Health promotion and African-Americans: from personal empowerment to community action

Self-help among African-Americans is that tradition of individual and group efforts aimed toward racial progress and defending against a hostile society. The purpose of this paper is to encourage African-Americans, regardless of income, to take personal responsibility for their health. This review discusses each side of the individual versus societal responsibility issue and provides a rationale for integrating these two perspectives. It argues that the tradition of community-based self-help among African-Americans is a mechanism for personal empowerment that can lead to collective action; it therefore has important implications for the improvement of African-American health.

The search made use of a computer-based inquiry with self-help, community health empowerment, and African-American or blacks used as descriptors. We also used a computerized search by the last names of key authors writing in the area of minority health. The review was limited to references between 1964 and 1994. The review also relied on our own professional libraries. Finally, 15 knowledgeable individuals employed at universities around the country were queried about their work, focusing on this subject. They were asked about their perceptions of the issues pertinent to the role of personal and societal responsibility in modifying health behaviors of African-Americans. SUMMARY OF IMPORTANT POINTS: Effective health behavior change strategies with black populations will require an integration of personal responsibility and advocacy for social systems change. The formation of effective self-help community-based coalition partnerships is viable strategy for forging systemic changes to address the health disparity problem.

The discussion concludes that blacks should hold themselves more personally responsible for solving their own problems while rejecting debilitating forms of extreme self-blame. Affiliation with self-help organizations and community coalitions for health empowerment is offered as a strategy for community infrastructure development with potential for improving quality of life.