Key demographic shifts underway in the United States will demand new approaches for health care delivery. It’s projected that in the next decade some 20% of the US population will be 65 and older, and as the population ages it’s becoming more racially and ethnically diverse. The US Census predicts that the next two decades will witness demographic reversals, with increases in the proportion of Blacks, Asians, and Hispanics as compared to non-Hispanic Whites.
This growth predicts an increasing number of the aged bearing a disproportionate burden of chronic disease, and the changing population suggests that we focus on patient disease experience and coping mechanisms. We’ve all seen how cultural beliefs perpetuated in familial, social, religious, and spiritual lore and practices influence decision making and care preferences.
For instance, prayer is frequently used by Black and Hispanic patients to address pain, and in one investigation, relaxation and prayer were described as alternatives to pain medication. Other examples of evidence-based programs that incorporate cultural elements benefiting racio-ethnic minority elders are BRITE, which focuses on substance abuse screening and intervention for older adults; Health for Hearts United, a church-based intervention to address cardiovascular risk in older African Americans; and the Arthritis Foundation Exercise Program (AFEP), a community-based program designed for older adults with arthritis.
Since it’s not uncommon for elders to age in place, expanding culture-affirming efforts may help to bridge a divide that contributes to health disparities. As such, existing community partners who offer programs that are valued by older adults should be bolstered and replicated within neighborhoods that are short on resources, but long on support and fostering resilience.
Cultural affirmation in the design of health programs can enhance care and contribute to increased social capital and support through familial and community participation.
Our charge as public health practitioners is to create sustainable, evidence-based community interventions by actively engaging minority elders and other respected community members in our research design activities, and incorporating their experiences into program implementation and evaluation.
Karyn E. Faber, EdD, MPH
Director of Undergraduate Experiential Learning;
Clinical Assistant Professor of Social and Behavioral Sciences