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Resilience in the Face of Serious Illness Among Chronically Ill African Americans in Later Life

Institute for Health and Aging, University of California, San Francisco.

Address correspondence to Dr. Gay Becker, Institute for Health and Aging, School of Nursing, University of California, San Francisco, Box 0646, San Francisco, CA 94143-0646. E-mail: becker{at}itsa.ucsf.edu

Objectives. The purpose of this work was to examine older African Americans' philosophies about their chronic illnesses and how those philosophies affected chronic illness management.

Methods. Three to five in-depth interviews were conducted over the course of several years with 38 respondents between the ages of 65 and 91. Both open-ended and semistructured questions were asked.

Results. Respondents demonstrated determination, perseverance, and tenacity no matter how serious their illnesses were. Racism was instrumental in shaping the responses of these African Americans to their illnesses through cultural values that emphasized independence, spirituality, and survival. Respondents demonstrated a resilient philosophy as they faced disabling illness.

Discussion. This research attests to the importance of examining racism in the analysis of how older ethnic minorities live with chronic illness, as it provides the context for understanding the development of culturally specific philosophies about illness. Resilience, as a culturally specific philosophy, is an important adjunct to chronic illness management in later life, and more needs to be understood about the dimensions that shape it by cultural group.