Disparities Among African American with Prostate Cancer

1. Disparities Among African American with Prostate Cancer By MilenReta TaghridNajdi PravinChacko

2. History of African Americans in the United States Slavery and Dehumanization • Property vs. Person • African Americans viewed as sub humans lacking intelligence, feeling character Emancipation, Segregation, Discrimination • Jim Crow Laws 1896 • Segregated healthcare system Segregation of Healthcare (20th century) • Medical exploitation during 19th & early 20th century • Slaves were used to test treatment of heatstroke and repair of vaginal fistula without anesthesia Tuskegee Syphilis Study • 1932 United States Public Health Service launched Tuskegee syphilis study on male African Americans that thought they were receiving treatment but were not • Lasted 40 years

3. History of African Americans in the United States Institutional Racism • Any form of racism occurring specifically within institutions such as public government Mistrust of the healthcare system • Result of medical exploitation Healthcare Disparities • Communication • Provider Prejudice • African Americans less participatory

4. Traditional Healing Methods/Practices • Originates from African countries/tribes • Belief in a higher-being • God • Spirits • Good/bad • Healers • Herbalists • Spiritualists/Diviners

5. Traditional Healing Methods/Practices • Folk medicine • Passed orally through generations • Simple recipes • Ritual recitations • Dance • Ndeup • Krump/Hip-Hop

6. Traditional Perceptions of Health & Illness • Health management strategies • Prayer • Self empowerment • Social support • Positive/negative influences on health

7. Traditional Perceptions of Health & Illness • Mistrust of medical system • Due to historical struggle, Tuskegee study • Understanding the patient as an individual • Do they have religious beliefs? • What do they value? • How do they cope with illnesses?

8. Current Health Care Problems Increasing cases of ethnic and racial minorities in the United States African American men have a higher risk of prostate cancer Primary care physiciansare not playing their roles Disparities in screening Other problem may occur in screening where false negative test result may be derived.

9. Current Health Care Problems • Poor communication between the patients and physicians • The miscommunications is enhanced by lack of cultural competence amongst the physicians. • Potentially, curative therapies are less recommended

10. Framework/Theory For Cultural Assessment The Purnell model is effective in assisting in improving the outcomes of ethnic and minority groups in the United States. The model assumes that all cultures have the common fundamental similarities. Also, assumes that difference existing among the cultures does not show the superiority of the culture It also outlines that culture influences individual’s responses and interpretation to the health care. The Purnell model outlines differences among races as an important factor to consider while performing health assessments investigating genetic diseases prescribing medication.

11. Implications of Healthcare Delivery • Mistrust has lead to multiple disparities amongst the African American Cultural Group • The disparities can be considered a result of racism and bias • African American men tend to have twice the mortality rates in prostate cancer • For all cancers, the five year survival rates are lower for black women • Race Consciousness and Culturally Competent Care can decrease disparities • CLAS 14 Standards • Continuing Education on minority health issues with specific emphasis on African Americans

12. References • Exploring africa. (2000). Retrieved from http://exploringafrica.matrix.msu.edu/students/curriculum/m14/activity2.php • Monteiro, N. M., & Wall, D. J. (2011). African dance as healing modality throughout the diaspora: The use of ritual and movement to work through trauma. Retrieved from http://www.jpanafrican.com/docs/vol4no6/4.6-13AfricanDance.pdf • Ravenell, J., Johnson, W., & Whitaker, E. (2006). African-american men's perceptions of health: A focus group study. Journal of the national medical association, 98(4), Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569257/pdf/jnma00191-0076.pdf • Snow, L. (1983). Traditional health beliefs and practices among lower class black americans. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011011/pdf/westjmed00196-0050.pdf

13. References • Boyd MD, Weinrich SP, Weinrich M, Norton A. (2001). Obstacles to prostate cancer screening in African-American men. J Natl Black Nurses Assoc • EwariAK, Gold HT, Demers RY, et al.(2009) Effect of socioeconomic factors on long-term mortality in men with clinically localized prostate cancer. Urology • Purnell, L. (2003). Trans-cultural diversity and health care. In L. Purnell and B. Fulanka (Eds.), Trans-cultural health care: A culturally; competent approach, (2 ed). Philadelphia: F A. Davis • Watts, R., (January 31, 2003). "Race Consciousness and the Health of African Americans". Online Journal of Issues in Nursing. Vol. 8 No.1 • Byrd, W. Michael, and Linda A. Clayton. An American Health Dilemma Vol. 1: A Medical History of African Americans and the Problem of Race, Beginnings to 1900.. New York: Routledge, 2000. Print.