultural beliefs, customs, and traditions between these groups (Purnell, 2013).

Ethnic Group Historical Suffering of Africans

    Unfortunately, African Americans have suffered a long history of inequality in social, economic, and educational opportunity. The history of slavery of black/African Americans has shaped their experiences throughout the centuries to present day in our country. Over the many years, the issues of skin color have led to dehumanization, segregation, a struggle for civil rights, and racism (Watts, 2003). 

    As for education, they were victims of school segregation and inferior facilities until a 1954 US Supreme Court decision, Brown v. Board of Education of Topeka, outlawed the separation of blacks and whites in the public school system. However, this educational deprivation has had long term consequences, such as unequal access to higher paying and higher status job opportunities, which has led to low wages and a disproportionate number (approximately 23%) of African Americans living at or below the poverty level (Rastogi et al., 2010). 

    Because of these realities, healthcare disparities persist in the 21st century for the descendants of slaves as an ethnic minority (Noonan, Velasco Mondragon, & Wagner, 2016; Watts, 2003). Also, the legacy of slavery has affected the mental health of blacks whose repressed but justifiable feelings of anger and outrage at the social injustices endured by their people for generations continue to have an impact on the psyche, leading to a high incidence of violent, depressive , and suicidal behaviors (Carten, 2015). 

    Because of racial and social injustice, African Americans are the least healthy ethnic group in the United States (Noonan et al., 2016) and they have the most health concerns because of genetics, access to care, environmental influences, and cultural factors (Mandal, Scott, Islam, & Mandal, 2013).

    Poverty and low educational attainment have had major consequences for the black American community in terms of social equality and health and medical issues. Although black families place a high value on education, which they see as a way to raise their standard of living by being able to secure better jobs and a higher social status, there continues to be a greater than average high school dropout rate among blacks, and many individuals remain poorly educated with accompanying literacy problems (Purnell, 2013). 

    Despite the fact that fewer African Americans have a college degree than white Americans, one promising trend is that recently the number of black workers in the labor force earning a college degree (25%) is growing more quickly than ever before (US Department of Labor , 2012). Nevertheless, low educational levels and socioeconomic deprivation that have persisted and continue to persist in the black community are strongly correlated with higher incidence of disease, poor nutrition, lower survival rates, and a decreased quality of life in general (Noonan et al., 2016 ; Purnell, 2013; Rognerud & Zahl, 2005).

    Also, increased exposure to hazardous working conditions in low-paying, manual labor jobs has resulted in a greater incidence of occupation related diseases and illnesses among this population. In addition, the majority of blacks reside in inner city areas where exposure to violence and pollution puts them at greater risk for disease, disability, and death. 

    The average life span of black Americans is shorter than that of white Americans because of the high death rates of blacks from cancer, cardiovascular disease, cirrhosis, diabetes, accidents, homicides, and infant mortality (Anderson et al., 2000; Dignam, 2000 ; Forrester, 2000; Holt, Kyles, Wiehagen, & Casey, 2003; Keyserling et al., 2000; Mandal et al., 2013; Monden et al., 2006; Noonan et al., 2016; Rognerud & Zahl, 2005; Samuelm Hodge et al., 2006). 

Africans Believes About Health and Education

    Also, blacks are at higher risk for drug and alcohol abuse, drug addiction, teen aged pregnancy, and sexually transmitted diseases (Purnell, 2013).Purnell (2013) reported findings indicating that African Americans are pessimistic about human relationships and that their belief system emphasizes three major themes:

1. The world is a hostile and dangerous place to live.

2. The individual is vulnerable to attack from external forces.

3. The individual is considered helpless, with few internal resources with which to combat adversity.

Africans Concepts about Health Care Providers 

    Because many African Americans tend to be suspicious of Western ethnocentric medical providers, they often seek the assistance of nurses and physicians only when they deem it absolutely needed (Purnell, 2013). Enough RNs from this ethnic group are represented in the nursing workforce in proportion to the number of blacks in the US population. 

    Blacks' mistrust of traditional US health care is believed to stem from centuries of discrimination and unethical research practices, such as the infamous Tuskegee syphilis study (Eiser & Ellis, 2007; Wilson, 2011). Instead, folk practitioners are held in high esteem by this population and are sought after for the culturally sensitive care they provide. 

    Common to the black culture is the concept of extended family, consisting of several house-holds, with the older adults often taking the leadership role within the family constellation. Respect for elders and ancestors is greatly valued. Older adults are held in high regard because living a long life indicates that the individual had more opportunities to acquire greater experience and knowledge. Decision making regarding healthcare issues is, therefore, often left to the elders. 

    Family ties are especially strong between grandchildren and grandparents, such that it is not unusual for grandmothers to want to stay at the hospital bedside when their grand children are ill. This extended family network provides emotional, physical, and financial support to members during times of illness and other crises (Forrester, 2000; Purnell, 2013).

    Single parenting within the African American culture is an accepted position without stigma attached to it. In 2011, approximately 67% of black or African American children were being raised in a single-parent family, as compared to 25% of white children and 42% of Hispanic or Latino children (National Kids Count Program, 2011). 

    Becoming a mother at a young age, although not highly desirable or condoned by black women, is met with a fairly high level of tolerance in this cultural group (Purnell, 2013). In fact, black women do not perceive negative sanctions within their culture if they do not meet the ideal norm of getting an education or job prior to marriage and children. Relatives are supportive of one another if help is needed with child rearing.

    Spirituality and religiosity are very much a prominent cultural component of this ethnic group's community. These aspects are a central and defining feature of African American life, serving as a source of hope, renewal, liberation, and unity (Carten, 2015). Spirituality is defined as a belief in a higher power, a sacred force that exists in all things. 

    Religiosity is defined as an individual's level of adherence to beliefs and ritualistic practices associated with religious institutions (Holt, Clark, & Kreuter, 2003; Mattis, 2000;Mattis & Jagers, 2001; Puchalski & Romer, 2000). Both spirituality and religion often play a role in the development and maintenance of social relationships throughout the human life span. 

    Blacks, more so than whites, turn to religion to cope with health challenges. Additionally, as trusted resources in the community, African Americans are turning more and more to their churches for support in times of illness, as a buffer against oppression, as well as for health education and other health promotion activities (Carten, 2015; Collins, 2015; Hayes, 2015). 

    Religious practices also have been found to influence health beliefs positively and influence health status and outcomes in the African American community (Newlin, Knafl, & Melkus, 2002). These strong religious values and beliefs by individuals may extend to their feelings about illness and health. Many black Americans find inner strength from their trust in God. 

    Some believe that whatever happens is God's will. This belief has led to the perception that black Americans have a fatalistic view of life (Purnell, 2013) and are governed by a relatively strong external locus of control (Holt, Clark, & Kreuter, 2003).A traditional folk practice, known as voodoo, consists of beliefs about good or evil spirits inhabiting the world. 

    One belief is that a religious leader or voodoo doctor has the power to appease or release hostile spirits. Illness, or disharmony, is thought to be caused by evil spirits because a person failed to follow religious rules or the dictators of ancestors. 

    Curative measures involve finding the cause of an illness a hex or a spell placed on a person by another or the breaking of a taboo and then finding someone with magical healing powers or witchcraft to rid the afflicted individual of the evil spirit(s). 

    Some black American families also continue to practice home remedies such as using mustard plasters, taking herbal medicines and teas, and wearing amulets to cure or ward off a variety of illnesses and afflictions (Purnell, 2013).