An act of political warfare: Self-care prioritization strategies of older African-American women with type 2 diabetes

Type 2 diabetes mellitus (diabetes) is the eighth leading cause of death in the United States. Diabetes disproportionately affects older adults and people of color. For older African American women, diabetes is considered a public health crisis. African American women 55 and older face higher mortality rates and more severe diabetes-related complications compared to their White counterparts. Secondary conditions such as cardiovascular disease, stroke, dementia, diabetic neuropathy, amputations, renal failure and blindness provide further complications to what is considered a major health challenge in the African American community. Self-management strategies are key to optimizing health outcomes for diabetes; however, in general, prioritizing self-care has been especially difficult for women given their adherence to cultural scripts that dictate prioritization of other-care over self-care. This paper presents selected narratives of Black women from a large qualitative study funded by the National Institute on Aging, which examined the diabetes management strategies of older adults residing in an urban area of the mid-Atlantic region of the U.S. The Black women selected for this analysis, have chosen to prioritize the self in the face of competing responsibilities, and by doing so display active resistance to the traditional gender expectations imposed upon women in American culture. We use Black Feminist Perspective to center and contextualize the variation in health experiences of Black women in our sample. For healthcare providers it is important to understand the experiences of African American women and the social forces which influence - hinder and support - their strategies for prioritizing health.