Abstract
Racial, ethnic, and cultural factors influencing mental health in later life are important to study in their own right. However, they also offer an opportunity to expand our understanding of mental health and mental illness in older adults independent of race, ethnicity, or culture. Any time an opportunity arises to examine a problem from a different perspective, chances increase that new light will be shed on the problem. For example, while suicide is greatest in older Americans compared with any other US population group, it is less frequent in older blacks than older whites. Why? Among the different theories that have been advanced, one holds that older African Americans in reaching later life have surmounted more threats to self-esteem (compared with whites) and are thereby better adapted to new challenges associated with aging.1 Still, the discrepancy in suicide rates between older blacks and whites remains an important research question. In studying suicide with attention to racial and ethnic variables, the opportunity presents itself to gain a more fundamental understanding of suicide itself—to the benefit of all older adults, indeed to the benefit of all age groups.
This paper focuses on some African American issues pertinent to geriatric psychiatry and identifies areas for further research. In addition to a selected literature review, the author draws on his own research from a 20-year longitudinal study, initiated in 1971, of a senior citizens' apartment building in Washington, DC, with a predominantly African American population.2 (1 = Group for the Advancement of Psychiatry, Committee on Cultural Psychiatry: Suicide and Ethnicity in the United States. New York, Bruner/Mazel, 1989; and 2 = Cohen GD: Lessons from longitudinal studies of mentally ill and mentally healthy elderly: A 17-year perspective, in Bergener M, Finkel SI (eds): Clinical and Scientific Psychogeriatrics, Vol. 1. New York, Springer, 1990.)
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