UCF: Intergenerational Influence on Healthcare Decision Making Among Older African Americans


By: Donna Neff, PhD, Co-Principal Investigator & Phildra J. Swagger, PhD, MBA, Research Coordinator / University of Central Florida – College of Nursing Intergenerational influence (IGI) may be a key component of health care decision-making among older To install African Americans. The challenge is there is little evidence about IGI as it relates to older, culturally diverse adults in the literature. The Florida Statewide Research Aging Study (FRAS) defines IGI as the influence of one generation on another in terms of the transfer of skills, attitudes, preferences, values, and behaviors, and is exploring IGI as a driver of healthcare decision making in older adults. IGI involved communication between younger and older generations.

In Florida, African-American, Caribbean and Hispanic/Latino communities represent 63% of the state’s population and are the fastest growing group among adults aged 65 years and older. As adults throughout Florida age, they rely more on family members, friends, and other loved ones to assist with their healthcare. This work explored how African Americans in particular rely on each other, if at all, when making decisions about taking part in health-related research. Findings from older African American participants from the central region of Florida helped to answer two questions: From whom do older African Americans seek health related information? and What influences communication regarding health-related decisions between younger and older African Americans?

We found that older African Americans value communicating health information with their family members, opportunities to share family health histories, and striving for illness prevention. Older African American participants rely on their adult children, relatives in the medical field, their own personal efforts to research conditions, and providers to influence their health-related decisions. One participant stated “I think, my daughter,. , ..She was former military and in health care. And she understands what’s going on currently.” Another noted “my son works in a hospital. So, he’s very familiar. And my daughter reads a lot. … I value their input.” Another value was sharing family histories where participants wished that family medical histories were shared more from one generation to another. These older participants noted that had they known or understood their family medical history sooner, they could have prevented or better controlled some of the health conditions they currently have.

One older adult stated “Like education, education, and at a very early age, because, you know, a teenager, a middle schooler doesn’t think about, you know, hypertension, heart disease, and those kinds of things unless they have it. So they don’t look at as real they look at as being an elderly illness.” Lastly, prevention emerged as the another theme. While the participants have learned to manage and live with their diseases, issues related to mental illness, obesity and other persistent conditions such as hypertension, high cholesterol and diabetes were deemed preventable. Of interest, one participant stated “And so at a very early age, they need to be taught, you know, and educated about these diseases that can come upon them, or diseases that they can control if they control what goes into their bodies, and how they live.

Our findings confirm what we know to be true! African Americans rely on and need each other as they age. We are also learning more about how intergenerational influence plays a significant role in healthcare decision making among older African Americans. While participants recognized the importance of IGI, these older adults had not benefited from health-related communication with family members and friends in their earlier years. However, what is encouraging is that they are now open to discussing their current health conditions with family members and others whose opinions they value. As IGI increases among this group, we expect health care seeking behaviors to change in both older and younger African Americans.

To learn more email: Donna.Neff@ucf.edu,

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