Understanding Emergency Department Utilization by African Americans for Routine Diabetes Care: Are We Asking the Right Cultural Questions?

Introduction:The emergency department is a source of routine care for many African Americans.Afrocentric cultural characteristics may serve as a better proxy than race for understanding preferences for emergency department use over primary care for diabetes management.Methods: A literature review was conducted including key terms related to transitional healthcare, emergency department recidivism, Afrocentric cultural characteristics, racism and health disparities, and diabetes in African Americans.An example of tailoring talking points using Afrocentric cultural characteristics is proposed using Jone's TRIOS Model, a Afrocentric Self-enhancing and Protective Theory.Results: The literature includes evidence to support a complex explanation for emergency department use by African Americans.Cultural characteristics that are self-enhancing and protective may explain preferences for emergency department care of diabetes.Cultural characteristics such as temporality, rhythm, improvisation, orality, and spirituality may drive a preference for emergency care.Conclusion: Tailoring care by using talking points consistent with cultural framing and culturally tailored diabetes education that is theoretically modelled has the potential to be delivered in the emergency department as a possible means of preventing recidivism, and risk for hospital readmissions.