"Working effectively with racial/ethnic groups requires an understanding that the goals, objectives, and messages should reflect the cultural values, beliefs, worldviews, and daily life experiences of the group, in addition to their health needs."

 

"These four groups—African Americans, Asian Americans and Pacific Islanders, American Indians and Alaska Natives, and Hispanics— currently constitute about one-fourth of the American population. By 2050, they will represent 47 percent, or almost half."

Given this window of opportunity to profoundly alter the future health of so many Americans, the challenge for tobacco use prevention educators and activists is to pose their messages and information in ways that are least disruptive to the traditional values and practices of these minority groups. Working effectively with racial/ethnic groups requires an understanding that the goals, objectives, and messages should reflect the cultural values, beliefs, worldviews, and daily life experiences of the group, in addition to their health needs.

Understanding the culture of the target audience and their underlying assumptions about tobacco use assures both that the educators’ message will be understood and that the values of the minority group are respected (1). Political correctness aside, respect for the client is a significant element in successful public health programs.

Health professionals generally agree that clients must be informed, persuaded, and motivated to adopt healthy behavior patterns. The ethics of helping individuals make positive choices, however, are tested when cultural and traditional values clash with health standards. For example, a health professional’s insistence that tobacco use has no redeemable health or social benefit poses a problem for members of minority groups who use tobacco in religious or spiritual ceremonies.

No single factor determines tobacco use patterns within or among minority groups. Instead, a complex mix of socioeconomic status, cultural characteristics, acculturation, stress, biology, advertising practices, product prices, and community interest affect individual and group tobacco use.

To help policymakers, community leaders, researchers, and public health workers develop culturally appropriate, effective tobacco prevention programs and materials for minority groups, “Overcoming Barriers” presents a digest of data, research, and practical applications on tobacco use and four population groups—African Americans, Asian Americans and Pacific Islanders, American Indians and Alaska Natives, and Hispanics. Additional resources for further reading and research are provided.

Terms to Know

Most data sources in the U.S. currently use four racial groups and two ethnic groups for classification purposes: African American, or Black; American Indian and Alaska Native; Asian American and Pacific Islander; White; Hispanic; and Non-Hispanic. Directive 15, “Race and Ethnic Standards for Federal Statistics and Administrative Reporting,” issued in 1978 by the U.S. Department of Commerce, uses the following labels and definitions, as described in the Surgeon General’s 1998 report:

African American Individuals who trace their ancestry of origin to Sub-Saharan Africa.
American Indian and Alaska Native Persons who have origins in any of the original people of North America and who maintain that cultural identification through self-identification, tribal affiliation, or community recognition.
Asian American and Pacific Islander Individuals who trace their background to the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands.
Hispanic Persons who trace their background to one of the Spanish-speaking countries in the Americas or to other Spanish cultures or origins.
White Persons who have origins in any of the original peoples of Europe, North Africa, or the Middle East. Some data sources separate this group into Non-Hispanic Whites and Hispanics.

Background

The April 1998 release of the Surgeon General’s report marked the first time that information on tobacco use among and within four large American minority groups was compiled into one resource. The report revealed the changing nature of the United States’ population. These four groups—African Americans, Asian Americans and Pacific Islanders, American Indians and Alaska Natives, and Hispanics—currently constitute about one-fourth of the American population. By 2050, they will represent 47 percent, or almost half. Such rapid growth indicates that these populations will be very young in age.

Table 1 shows U.S. population distribution by race/ethnicity and percentage change. Table 2 shows estimated percentage distribution of the U.S. population, by race/ethnicity, 1990–2050.

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