Spiritual well-being among older african americans in a midwestern city.

More than many other cities in America, older African Americans in Milwaukee, WI contend with negative environmental, socio-economic and health challenges in one of the most hyper-segregated cities in America. This research examines the role of spirituality and religion in their lives and the ways that spirituality and religious affiliation contribute to their quality of life. Over 500 elderly respondents aged 55-105 completed a questionnaire. The analysis found: (a) strong identification with religious institutions and high levels of attendance and participation in religious activities, (b) a substantial number felt support from fellow church members, and (c) strong reliance on spirituality and their sense of connection to God as sources of strength in coping with personal challenges. This study adds to the findings of other research done which stressed the importance of spirituality, religious practice and congregational assistance in serving critical survival functions for older African Americans. This is the first such research done, however, reporting on Milwaukee's African American older adults. This study used mixed methods of research, conducting both a descriptive statistical analysis of African American elderly in Milwaukee County to develop a profile while simultaneously gathering, where possible, qualitative data as well, in the form of narratives, written comments and field notes of first hand observations on this growing population.

Systemic barriers to health care access for U.S. women with HIV: the role of cost and insurance.

Lack of access to health care has particularly brutal consequences for low-income U.S. women with HIV who, without regular and consistent primary care, including treatment with highly active antiretroviral therapy (HAART), are less likely to live long and well with HIV. This article explores barriers to basic health care encountered by a sample of 55 HIV-infected women from urban and rural Wisconsin who participated in a longitudinal, qualitative study. In a series of 10 in-depth, story-eliciting interviews over a two-year period, each woman explained in detail what it was like for her to obtain health care since becoming infected. Conveying women's subjective experiences of trying to get the care they needed, their stories highlight serious institutional impediments to health care and provide a discomfiting glimpse of the systemic forces that limit access to health itself. Findings convey how the extraordinarily high cost of U.S. health care, the unpredictable and disjointed array of out-of-pocket costs, and the complex and obfuscated intricacies of health insurance impeded women's access. They lived a paradoxical reality: having an illness they feared, needing treatment for long-term survival, and being unable to meet its costs. Each woman's story reflects deep fissures in the U.S. health care system.

Self-care of women growing older with HIV and/or AIDS.

The purpose of this report is to describe the ways older women living with HIV perceive of and practice self-care. Data are taken from a culturally diverse subsample of 9 women age 50 years or older who participated in a larger longitudinal qualitative study of women who were HIV infected. During a period of 2 years, 10 semistructured narrative interviews were conducted with each of the 9 participants to gain an in-depth understanding of their experiences with symptom management, adherence to medical regimens, reduction of HIV risk, access to health care and social services, and personal efforts to maintain their health. Transcribed data were managed using Nvivo software and analyzed using multistaged narrative analysis. Findings suggest that mature women living with HIV integrate actions to maintain bodily comfort and improve physical well-being with actions that champion and conserve the existential self. Excerpts from their interviews illustrate this dialectical understanding of self-care.