Discriminatory provider practice patterns are also a significant source of ethnic differences in health care outcomes. Health services research has reported that physicians are less likely to provide African American older adults with appropriate medical interventions such as:
- Breast cancer screening
- Recommended treatment (breast conserving surgery plus radiation) instead of mastectomy for local breast cancer
- Treatment with newer antidepressants
- Post-hospitalization follow-up inpatient treatment for mental illness
- Revascularization procedures after angiography
- Treatment with beta blockers after myocardial infarction
- Implantable cardioverter-defibrillators or coronary revascularization procedures after cardiac arrest
- Thrombolytic drugs or primary angioplasty after acute myocardial infarction
- Cerebral angiography, anticoagulant therapy, or carotid endarterectomy after transient ischemic attacks
- TPA after ischemic stroke
It is important for providers to understand that cultural norms, historical context, the value of family, and religious beliefs are key determinants of social and kinship networks which in turn affect health behavior and outcomes in all older adults, including African American older adults.
Belief systems and tradition impact health care utilization and provide a basis on which health care providers should deliver culturally sensitive care. Literature has shown that older African Americans are more likely to rate their health as fair or poor than White older adults and are less inclined to seek health care early in the course of a disease. African American older adults are less likely to practice preventive health behaviors such as obtaining breast or prostate cancer screening.
On the other hand, health providers are less likely to offer some of these services to African American older adults than they are to their White counterparts. Religion plays a major role in determining the health beliefs and behaviors of African American older adults. Quality of life and life satisfaction are enriched by increased frequency of contact with friends and the availability of family help (Adams, 2000).
