Changing Culture in Health for People of Color

Culturally, privacy has always been a part of the DNA to keep a code of silence around personal business. Everyone has heard the expression, “I am not going to share my business.” The expression of not sharing one’s business has become a cultural way of operating. The secrets are akin to dis-ease in our families and communities because we cannot begin to cure what is hidden. The message “it’s my business” has spread generationally, affecting the ability to access good healthcare and gain support. No one can combat health challenges alone. The message to keep secrets prevents early detection of diseases or the ability to eradicate the most prolific illnesses in our communities, such as diabetes. It is time our communities unmask the secrets to undo the thinking it’s my business- it’s all of our business.

At some point in one’s life, you do not have a personal business because doctor(s), family members, or even friends need to know your business for a healthy life. Privacy has always held a significant place in many cultures, including among people of color (POC). Historically, keeping personal matters within the family or community has been a way to maintain dignity and autonomy, particularly in societies where people of color have faced systemic discrimination and marginalization. This cultural emphasis on privacy extends to health matters, often resulting in a strong desire to keep medical issues private. However, as individuals age, the necessity for openness in health-related issues becomes critical for ensuring quality of life and effective care. To gain a healthy life, people of color need to demystify the “what is your business,” leading to secrets that eventually affect health, lifestyle, and relationships. Withholding information from doctors, family, and friends creates a lack of trust and builds a wall around the person in need; eventually, when the information is finally shared, it may be too late to solve.

The Cultural Impact of Secrecy

For many people of color, not sharing your business is a part of the culture because of the lack of trust or expectations of harm by sharing. Sharing personal or family matters outside of trusted circles can be seen as a vulnerability, potentially exposing individuals to judgment or stigma, yet personal business is often not shared even among family. This perspective is deeply rooted in a historical context where communities of color have had to safeguard their lives and well-being against external threats, and this oppression has now turned this practice against us. The longstanding historical oppression of secrets as a standard practice is detrimental to the secret holder.  

In many cultures, especially Black people, discussing health issues can be scary, leading to thoughts of retribution in their daily lives, impacting jobs, access to support, and respect. Often, withholding important aspects of health, especially mental health, is associated with weakness or defeat. The culture that leads to judging mental health, chronic illnesses, or age-related conditions can be stigmatizing and hurtful, leading to other conditions such as loneliness, oppression, or even suicide. Further, sharing health conditions can become a weapon used against POC to gain or sustain work or economic access. As a result, many elders may hesitate to share their health concerns, even with close family members or healthcare providers, producing exponential problems in catching illnesses or diseases in their early stages. Consider short-term illnesses, when kept secret, can create long-term sickness or even bloom into disease. People of color need to unmask what is called “our business” or secrets for successful health and better relationships around care.

The Importance of Communicate in Aging

As individuals age, the complexities of managing health often increase. Conditions such as diabetes, hypertension, heart disease, and dementia are more common in older adults and require careful management and monitoring, especially in the Black community. The trickiness of secrets and hidden information to maintain privacy can directly conflict with the practical need for open communication about health, health directives, asset transference, and burial requirements.

As we age or when sick no one has business to keep private. When Black people and people of color share, they can increase their quality of life.

Quality of life in later years often depends on timely medical intervention, adherence to treatment plans, and the support of a care network. When health issues are kept private, critical signs can be missed, treatments delayed, and opportunities for preventive care overlooked. In this context, someone knowing your “business” is not an invasion of privacy but a necessary step towards ensuring effective care and support. It is essential to share incontinence, pain, and more. In our communities, stories are told of people who have worked in pain or engaged in extreme ways in their day-to-day lives and are honored for these actions. The stories are shared as hero or shero stories when, in actuality, people operate at high pain thresholds, leading to other short and long-term issues. In Black and Brown communities, their stories are our stories and, when hidden, become problematic for the overall community.

Steps to Closing the Gap for Better Communication

1. Education and Awareness: It is essential to educate healthcare providers, families, and communities about the importance of open communication in health. Providers should be trained to approach these conversations with cultural sensitivity, understanding the deep-rooted values around privacy.
2. Building Trust: Establishing trust between family, patients, and healthcare providers is crucial. Trust can be achieved through consistent, respectful, and empathetic communication. When individuals feel understood and respected, they are more likely to share vital health information. This opportunity is to try to prevent judging in all situations when others are sharing.
3. Family Involvement: Encouraging family discussions about health can bridge the gap between cultural privacy norms and the need for openness. Families can play a critical role in supporting their elders by being involved in medical appointments and care plans. In families, we can teach our children to appreciate their elders and promote healthy dialogue, open communication around a better quality of life, and the signs of illness for preventative care.
4. Community Support: Families, community leaders, and organizations can be instrumental in shifting attitudes toward health privacy by promoting health education and open discussions within a culturally relevant framework; this can help normalize the sharing of health information.

People of Color need to demystify their secrets and share for a healthier life.

People of color need new cultural values of open expression around what your “business” is. We don’t have “business” when it comes to health because our community requires open communication to bridge good health, the best methods for care, and support systems to increase the quality of life. Open communication is essential for people of color, especially as they age. Open communication about health issues should be seen not as a betrayal of privacy but as a necessary adaptation to ensure quality of life. By fostering an environment of trust, respect, and cultural sensitivity, families, communities, and healthcare providers can work together to support the well-being of aging individuals while honoring their cultural heritage. We don’t have business when it comes to our health and or even finances, we only have care.