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Older African Americans may be suspicious of clinicians, believing their health is personal and up to God’s will.

Because they may be reluctant to share personal or family issues, building a trusting relationship is key.

Many are affiliated with Christian denominations—notably Baptist and Church of God in Christ. Maintaining good health is associated with good religious practice.

Many churches maintain a health ministry, through which congregations and parish nurses support good health with flu shots, blood pressure checks, and health education.

In general, the older generation is more conservative, may have a more traditional view of gender roles, and may shun interracial dating and marriage.

Elders are respected and often provide care for their grandchildren.

By 1996, 28 percent of this population was reported to have a poor-quality diet, compared to 16 percent of whites.

African Americans are becoming increasingly health conscious, seeking health screenings and treatments, although health literacy in this population tends to vary by generation.

Institutionalization of elders has historically been avoided, with sons and daughters taking on the family caretaker role.

Many African Americans like hearty meals that may include meat, fish, greens, rice, grits, white and sweet potatoes, corn, turnips, eggplant, peanuts, and homemade desserts.

The family may be matriarchal, although father or mother may take on the decision-making role.

For African Americans, women more than men tend to remain unmarried, and more women have been educated at the college level.

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