Health Diversity — Constructively Calling out Differences: Is It a Bad Thing that Latinos and African Americans Are Less Likely to Seek Help for Alzheimer’s?
by Andrés T. Tapia; research by Susan Welch–
The vital and laudable pursuit of identifying and closing heathcare disparities can trip up on well meaning but ethnocentric analysis.
Consider the start and end points of recent research on racial/ethnic disparities around Alzheimer’s.
First, is there are gap? Yes, there is. CNN recently reported on the Alzheimer’s Association’s finding that Hispanics and African Americans are more likely to contract Alzheimer’s than whites–and to show symptoms at a younger age. Hispanics tend to show signs of Alzheimer’s seven years earlier than white people do. African Americans between the ages of 55 and 64 are more than three times as likely as whites to suffer from Alzheimer’s.
Second, given this greater incidence of Alzheimer’s among Hispanics and Blacks are they more likely to seek medical help? No, they are not. In fact, according to Medical News Today, Hispanics and African Americans are less likely to seek medical help for Alzheimer’s than their white counterparts–even when access to health care is comparable.
So far the facts tell a straightforward story. Now the research moves into interpretation and here’s where the inadvertent ethnocentrism begins to slip in.
So why do African Americans and Hispanics have a higher prevalence of Alzheimer’s? Cultural differences, say a couple of reports conducted or reported on by outlets influenced by a majority European American culture worldview.
Now watch what happens. While the important and necessary analysis is accurate about why the gap, note the assumptions made about whether the why is a good or a bad thing.
In Hispanic and African-American communities, the reports point out, elders are so respected that those around them may gloss over rather than point out telltale mood swings and/or cognitive deficiencies that begin to surface. What is actually a symptom of Alzheimer’s may be written off as a “normal” sign of aging. A Harris Interactive® study found that 37% of African Americans and 33% of Hispanics hold the view that Alzheimer’s symptoms are a normal part of aging. And since aging is normal, why would there be “treatment” for it? Here we have a cultural assumption that admittedly is likely detrimental as an illness goes untreated and family members don’t receive proper counsel for managing Alzheimer’s fallout on them.
But check out this next cultural assumption. The New York Times reports that another cultural dynamic making it harder for Hispanics and African Americans to get help for Alzheimer’s is the tendency to dismiss nursing home options as incompatible with family values. Hispanics with Alzheimer’s, for example, tend to live with and be cared for by extended family groups. While this may be good for patients, ”it creates significant stress and hardship for families.”
And the outcome of not being shunted off to a nursing home? In making the case that the burden on Latino and African American families is even worse than just having them at home, the Science Daily claims that they have to care for them for even longer because Hispanics and African Americans with Alzheimer’s tend to outlive their white counterparts, even when controlling for other socioeconomic factors. On average, Latinos with Alzheimer’s tend to live 40% longer, and African Americans 15% longer, than whites with Alzheimer’s.
So why the implied message that Latinos and African Americans would be better off not caring for their loved one with Alzheimer’s at home where they are likely to live 40% and 15% longer respectively?
Whoa.
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