Cultural Considerations in People of African Descent

No doctor evaluates and manages disease in a vacuum; the racial background and cultural context within which the patient exists may influence such factors as terminology chosen to communicate with patients, diseases on the physician’s differential, and/or medications selected for management of a condition. For instance, when communicating with an African American woman, one might choose to ask about her flesh moles rather than her dermatosis papulosa nigra. Or one might steer clear of 10% benzoyl peroxide in an African American acne patient whose skin is prone to postinflammatory hyperpigmentation due to concerns of irritation. It is incumbent upon the dermatologist to be knowledgeable about the medical and cultural aspects of his or her patients that influence the ability to provide quality care. This chapter addresses the cultural considerations in treating patients of African descent. The conversation about race and ethnicity is complicated. There is discussion and debate in natural and social scientific arenas about the meaning and significance of each. Terms keep changing and are sometimes confusing. And for some, it is just plain uncomfortable to talk about at all, and avoidance can seem easier than risking saying the wrong thing or inadvertently offending a group of people. That being said, most patients are not involved in anthropological or biological debates, and their race and culture are important to them. These factors may impact their perceptions of disease, utilization of health services, and disease outcomes. So understanding the cultural context in which the patient and his or her disease exist is paramount.