Minority women and advocacy for women's health.

US minority health issues involve racial/ethnic disparities that affect both women and men. However, women's health advocacy in the United States does not consistently address problems specific to minority women. The underlying evolution and political strength of the women's health and minority health movements differ profoundly. Women of color comprise only one quarter of women's health movement constituents and are, on average, socioeconomically disadvantaged. Potential alliances may be inhibited by vestiges of historical racial and social divisions that detract from feelings of commonality and mutual support. Nevertheless, insufficient attention to minority women's issues undermines the legitimacy of the women's health movement and may prevent important advances that can be achieved only when diversity is fully considered.

Cultural identity and health lifestyles among African Americans: a new direction for health intervention research?

OBJECTIVES: To assess associations of cultural and personal identity variables with socioeconomic status (SES) and health lifestyle in African Americans. DESIGN: Cross-sectional. METHODS: A questionnaire administered to 333 African Americans, ages 40-70 years, at enrollment in a nutrition education study assessed: African-American cultural identity (15 items scored 1 [low] to 4 [high]); reference group (two questions about perceived success in the Black or White way of life-scored as bi-cultural if "yes" to both); personal identity (4 items on: self-concept as attractive, self-confident, satisfied and friendly-scored 1 [no/not sure] or 2 [yes]); and selected demographic and lifestyle variables. RESULTS: Cultural identity factors reflecting participation in and belonging to African-American culture and bi-cultural reference group were related to higher SES, lower fat diets, not smoking, current drinking, and higher leisure time physical activity (cultural identity only), particularly in women (P<.001 to P = .06). Associations of cultural identity with physical activity and of bi-cultural reference group with low-fat eating and not smoking (females) remained significant at P<.05 after adjustment for SES. CONCLUSIONS: A greater emphasis is needed on aspects of cultural identity that are positively related to health lifestyles as distinct from aspects that might act as barriers.

Cultural aspects of African American eating patterns.

The high mortality from diet-related diseases among African Americans strongly suggests a need to adopt diets lower in total fat, saturated fat and salt and higher in fiber. However, such changes would be contrary to some traditional African American cultural practices. Focus group interviews were used to explore cultural aspects of eating patterns among low- and middle-income African Americans recruited from an urban community in Pennsylvania. In total, 21 males and 32 females, aged 13-65+ years were recruited using a networking technique. Participants identified eating practices commonly attributed to African Americans and felt that these were largely independent of socioeconomic status. They were uncertain about links between African American eating patterns and African origins but clear about influences of slavery and economic disadvantage. The perception that African American food patterns were characteristically adaptive to external conditions, suggest that, for effective dietary change in African American communities, changes in the food availability will need to precede or take place in parallel with changes recommended to individuals. Cultural attitudes about where and with whom food is eaten emerged as being equivalent in importance to attitudes about specific foods. These findings emphasize the importance of continued efforts to identify ways to increase the relevance of cultural context and meanings in dietary counseling so that health and nutrition interventions are anchored in values as perceived, in this case, by African Americans.

Recruiting minorities into the profession of epidemiology. Surveying the applicants' mail. American College of Epidemiology Committee on Minority Affairs.

The underrepresentation in epidemiology of members of racial/ethnic minority groups is greater than in medicine and health fields in general. Using printed recruitment materials, we evaluated the impression that epidemiology programs might make on prospective minority students. Mainstream recruitment materials were solicited from all identifiable U.S. epidemiology programs (n = 70) by requesting copies of typical mailings to prospective students. Of 51 respondents, 46 sent materials that could be analyzed by tabulating and evaluating minority-related content in text and pictures. Materials reflected a generally low-key approach to epidemiology student recruitment. Most minority-related text referred to affirmative action or financial aid and was at the school level rather than specific to the epidemiology programs. Few minority-related epidemiology course titles or research interests were identified. We recommend including more information about epidemiology and its relevance to minority health in mainstream recruitment materials as one possible strategy for increasing the number of minority applicants.