Recognizing the Deleterious Effects of Trauma On Older African Americans: A Cultural Perspective
Trauma experienced as a result of disaster can have deleterious effects on some populations. Researchers suggest that difficulties faced post disaster for African Americans are especially magnified (Elliott and Pais, 2006) due to systematic social vulnerabilities such as discrimination, oppression, health disparities, poverty, and other stressors of daily living (Boyd-Franklin, 1989; Turner & Lloyd, 2004). For example, during Hurricane Katrina many of these displaced survivors were African American, poor, and elderly (Horner, 2006) which placed them at high-risk (Ursano, et al., 2003). Specific disaster related problems have been reported to include elevated mental health or psychological distress, as well as negative health problems for African Americans (Galea et al., 2002; Sastry & VanLandingham, 2009; Shinfuku, 2005).
This study explores the trauma experience expressed by Katrina survivors and seeks to understand the manifestation of depression and its consequences. This proposed study is intensely important in that older African Americans have been underrepresented in the trauma literature.
This research is derived from a larger study of displaced, African American Katrina survivors, ages 55 and older. Quantitative and qualitative data were collected concurrently 1 - 5 years post Katrina using purposive sampling. These two approaches were used to complement one another with the qualitative findings elaborating the quantitative findings (Onwuegbuzie & Leech, 2006). A standardized instrument (CES-D) was used to measure participants with higher depression symptomology (n=27); a subsample of the larger study. Qualitative data is collected through in-depth, semi-structured interviews of these survivors. Grounded theory, using constant comparison methods was employed to analyze the data. Interviews with participants were transcribed verbatim and prominent themes were identified using inductive processes adhering to common criteria of coding and the identification of themes (Marshall & Rossman, 1995; Glaser & Strauss, 1967).
Comparisons were made of those with depressed symptoms and those who did not; 43% of the larger population displayed elevated symptomology. There was higher risk for depression based on gender and general physical. Of this population, 70% were women, 81% self-reported fair to poor health. This study elaborated on depression and other difficulties as a result of trauma. Participants reflected the struggle in acknowledging psychological problems and the influence of stigma in the community. These primary categories were evident: 1) Diminished psycho-social functioning related the burden of “Going through a lot” and sub-themes exemplifying fear or stress, 2) Reduction in activities, 3) the prevalence of ambivalent appraisals of status, 4) dealing with loss and finally, 5) the weight of negotiating through the past trauma and new conflicts.
Conclusions and Implications:
This research has important implications that address the application of this knowledge base to more effectively guide social work education and practice approaches. It deepens our understanding of processes that influence the mental health of trauma exposed African Americans. The results underscore the importance of a cultural perspective and competency in responding to the needs of diverse populations. It further suggests the need for more research on accumulated trauma and how it may effect older, diverse populations.