Other Free Encyclopedias » Medicine Encyclopedia » Aging Healthy - Part 1 » Cultural Diversity - Lifelong Processes, Hispanics, African Americans, Native Americans, Aleuts, And Eskimos, Asian And Pacific Islanders

Cultural Diversity - Lifelong Processes

age nursing social differences elders age minority family

The United States is peopled by groups that arrived in search of economic opportunity or political refuge, as well as by populations who were conquered, enslaved, or subordinated. To understand the social position and characteristics of today's minority elders, one must appreciate the lifelong processes and historical experiences that have brought them to their current stage of life. A life course perspective highlights the ways in which earlier life circumstances significantly channel people's later opportunities, outcomes, and quality of life decades later. For instance, the persistent racism, economic inequality, and residential segregation experienced by many African Americans early in life have had harmful effects on later development and life chances. These effects accumulate over the life span and can widen disadvantages in health, survival, and economic well-being (Jackson et al., 1993).

Today's elders have been shaped by their membership in birth cohorts that have lived through particular historical periods. Contemporary minority elders, born in the United States prior to 1940, have experienced a very different social context than those who will be elders in the future, born after the mid-1950s. For one thing, these later cohorts have had the benefit of more Chef David Qiang Dai uses a wok to prepare a traditional Chinese meal at the Aegis Gardens assisted living facility in Fremont, California. When it opened in late 2001, the retirement community was thought to be the first for-profit company to target Asian senior citizens. Qiang Dai also prepares other cultural dishes upon request. (AP photo by Julie Jacobson.) education than earlier cohorts, who often came from poor, rural backgrounds. Later, younger cohorts not only have had more years of formal education, but also have had a better quality of education by receiving part, if not most, of their education in desegregated schools. Later cohorts have had the historical benefits of better health care, and more economic and employment opportunities in the wake of the civil rights movement.

Lifelong processes produce racial differences in survival to older ages. Members of minority groups who live to be old are more highly "selected" than their white peers. For example, for every 100,000 black and white men born alive, 17,000 more white men than black men will reach age sixty-five. Similar differences are found for women, though not as dramatic— 10,100 fewer black women will reach age sixty-five (Williams and Wilson, 2001). Exposure to risk factors and stress hastens the early onset of chronic disease and premature death, which lower the probability that African Americans will live to be old.

Observers have speculated that inequalities over the life course are further compounded when adults reach later life. A "double jeopardy" hypothesis posits that minority elders face the dual burden of racial and age discrimination The result is that these elders are doubly disadvantaged in their health and economic well-being, and this accentuates the disparities between minorities and whites. One can even conceive of multiple jeopardy, such as being a women and old and a minority. An alternative hypothesis is that age acts as a "leveler," narrowing differences between majority and minority elders. Minorities may become relatively less disadvantaged as they age because, having dealt with racial discrimination over their entire lives, they are prepared to cope with age discrimination; because health problems in later life cut across racial lines; and because welfare state programs such as Social Security and Medicare have given minority elders greater access to health care and income security. Research has not settled whether either of these two perspectives—double jeopardy and age-asleveler—is a more accurate depiction than a state of persistent inequality for minority elders (Ferraro and Farmer, 1996; Pampel, 1998).

Mortality patterns of African Americans support a leveling hypothesis. Over most of the life span, age-specific death rates for African Americans are higher than those of their majority group counterparts. But mortality rates increase more slowly with age for African Americans than for whites in later life, and after the late eighties there is a "crossover" so that white majority group members have higher mortality rates than African Americans. However, this apparent crossover pattern is controversial. Some argue that it is a function of selective survival, in which the hardiest African Americans reach late life. Others argue that the observed phenomenon is an artifact of age misreporting for African Americans whose births went unregistered in the South early in the twentieth century (Williams and Wilson, 2001).

Elders from minority groups are likely to have benefited from remarkable extended family support networks (Stoller and Gibson, 2000). Racial and ethnic groups are characterized by family-centered cultures with traditions of mutual aid in the form of practical, emotional, and material exchanges. Closer kin bonds also foster affection across age groups. The patterns of giving and receiving in these social support "convoys" are born of ethnic cultures and rural backgrounds where family remains a strong feature of social organization. The nature of family is also a strategy for meeting economic need, sharing scare resources of time and money. African Americans have tended to have open kin networks that allow both blood relatives and non-kin within the family. Asian and Hispanic groups tend to limit family support to persons with close blood ties (Dilworth-Anderson and Burton, 1999). An often noted feature among Asian peoples is the norm of filial piety or children's duty, a tradition of respect and deference toward parents and grandparents that is rooted in Confucian culture.

Strong familism can aid elders when they need physical assistance, help with household chores, or a place to live. Minority elders have thus been less likely to turn to formal support systems, such as government services or nursing homes. At the same time, familism does not excuse elders from giving when other dependent family members are in need, for example, accepting grandchildren into their households. Elders also assume an obligation to be the conservators of cultural heritage for younger kin. As economic forces and acculturation threaten to dissolve the solidarity of extended family networks, one important question is whether the next generation will continue to maintain family support for tomorrow's elders.

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