African American Psychology Final

Religion and Spirituality 

7 November 2024

History of studying African American religion

  • Beginning in the 1950s: the number of studies focused on the role of churches in civil rights activism

  • Mid 70s: there started to be a lull in research

  • But in the 80s and 90s onward, there has been a resurgence of interest in this field of scholarship 

  • Studies have consisted of national surveys, community surveys, and general population surveys as sources of information

Pew Research Center, 2021

  • Nationally representative survey of 8,660 Black adults (ages 18-older)

  • Respondents identify as Black or African American, including some who identify as both Black and Hispanic or Black and another race (such as Black and White, or Black and Asian)

  • Survey was complemented by small group discussions with Black adults of various ages and religious leanings, and interviews with Black clergy 

Correlates of Religiosity

  • African Americans are more religious 

    • Believe in God/higher power

    • More likely to go to church (only slightly higher than whites)

    • Pray

    • Read the Bible or other religious materials

    • Report their faith is important

    • Share their religious beliefs with others

    • In addition, many African Americans – especially elders, may receive material aid and psychosocial or emotional support from church elders – may request that prayers be offered on their behalf

Demographics & Religiosity

  • Gender: black women report much higher levels of most forms of religiosity than black men 

  • Age: generally religiosity increases monotonically – increases with age and decreases with youth

  • Geographic differences: Southerners tend to report higher levels of religiosity than other African Americans living in other areas of the country

  • Education and income: only modest, positive association with public religious involvement (e.g., church membership and frequency of attendance), but generally unrelated to more private, non-institutionalized expressions of religiosity 

Dimensions of African American Religiosity 

  • Organizational (e.g., religious attendance and congregational participation)

  • Non-organizational (e.g., prayer, Bible study, religious media consumption)

  • Subjective religiosity (e.g., strength of personal religious identity) 

Denominations: Black “Mainline” Churches

  • Baptist: 49-60% of African Americans are Baptists

  • Methodist 6-14%

  • Catholic 5-10%

  • No specific denominational affiliation 4-8% 

  • Overrepresented in Jehovah’s witnesses, Baptists, Muslim, 7th Day Adventists, and Pentecostals

  • Underrepresented in groups that claim no religion 

Changing religion?

  • Switching denomination is less frequent among African Americans

  • However, some studies suggest that a growing % of African Americans are abandoning organized religion – especially younger cohorts 

  • At the same time a “non trivial” proportion of persons are leaving black mainline churches are converting to smaller conservative groups (e.g., the Church of God in Christ, Jehovah’s Witnesses)

  • Compared to “stayers” those that leave organized religion attend to be younger, non-southern male, and tend to be relatively isolated from family and community networks 

Religion, Spirituality, and Well-being

  • Positive psychosocial outcomes from religious involvement:

    • Positively related to overall life satisfaction of African Americans – especially among older, non-southern African Americans  

    • Associated with lower depression and mental distress 

    • Helps with coping and dealing with stressful problems (planning and organizing)

    • Less substance use 

    • Prayer and coping – more likely to be used by African Americans who are dealing with bereavement or health problems (their own illnesses or those of loved ones). The “positive reframing” of illness can help them realize their strengths, pull them together as family   

    • Social support 

    • Increase likelihood of longevity, health 

    • Religion, Spirituality, and Well-being – Mental Health Assistance

      • Clergy may be the first line of help for those who are experiencing mental health issues 

      • Barriers for seeking professional mental health care


Faith in the Hood (2013)

  • Southeast DC, the city’s poorest region, has only one sit-down restaurant, but hundreds of churches. Faith in the Hood is a compelling portrait of the inner city, as seen through the prism of the spiritual life of its people

  • The film profiles five ministries:

    • A street ministry for former convicts

    • A socially active storefront church

    • A powerful Afro-centric church

    • An evangelical camp for youth

    • And an Islamic school 

  • With commentary from leading experts on African American faith, the film displays the richness of religion and its centrality as a defining aspect of black community life 

My note 

  • Some of the most churched places have the greatest level of suffering

    • How can so much suffering exist with so many churches?

  • When the economy declines, low income cities are hit the hardest

    • Higher income people in those cities leave and “white flight” occurs, and the people who are left are the lowest income which makes the cities suffer

  • Churches can provide security and comfort to young people

  • People need existential resources to hold onto in times of suffering because people are fragile 

  • Is it the spirit of Jesus in the room or unchecked emotions? Does it matter? Either way, it allows an individual to release emotionally and feel supported in their struggles → paraphrased from the movie 

  • “Black religion is liberatory” 

    • Historically, religion in black life has been prominent 

  • When religion is described as black it is a way of tying the social reality of black americans with religion

    • Race intervened with people’s relationship with religion throughout history 

  • The Nation of Islam had little connection to Islam from around the world

    • When it was founded in 1933, it was markedly different from black christianity and black judaism

    • Islam constituted a critique of the black religious landscape

      • It asserts a conservative worldview

    • Black Muslims were asked to change their names to detach from white America and replace their last names with an X

    • One man thought that becoming muslim brought more god into his life because he thought about god every day rather than just on sundays 

  • Religion has to be an individual choice

  • Rev. Eugene Rivers says that religion and music are the common variables among all black people across the world 

    • “It’s either the black church or nihilism and decay…those are the choices for the black poor”

  • Trauma

    • Clergy members and faith leaders can help people deal with psychological struggles and trauma 

Features of Traditional African Religions (Belgrave & Allison’s synopsis from African scholarship

  • Belief in a supreme being. God who created all things and is everywhere

  • God is good. Rewards for goodness, but also punishes evilness.

  • Belief in divinities. They stand next to God and serve as intermediaries between God and man. They are nature spirits.

  • Belief in spirit beings. Next to God and divinities. Spirits can be ghosts. 

  • Belief in ancestors. Our heroes and heroines with special powers in the afterlife.

  • Belief in the practice of magic and medicine. Practice, intervention, and curse through the spirits and divinities to men and healers

  • The soul is immortal. One’s soul survives death and becomes a spirit.

  • Little concern with the afterlife. Focus on human attainment in this world. 

  • Communalism. Supports the values of social solidarity, harmony, and cooperation.

  • Provides a moral code. Sanctions exist and misfortunes are earned. Good fortunes are rewards. 


Health Issues

14 November 2024


In-class video – Black women and cancer disparities 

  • Black women are more likely to be diagnosed with uterine, cervical, and other kinds of cancers

Health Terms

  • Epidemiology - a special branch of medical research devoted to studying the occurrence of disorders in populations and the risk factors associated with these disorders 

    • Prevalence - the total number of cases of a problem or disorder occurring in a population at a given time 

    • Incidence - the number of new cases of a problem or disorder that occur over a specific time period 

  • Mortality - the relative frequency of death or death rate in a population 

  • Morbidity - the proportion of sickness or a specific disease in a population 

African American/Black Population in the United States

  • In 2022, an estimated 40.6 million people identified as Black or African American alone, making up 12.2% of the total US population. An additional 7.3 million people identified as Black or African American in combination with one or more races. The total Black and African American populations constitutes 14.3% of the total US population 

Defining Health Disparities

  • “Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.” - Dr. Harold Varmus, National Institute of Health 

Coronary Heart Disease (CHD)

  • CHD - includes arteriosclerosis “hardening of the arteries” and atherosclerosis, the buildup of plaques in the walls of the arteries 

  • CHD deaths have decreased in the US. Yet CHD still remains the number one killer in the US for adults 

  • The major modifiable risk factors for CHD are high blood pressure, high blood cholesterol, cigarette smoking, excessive body weight, and physical inactivity 

  • Major disparities exist among population groups, with a disproportionate burden of death and disability from CHD in minority and low-income populations 

  • In early nationwide study, CHD death rates per 100,000 people were 241 for Black males and 209.2 for White makes, compared to 160.3 for Black females and 125.1 for White females (NCHS, 2006) 

  • Disparities in risk factors for CHD

    • Disparities also exist in the prevalence of risk factors for CHD. Racial and ethnic minorities have higher rates of hypertension, tend to develop hypertension at an earlier age, and are less likely to undergo treatment to control their high blood pressure 

    • For example, in one study, the prevalence of hypertension in a sample of 7,000 of US adults was 40.5% for Black Americans, 27.4% for White Americans, 25.1% for Mexican Americans 

  • Preventative actions – CHD

    • Preventative actions such as regular cholesterol checkups show disparities; Blacks and Mexican Americans tend to be screened less frequently than Whites. They are also not told about their condition as frequently 

  • Weight disparities

    • Among adult women, the age-adjusted prevalence of overweight continues to be higher for black women (53%) and Mexican-American women (52%) than for white women (34%) 

Infant mortality 

  • Infant mortality is an important measure of a nation’s health and a worldwide indicator of health status

  • Infant mortality rates vary substantially among and within racial and ethnic groups

  • Infant death rates among Blacks, American Indians, Alaska Natives, and Hispanics were all above the national average of 6.86 deaths per 1,000 live births. The greatest disparity exists for blacks, whose infant death rate (13.68 per 1,000) is nearly 2 and a half times that of white infants (5.76 per 1,000) (MacDorman & Mathews) 


3 December 2024

Cancer

  • Cancer represents over 100 diseases that result from some malfunctioning in the cellular programming of our bodies

  • Cancer is the 2nd leading cause of death in the U.S. 

  • Recent data indicate that the incidence and death rates from all cancers combined decreased since 1975 in men and women overall and in most racial and ethnic populations…but significant disparities do exist 

  • Cancer disparities

    • Big issue: 

      • Ethnic minority groups are more likely to be identified much later in the stage of the disease progression than through early screening 

      • Consequently, some may receive little or no treatment

      • Some may not receive treatment that is at the currently accepted standard of care 

    • Mortality

      • Blacks have a cancer death rate higher than that of whites (248.1 vs 195.3 per 100,000)

      • Death rate for cancer for black men is notably higher than it is for white men (339.4 vs 242.5 per 100,000)

        • Lung and bronchial cancer mortality is higher for black men than for white men (101.3 vs 75.2 per 100,000)

        • Prostate cancer mortality for black men is roughly two and one-half times that of white men (68.1 vs 27.7 per 100,000)

    • Hispanic women continue to have the highest incidence rates for cervical cancer, but African American women have the highest death rate for cervical cancer (Hispanic women have the 2nd highest) 

    • African American women continue to have the highest rates of mortality from breast cancer 

    • African American men have more cancers of the lung, prostate, colon, and rectum than do white men 

Diabetes

  • Diabetes is another comprehensive label that includes a set of diseases in which high blood sugar levels occur as the result of problems in the release or activity of insulin in the body

  • Type 1 diabetes - insulin dependent, AKA “juvenile onset” diabetes, which is typically associated with biological, genetic, or environmental factors 

  • Type 2 diabetes - AKA “adult onset” diabetes, accounts for up to 90% of all diagnosed cases of diabetes 

  • Ethnic disparities

    • Compared to whites: 

      • hispanic/latinos

      • African Americans

      • Asian Americans and Pacific Islanders

      • Are twice as likely to suffer from type 2 diabetes

      • Native Americans and Alaska Natives are 2.6 times more likely 

HIV

  • In 2018, African Americans/Blacks accounted for 42% of the 37,968 new HIV diagnoses in the US. Of these new HIV diagnoses:

    • 42% were among adult and adolescent African Americans/Blacks

    • 31% were among African American/Black men

    • 11% were among African American/Black women

  • The death rate for African Americans/Blacks was higher (16.3 per 100,000) compared with any other racial/ethnic group (2.5 whites). In 2018, African Americans/Blacks represented 43% of all deaths of people diagnosed with HIV

  • A recent study showed that African Americans/Blacks diagnosed with HIV are less likely than other groups to 

    • Be linked to care

    • Retained in care

    • Receive antiretroviral treatment 

    • And achieve adequate viral suppression

Barriers to Health Care

  • Black people are more likely to face barriers to health care and have worse health outcomes compared to white people

    • 10% of black people are uninsured compared to 7% of white people

    • 14% of black people went without care due to cost in the past 12 months compared to 11% of white people

    • 21% of black people self-reported fair/poor health status compared to 16% of white people 

  • Black adults are more likely than white adults to report unfair treatment and certain negative experiences when seeking health care

  • Black adults attribute health inequities to less access to quality care, range of other reasons 

    • Less access to quality medical care where they live

    • Live in communities with more environmental problems 

    • Etc.




Socioeconomic status (SES)

  • “Socioeconomic status (SES) encompasses not only income but also educational attainment, occupational prestige, and subjective perceptions of social status and social class” (APA) 

  • Socioeconomic status, race/ethnicity, and health outcomes 

  • What is well known…

    • Both SES and race/ethnicity have been found to relate to a variety of health outcomes

    • Health disparities have been consistently found for individuals different in SES level

    • Minority groups are disproportionately represented in low socioeconomic strata in the United States

  • However… 

    • Less recognized is that at most levels of SES, morbidity and mortality rates are higher for blacks than for whites, ie, black and white differences in health are not simply attributable to group differences in SES


Psychosocial Adaptation and Mental Health

Traditional theoretical models of pathology

  • Psychodynamic: intrapsychic conflict due to abnormal psychosexual development – arrested development, failure of defensive mechanisms to control desires of the id

  • Behavioral: set of undesirable, maladaptive behaviors that are learned

  • Cognitive: maladaptive cognitions

  • Humanistic: conflicts in between actual and ideal self 

Traditional medical/disease model

  • DSM-5-TR: based on the psychiatric/medical model of illness – syndromes are classified

  • ICD-11: international classification of diseases 

Africentric perspectives: White & Parham

  • A psychologically healthy Black person is one who:

    • Interprets the African American ethos (philosophy, emotional tone/spirit) into their life 

    • Is adaptive to their environment and is able to relate to others 

    • Is in touch with their African American self – self knowledge becomes essential 

  • Health is understood in the context of the black culture, not the Euro-American culture in which may have other philosophies, values, and beliefs that lead to the normative standard

Parham’s formula for “disordered behavior”

  • An absence of spiritual enlightenment

  • An overreliance on material versus the spiritual

  • An inability to access one’s humanity 

  • Goals of therapy: personal transformation of who they are and becoming what they can be 


Africentric Perspectives: Azibo’s mental order & psychological misorientation

  • Mental order: the achievement of psychological and behavioral functioning that is in balance with nature 

  • Psychological “misorientation” – a Black personality disorder that results from an individual functioning without an African belief system and mentacide (a process in which individuals lose their psychological Blackness), and other types of disorders (e.g., materialism, depression, reactionary disorders)

Africentric Perspectives: Akbar’s nosology

  • Akbar’s nosology (or system of classification of diseases) of mental disorders is based on our social system pathological society that leads to four types of disorders:

    • Self-destructive

    • Alien-self

    • Anti-self 

    • Organic 

      • Medical/biological based disorders 

Mental health

  • Consistent with core Africentric values of spirituality, communalism, a relational orientation, and interdependence 


Biopsychosocial Model

  • This model states that there is an interaction of biological, psychological, and social factors that lead to an individual’s health (mental and physical) and adaptation/adjustment 

Mental Health Services Pattern of Help-Seeking

  • An inconsistent pattern of help-seeking from African Americans

    • Research has shown both overuse of inpatient services and the over-and underuse of outpatient services depending on the setting and the problem

    • More rigorous, controlled studies have shown that particularly in outpatient services, African Americans were less likely than White Americans to seek mental health services 

  • Help seeking

    • African Americans sought services as a result of referrals (by physicians, family members, and friends)

    • Tended to contact physicians, ministers, and hospitals more so than psychologists, physiatrists, or community mental health centers

    • Sue and Sue noted that African Americans tended to average fewer sessions and to terminate from outpatient psychotherapy earlier than White Americans

    • More recent findings suggest that African Americans may be more open to discussing personal problems with a professional and letting friends know that they were seeking professional help

    • Yet they were more likely to express negative attitudes and less likely to use mental health services after professional contact

  • Possible reasons for inconsistent use

    • Economic barriers (e.g., lack of health insurance)

    • Therapists’ race and/or ethnicity

    • Stigma

    • Gender and problem type 

  • Sanders Thompson’s focus groups (conducted in 2000) targeted discussions regarding: problem type, therapist image, race/gender/ethnicity of therapist, service center characteristics, therapist characteristics, discussion of race/ethnicity within therapy, therapy goals

  • Sample: 201 African Americans (134 women and 66 men). 24 mixed-sex focus groups conducted in an urban, Midwestern city 

Psychologists and therapy

  • Psychologists → described as older White males, who were unsympathetic, uncaring, and unavailable – impersonal was a common descriptor 

  • Participants noted lack of psychologists’ participant in the community

  • Difficulty locating African American or ethnic minority psychologists

  • Those who had experience with psychotherapy discussed the importance of the therapist’s competence in diagnosis, treatment, and concern for client’s welfare 

  • Mistrust → generated the greatest debate in the groups. Some felt that stereotypes of African Americans are so strong that psychologists could not be unbiased in their perceptions

    • What helps decrease mistrust?

      • Therapist not appearing overwhelmed by their problems and issues

      • Therapist demonstrating genuine concern, appropriate inquiry, and engagement with the client 

  • Views on psychotherapy

    • Majority described a negative perception of psychotherapy: invasive, impersonal strategy to relieve distress. However, many discussed the need for competent care

    • Those who had experienced longer treatment held more positive views of psychotherapy 

    • Many reported hearing about psychotherapy complaints (e.g., cold interactions, difficulties connecting, worries about confidentiality especially related tor referrals coming from the courts and schools)

    • There was an expectation of psychoeducation

      • Psychoeducation includes an explanation of the problem(s), goals of treatment, expected length of treatment, specific ways in which therapy will help, provision of skills and strategies that will help 

  • Cultural sensitivity

    • Over half stated that race did not matter in the provision of mental health services but indicated a vague sense that perhaps it did

    • Men and lower income participants were more likely to believe that race mattered

    • Concerns centered on the history of African Americans in the U.S., pervasive stereotypes of African Americans