The suggestion that lies behind this study is that healthcare professionals must look into the details of everyday life and seek to understand how the aspirations of diverse groups affect their choices and goals.
On deeper cultural levels, African-Americans also face unique problems that relate to health and well-being. The African-American family appears almost endangered in modern day America, and African-Americans face thereby a real problem when it comes to finding the necessary familial and community support when faced by major health crises. In area after area, Blacks do not receive the same kind of aggressive treatment as received by Whites. In a study of 53,000 African-American heart attack victims, it was found that Whites received much more aggressive treatment and care, while only forty-seven percent of impoverished African-Americans received treatment in intensive care units as compared to seventy percent of Whites in similar economic circumstances (Jewell, 2003, p. 196). African-American children lack solid family structures to take care of them, and who end up dependent on state child welfare departments are also commonly neglected and victimized. In a 2002 Florida case, Rilya Wilson a five-year-old African-American girl was missing for more than a year while her caseworker reported her to be doing fine in foster care. Upon investigating the circumstances of this failure to report the girl's disappearance, it was discovered that the social worker had not made monthly visits as demanded by official procedures, and that, in addition, such practices were widespread throughout the department,
This case... [being] yet another indication of how social systems establish and maintain policies that are contributing to the destabilization of African-American families, even those families struggling and striving to meet the basic social and economic needs of their members." (Jewell, 2003, p. 226).
The African-American family is struggling to survive, and the healthcare professionals that are charged with trying to save it, do little to help, and much that contributes to its decline. People in the lowest income households are six times as likely as others to have difficulty in meeting a basic need, while one-third of all African-American families vs. only seventeen percent of Whites face these difficulties (Casper & King, 2004, p. 73). The social breakdown and economic disadvantage of African-American families is creating a healthcare epidemic that is scarcely challenged by current programs.
Unfortunately, disparities in healthcare and general health and well-being can often be traced to more profound, and longstanding, social and cultural arrangements. African-Americans have been at the bottom of the American socio-economic scale since the country's earliest days. Beginning as slaves, they eventually escaped from bondage into the "separate but equal" discrimination of Jim Crow. Both systems shared an inherent believe that Blacks were somehow less than people, and did not deserve the same treatment or level of service as members of the majority White group. African-Americans have suffered from disparities in healthcare under both the old legal discrimination and under today's supposedly fair and equitable system. In former times, a lack of training and equipment meant that the Black physicians who were needed to treat Blacks could not reach the individuals in not of care. And today, while government programs help to some extent, large numbers of African-Americans still face economic disadvantages similar to those faced by their ancestors. Few health programs target African-Americans as African-Americans or take into account the range of cultural differences and aims that contribute to the maintenance of good health. Even when they are treated, African-Americans still tend to receive noticeably substandard care. The African-American family s falling apart. Unable to give support to its members, it is failed also by social service systems that frequently cause more harm than good. Families must be strong in order to build strong communities in which individuals can thrive. The continued existence of unequal power relations between the African-American minority and the White majority continues to deprive Blacks of adequate healthcare.
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