Particularly because of the experience of many African American older adults who grew up with segregated health care and social service systems in which they faced continual discrimination, it is extremely important to show respect to them in clinical settings in order to put them at ease and establish rapport. This includes at the least, using respectful titles (e.g., Mr., Mrs.) unless they give the clinician and staff permission to do otherwise.
The Tuskegee Experiment
The knowledge of the 40-year Tuskegee Experiment, which recruited African American men with syphilis to be a part of a research project in which they were promised but never given treatment, is widely known in the African American community.
This memory, in addition to the widespread discrimination most have faced in their lifetimes, are likely to provide reasons for African older adults to be more than a little suspicious of health care providers, especially those who suggest any type of experimental treatment or research. Clavon (1986) and others have emphasized the importance of recognizing and respecting patients’ cultural habits, listening attentively, and encouraging conversation.
Providers have also been encouraged to examine their attitudes and stereotypes of older adults from different racial and ethnic populations, especially African Americans, in light of the findings implicating referral patterns of providers in the differential utilization of services.