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Although adoption agencies take pains to gather medical and family history information, it is often not possible to have full information for the entire birth family.

In a closed or semi-open adoption, there may be no way for an adopted child to ask questions or clarify vague or missing information that may only become relevant long after the adoption occurred.

There can also be significant concerns about coupled with specific hurt feelings over the birthmother's choice to "reject" the child" to "give me away" or "not wanting me enough." Such hurtful and vulnerable feelings may be compounded should the child learn that the birthmother later had other children that she chose to raise herself.

Adopted children may also suffer from a loss of access to important medical or genetic birth family histories.

In 1965, African Americans were more than twice as likely as whites to eat a recommended diet of fruit, vegetables, fat, fiber, and calcium.

By 1996, 28 percent of this population was reported to have a poor-quality diet, compared to 16 percent of whites.

Identity issues are of particular concern for teenagers who are aware that they are adopted and even more so, for those adopted in a closed or semi-open circumstance.

Not every adopted child will express an interest in his or her birth family history.

Such children prefer to just leave the adoption as a "done deal" and move on with who they are now, letting the past stay in the past.

Traditionally, many elders eat a large noon meal on Sunday after church.

Traditional African-American food—sometimes referred to as “soul food”—is diverse and flavorful with origins in Africa, the West Indies, and American southern states.

There is nothing wrong with adopted children who fail to show concern about their birth parents, and likewise, nothing wrong with adopted children who do show such interest.

The following guides emphasize information that can be used to stimulate thinking about cultural differences and prompt questions that will help providers understand how their patients identify with and express their cultural backgrounds.

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