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December 2004, Vol 94, No. 12 | American Journal of Public Health 2066-2073
© 2004 American Public Health Association

PUBLIC HEALTH MATTERS

Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status

Gay Becker, PhD, Rahima Jan Gates, PhD and Edwina Newsom

The authors are with the Institute for Health and Aging, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Gay Becker, PhD, Institute for Health and Aging, University of California, San Francisco, Box 0646, San Francisco, CA 94143-0646 (e-mail: becker{at}itsa.ucsf.edu).

Little is known about the self-care practices of chronically ill African Americans or how lack of access to health care affects self-care. Results from a qualitative interview study of 167 African Americans who had one or more chronic illnesses found that self-care practices were culturally based, and the insured reported more extensive programs of self-care. Those who had some form of health insurance much more frequently reported the influence of physicians and health education programs in self-care regimens than did those who were uninsured. It is concluded that the cultural components of self-care have been underemphasized, and further, that the potential to maximize chronic illness management through self-care strategies is not realized for those who lack access to health care.




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