Introduction and Background
The extent to which healthcare practitioners fully understand the relationship between food habits relative to cultural health beliefs, health behaviors and the personal health status of older adults is extremely important to the provision of appropriate successful client-centered nutrition education intervention strategies. It has been well established that certain foods have beneficial nutritive and disease preventing effects on life-threatening health conditions (i.e., the leading causes of death: heart disease, cancer, stroke, diabetes). Cross-racial studies of U.S. populations indicate that Blacks (1) older adults have a disproportionately high prevalence of the afore-mentioned health conditions. (2) Yet, few if any gerontological studies have been done exploring whether Black older adults are aware of the relationship between their health conditions and their food consumption patterns. A study examining 265 nutrition education intervention research studies indicate that among the intervention studies with adults over 65 years of age, only one study measured health outcome expectations and a very few measured nutrition knowledge relative to food consumption. (3) None of these studies were cross-cultural examining differences among Black older adults.
The U.S. Census data indicate that adults 65 years of age and older are the fastest growing segment of the U.S. population. Changing immigration patterns contribute to the graying of the U.S. society in general and in urban areas such as New York City (NYC) specifically. New York City is home to the largest population of foreign-born persons living in the U.S. (4) Currently, 35% of immigrants residing in NYC are from the Caribbean. Census data also indicate that 40% of seniors in New York State (NYS) reside in NYC. Many Black elders tend to live in large urban areas including NYC. Even though these data have existed for a long time, there are few inter- and intra-cultural studies examining cultural and/or ethnic differences among Black elders. (5) This is due, in part, to the fact that there is a persistent myth that Blacks in the U.S., particularly in NYC, are a homogeneous group, void of differences in traditions and customs. (6) As such, many healthcare institutions and practitioners providing services to Black older adults in urban areas such as NYC use a generic approach to gathering nutrition data prior to and during nutrition education intervention, which bypasses important cultural nuances. Indeed, there are cultural and ethnic differences (including food habits, (7) health status (8) and cultural health beliefs (9) among subgroups of Black older adults in the U.S. that can affect their health status.
An insight into the previously stated differences relative to health status is essential to the development of culturally appropriate nutrition interventions aimed at promoting health and preventing disease among these important and growing segments of the U.S. population. The problem of imbalanced nutrition is especially salient to many NYC Black older adults because of their relatively poor health, economic disadvantage and limited access to good quality supermarkets. (10) Also salient is the fact that the consumption patterns of African Americans (AAs) are different from those consumed by Caribbean-born (CA) elders-who might be maintaining lifelong ethnic foods habits to preserve cultural identity. Today, many CA elders have access to an abundance of ethnic foods in NYC that facilitate the perpetuation of these habits, some of which are good while others might need to be modified. Very little has been done within the context of public health research even though there have been speculations that some foods, indigenous to the Caribbean, are linked to the very high rate of specific health conditions including certain cancers. For example, certain foods grown only on the Island of Jamaica, are believed to be linked to the very high rate--04/100,000--f prostate cancer among Jamaican men who have the highest rate of prostate cancer in the world. …