Ethnic notions and healthy paranoias: understanding of the context of experience and interpretations of healthcare encounters among older Black women.

OBJECTIVES: To report the first-hand perspectives of older Black women within healthcare encounters that impact the trajectories of health-seeking behavior; to examine their perceptions, expectations, and beliefs about the role of cultural difference within predominantly White (US) healthcare settings; and to explore how sharing personal experiences (theirs and others') as a fund of knowledge influences ethnic notions. This research is aimed at the development of community resource partnerships and effective healthcare service delivery with intervention and promotion efforts targeting older Black women.
DESIGN: Ethnographic data collected over a 24-month period (2003-2005) from 50 older Black women in Tucson, AZ, USA are discussed on three levels: (1) expectations and beliefs; (2) the use of ethnic notions in the form of healthy paranoias as part of individual and communal health advocacy; and (3) perceptions of interethnic communication within healthcare settings, including feeling uncared for by healthcare providers and support staff.
RESULTS: Disparities in older Black women's health and well-being are often constructed and filtered through 'non-clinical' influences, such as cultural differences, individual experiences, and beliefs about 'race' or 'being' a Black female.
CONCLUSIONS: Unfamiliarity with ethnic notions may cause misinterpretations and misunderstandings and may influence interactions between older Black women and healthcare providers.