African-Americans

Alex Belk, Tara Brown, & Ann-Katherine Johnson

NU 542: Transcultural Nursing and Healthcare
March 10, 2023
History
● Africans began being kidnapped and brought to the
“New World” in 1619.
● Family units were broken and Africans were sold as
slaves, typically separated from their families.
● The 13th amendment was passed in 1865 after the
Civil War, ending slavery.
● Civil rights movements in the 1960s addressed (Degroot, 2019)

lingering racism, segregation, and discrimination.

(History, 2009)

Alex Belk
Economy

● The median household income in the U.S. is $45,485, African-Americans average at $38,344 (Giger &
Haddad, 2021).
● African-Americans are overrepresented in certain occupational categories; home health aids, transit
and intercity bus drivers, nursing assistants, correctional officers, and security guards (U.S. Bureau of
Labor Statistics, 2021).
● Black men have the lowest employment rates among all race/ethnicity groups in the U.S.

Alex Belk
Workforce Issues
● Many African-Americans feel separate from
● 65.5% of African-American men
their White counterparts and tend to isolate
participate in the workforce,
themselves or get isolated from others.
compared to 74.3% of Whites.
● Although they speak English, the dialect of
● 63.2% of African-American women
many African-Americans is different than the
participate in the workforce,
dominant culture of the U.S., this can
compared to 60.3% of Whites.
potentially be a problem at work.

(Giger & Haddad, 2021)

Alex Belk
Education

● 84.1% of African-Americans have a high school diploma, compared to 91.6% of Whites

● 12.8% hold a bachelor’s degree or higher, compared to 21% of Whites.
● African-American females have higher rates of education than males.
● Discriminatory practices, racism, and segregation have led to many African-American families falling
“behind” in education for many generations.

(Giger & Haddad, 2021)

Alex Belk
Public Services

● The African American Employment Program (AAEP) was created by the Department of Commerce to
help plan and implement strategies to hire and retain a more diverse workplace (Office of Civil Rights,
2021)
● African American History Month, or Black History Month, was designated to honor and commemorate
the different contributions that African-Americans have brought to the U.S.

Alex Belk
Core Cultural Patterns

● African American children

● Collectivism vs. individualism tend to be more collectivistic
● while the adults tend to be
Religion/spirituality
more individualistic.
● Orality- language is very important in the
African-American culture.

(Jones & Campbell, 2011)

Alex Belk
Language

● English is the preferred language by African-Americans.

● Many African-Americans speak a “Black English” dialect instead of Standard English.
● Black English differs from Standard English in pronunciation, grammar, and syntax.
● When African slaves were brought to the U.S., most had to give up their African languages and learn
English in order to communicate.

(Giger & Haddad, 2021)

Alex Belk
Use of Silence/Touch

● African-Americans use touch more often than European Americans (Elliot, 2016).
● Most Americans, including African-Americans, tend to be uncomfortable in prolonged silence and will
speak to fill the void.
● The use of physical interactions, fist bumps, personal hand shakes, and pounds are used often when an
African-American greets another (Ross, 2022).
● A common “power sign” for African-Americans is a raised fist.

Alex Belk
Verbal/Nonverbal Communication

● Communication is generally passionate and animated.

● Information presented as neutral or objective can be seen as less credible.
● Eye contact is held by the speaker when communicating.
● Large gestures are the norm and are seen as enhancing the message being conveyed.
● Directness is preferred over indirectness.

(Elliot, 2016)

Alex Belk
Space & Time

● The concept of time varies between African-American individuals, this is thought to be due to
education level and socioeconomic status.
● Some are future oriented and very punctual, while others are more present and not future oriented.
● Individuals who are not future oriented tend to have low paying- jobs or be jobless.
● African-Americans tend to prefer closer personal space and like to be surrounded by family/friends.

(Giger & Haddad, 2021)

Alex Belk
Historical Review of Slavery

The destruction of the African family began in 1619 when slaves were captured and taken to the new world
this forcibly removed strong men, women, and children from their families and tribes. Their separation was
continued because they were placed on on ships without regard for family unity, tribes, or kinship.

The children and infants were separated and sold from their mothers. The decision of marriage was left up to
the discretion of the owner. Many were not permitted to marry outside of the plantation. Many were
assigned mates when they reached breeding age.

Once a child was born, they were viewed as the slave owner, rather than the parents. During slavery, families
lacked autonomy because the family members were someone else's property.

(Giger & Haddad, 2021)

Ann-Katherine Johnson
Social Organization

● Social organization can be defined by how a

cultural group organizes itself around particular
units. Some examples are racial or ethnic groups,
family, communities, or social groups.
● African Americans are the only cultural group that
has not assimilated into the mainstream society,
they socialized in predominantly African
American environments due to legalized
segregation.
● There are predominantly African American
neighborhoods, churches, colleges, primary and
secondary schools.

(Giger & Haddad, 2021)

Ann-Katherine Johnson
African-American Discrimination

● Because of racism and segregation African Americans

are often accused of having a more separate and
confined pattern of communication. This has restricted
African Americans from participating in the wider
White society.

(Giger & Haddad, 2021)

Ann-Katherine Johnson
Residuals of Slavery
● The African American men were still denied jobs or given
jobs that were degrading and dehumanizing even after
slavery was abolished and during the emancipation
period.
● From the time slavery was abolished until the mid 1960s,
in some parts of the country African Americans were still
being attacked, lynched, and murdered. Sexual attacks on
women were still continued.
● Even throughout the discriminatory practices and acts of
violences there were still some families that were able to
establish themselves. These families were able to
develop a secure economic status. They soon began to
establish schools, churches, and other social
organizations.

(Giger & Haddad, 2021)

Ann-Katherine Johnson
Family Roles

● The African-American mother or wife is seen as responsible for protecting other family member’s
health, she is expected to assist each family member in maintaining good health and determining
treatment if a family member is ill.
● African Americans are composed of large units and tend to be very supportive during times of crisis
and illness.
● The nurse should include all members of the unit in planning and implementing care because a
member of the unit may provide care of advice that could be detrimental to the patient.

(Giger & Haddad, 2021)

Biological Variations

● The lack of understanding biological and cultural differences has been a disadvantage in their
healthcare when it is compared to the members of the more dominant culture.
● It is noted that socioeconomic status also plays a role in unequal health care treatment, if it were
leveled health care disparities might still exist.
● Susceptibility the a disease is determined by genetics and environment. Technological advances in
medicine have contributed to improvement in general health and increases in the lifespan of all
Americans.
● For African Americans, death from heart disease, cancer, stroke, diabetes, and acquired
immunodeficiency syndrome are much higher than those of the general population.

(Giger & Haddad, 2021)

AID/HIV Risk

● The CDC reported that African Americans, Hispanics, and Latinos that HIV has had the most severe
impact on homosexual and bisexual African American and White males between the ages of 30 and
40. The greatest number of new infections 3,401 (54%), occured in African American gay and bisexual
males ages 13-24.
● African American women continue to account for the largest number of new HIV infections compared
with infection rates of other races. In 2015, the incidence of infection for African American women was
5 times the rate for Latin American women and 15 times the rate for White women. The same report
indicated that the common mode of transmission for African American women was through
heterosexual contact compared with white women in whom the common mode of transmission was
intravenous drug injections.

(Giger & Haddad, 2021)

Cardiovascular Disease
● Cardiovascular disease is the number one
cause of deaths in African Americans.
Coronary artery disease and stroke
together account for more than one third
of all deaths in African Americans.
● African Americans are more likely to die of
a myocardial infarction than any other
racial or ethnic group. The disparity in
death rates between African Americans
and Whites is partially due to hereditary
predisposition for hypertension, type 2
diabetes, obesity, and lifestyle choices.

(The Heart Foundation, 2018)

Lactose Intolerance

● 90% of African Blacks and 75% of African-

Americans have lactose intolerance. It is
genetically transmitted although the specific
gene has not been identified.
● Lactose intolerance is the lack of the enzyme
that converts lactose to glucose and galactose.
As a result a person will have bloating, cramping,
and diarrhea. It is diagnosed based on signs and
symptoms of that occur after drinking milk or
other things that contain lactose.

(Giger & Haddad, 2021)

Environmental Health Threats
Grief, death/dying, & death rituals

●African Americans have large families/networks and during the grief, death/dying process, they may tend to express
themselves in different ways such as some may be very expressive, some may cry, and some may remain silent and stoic.

●Large gatherings are typical at the time of death and burial process.

●There are time when some African American families maintain “the tradition of keeping the body of the deceased in the home
the evening before the funeral” (Giger & Haddad, 2021, p. 174, para. 3).

●It is common for African American individuals to view death as a natural part of living and keep their hope in that in the future
they will be reunited in heaven.

●Some African Americans may have church nurses who help the family view the body and help the family with the stress they
may endure.

(Giger & Haddad, 2021, p. 174, para. 3)

Tara Brown
Barriers to Care

●African Americans tend to use what is known as Black English when communicating with others. This means they pronounce terms
differently and use slang words which may cause communication issues when serving the individuals being served (Giger & Haddad, 2021, p.
164, para 2).

●African Americans may perceive illness as a natural occurrence that results from disharmony and conflict in one’s life.

●Africans believe there are three general areas that may affect one’s health such as environmental hazards, divine punishment, and impaired
social relationships.

1.Environmental Hazards: An example environmental hazards may be being injured during a tornado.

2.Divine punishment: An example of divine punishment may be cirrhosis of the liver caused by excessive alcohol use.

3.Impaired Social Relationships: An example of impaired social relationship may be a child not speaking to the father due to some childhood
trauma he/she may have experienced.

(Giger & Haddad, 2021, p. 170, para. 3)

Tara Brown
Illness & Wellness Behaviors

●In the African American culture, individuals may perceive illness as a natural occurrence that may result in
disharmony or conflict in that person’s body.

●There may be some African American Individuals who may not be able to determine if their illness is physical,
mental, or spiritual and may treat themselves with a combination of treatments.

●Some African Americans may not feel comfortable with bothering the nurse when experiencing pain and may not
express the need for pain medication.

●African Americans may also perceive pain as God’s will which may result in a form of stoicism.

(Giger & Haddad, 2021, p. 170)

Tara Brown
Folk Medicine

●African Americans may use folk medicine based on different spirituality such as witchcraft, voodoo, magic, and
orthodox medicine (Giger & Haddad, 2021, p. 171, para. 3).

●There are many different elements used as folk medicine in the African American culture such as Spanish moss,
vitamin E oil, cayenne pepper, aloe vera, baking soda, leeches, black dog, rattlesnake skin, buzzard feathers, silver
dime, garlic, EELSKIN, woodlice, etc. (Duke University, 2022).

●There may be boundaries for the African American folk healers such as the “granny” may only posses the knowledge
to cure simple illnesses where a “witch doctor” is believed to possess supernatural powers that may allow healing
such as casting out demons (Giger & Haddad, 2021, p. 173, para. 1).

Tara Brown
Healthcare Providers

●Jordan Identified distinct types of folk practitioners, the first being referred to as the “granny” or “old lady” that
serves as a consultant.

●The consultant is usually knowledgeable about the types of remedies made from spices or natural substances that is
used to treat illness.

●The second practitioner is known as the “spiritualist”. This practitioner combines rituals, spiritual beliefs, and herbal
remedies for specific illnesses.

●Finally, is the third practitioner. This practitioner is the voodoo priest or priestess. In some areas this practitioner is a
man where in the US the practitioner must be a woman and may inherit this title only by birthright or special gift.

(Giger & Haddad, 2121p. 171 & 172).

Tara Brown
 References
African American Employment Program. Office of Civil Rights. (2021, February 17). Retrieved March 6, 2023, from
https://www.commerce.gov/cr/programs-and-services/special-emphasis-programs/african-american-employment-program
DeGroot, G. (2018, January 19). Review: Squadron: Ending the African slave trade by John Broich [photograph]. Retrieved March 6, 2023, from
https://www.thetimes.co.uk/article/review-squadron-ending-the-african-slave-trade-by-john-broich-b7dssrmh7
Duke University. (2022). Black History Month: A Medical Perspective: Folk Medicine. https://guides.mclibrary.duke.edu/blackhistorymonth/folkmed
Giger, J. N., & Haddad, L. G. (2021). Transcultural nursing: Assessment and intervention (8th ed.). Elsevier.
Hannah. (2018, August 30). African Americans and heart disease. The Heart Foundation. Retrieved from
https://theheartfoundation.org/2018/09/07/african-americans-and-heart-disease/
Jones, J. W., & Campbell, S. D. (2011). Cultural Psychology of African Americans. Online Readings in Psychology and Culture, 3(1).
https://doi.org/10.9707/2307-0919.102
Labor force characteristics by race and ethnicity, 2020. U.S. Bureau of Labor Statistics. (2021, November 1). Retrieved March 6, 2023, from
https://www.bls.gov/opub/reports/race-and-ethnicity/2020/#:~:text=By%20race%2C%20Whites%20made%20up,less%20than%20half%20a%20per
cent
.
Ross, L. (2022, September 21). Power Signs. The Washington Informer. Retrieved March 9, 2023, from
https://www.washingtoninformer.com/power-signs/.
U.S. slavery: Timeline, figures & abolition - history. History. (2009, November 12). Retrieved March 6, 2023, from
https://www.history.com/topics/black-history/slavery