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The purpose of this report is to relate the findings of the study ‘Concepts of Health in Older Urban African American Women with Chronic Health Conditions.’ This investigation, undertaken at the request of the Indiana Minority Health Coalition, Inc. (IMHC) is collaboration between IMHC, Butler University College of Pharmacy and Health Sciences, and the community partner, the Black Nurses Association of Indianapolis, Inc. (BNA). The purpose of the study is to gain an understanding of the ways older African American women from medically underserved areas of Indianapolis characterize the various parts of the concept of health; how they understand and interpret the determinants of health status; and to understand how they assess health.

Researchers decided to hold focus groups of African American women from Indianapolis ages 50 years and older who had at least one diagnosis of a chronic illness. The Principal Investigator created a moderator’s guide for the focus group. All research partners met to review and redesign the guide to make sure that it was appropriate and would be effective in stimulating discussion to address the three specific aims. The groups, one of currently employed women, two of residents of senior/disabled housing, one group of members of a community church, and one mixed-recruitment group, were held in community settings. Participants received $25.00 gift cards for their involvement.

Major findings are that women view ‘health’ as a concept that includes many elements: physical health, mental/emotional health, ability to function through day-to-day activities, and spiritual health. These components work together to produce a state of wholeness or well-being. ‘Health’ is determined through interplay between influences that operate on many levels: the personal, the interpersonal, and the immediate and social/political environment. Specific determinates include health behaviors, state of mind, stress, relationship with God, and the aging process. Women speak at length about their relationship with institutions of healthcare. They express problems in communicating with their healthcare providers, feeling that they are not treated as unique individuals, and they often express distrust of providers. Participants assess their own health through paying attention to their own physical symptoms, their state of mind, and their energy level. Medications are named as determinants of health and markers of health status. Women assess health of their families and friends through observation, intuition, and communication. These women act as facilitators of health status and behaviors for their family members and others in the community.

Women are well aware of the importance of positive health behaviors, especially diet and exercise, and they feel strong senses of control over their health. As these women envision ‘health’ as involving many concepts and levels, interventions need to address issues beyond the physical, involving women actively through relationships within communities. Public health professionals need to work with these women in a respectful and collaborative manner. Issues that need further exploration are interplay between mental and physical health through the aging process, patient-provider communication, and women’s understanding of medications in maintaining and improving health.


This is an electronic copy of a report prepared for the Indiana Minority Health Coalition. Archived with permission. The author(s) reserves all rights.