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From 2017-2022, I lived in Charleston, South Carolina and worked at a lovely community in Mount Pleasant just a few miles from Isle of Palms and Sullivans Island. It was such a beautiful place with rich culture and delicious food. I loved visiting the historical sights and learning about the history of the area. It wasn’t until I started doing more research and asking questions to my fellow coworkers who many were descendants of enslaved Africans that I realized how influential the Gullah Geechee culture has been on the area and that these individuals are facing some very unique issues today.

It wasn’t that long ago that the national news was reporting on an older woman in Hilton Head, SC that refused to sell her property to a developer which resulted in some legal battles, and it caught the attention of celebrities like Tyler Perry and Kyrie Irving. The truth is this situation is not new or rare, it has been happening for decades and continues today. I found that not many people knew about this population and these ongoing issues, so I would like to share a paper that I wrote for one of my doctorate classes in diversity in aging.

Gullah Geechee is the term used to describe the culture and individuals who are descendants of enslaved Africans along the sea coast from the southern parts of North Carolina down to Jacksonville, Florida (Gullah Geechee Corridor, 2020). Their isolation on the islands of the southeast coast allowed them to maintain much of their unique African culture from food, religious practices, arts, music, and also language (Green, 2013). This culture was developed on the rice and cotton plantations as slaves came from different parts of West Africa which all carried their own culture and beliefs; Gullah Geechee was the product of these slaves from different backgrounds trying to maintain some sort of identity and connection with their African roots (Pollitzer, 1999). When slaves arrived here in the United States no records were kept on where the slaves were taken from in Africa, making it difficult to know the exact ancestry of enslaved individuals (Jones-Jackson, 1987).

Despite the drastic changes throughout the past 200 years, Gullah Geechee culture remains a major influence on these coastal areas today. It also remains a culture and people that are highly studied by an array of different disciplines because it is the most distinctive African American population in the United States (Green, 2013). The Gullah Geechee people who still live on the Sea Islands today have genetic makeup closer to African people than European or other ethnicities (Jones-Jackson, 1987). Green (2013) describes five categories of Gullah Geechee people in today’s modern world: Traditional Gullah Geechee, Modern Gullah Geechee, Gullah Geechee family, Gullah Geechee diaspora, and Gullah Geechee descendants. The traditional type remain on the islands and for the most part have maintained the culture and traditions. The modern individuals have remained in the area, but have become distant from the culture and traditions or modern can also be individuals who moved out of the area, but keep cultures and traditions. The family type are individuals who have moved away from the area, but either keep in touch with relatives and culture on the sea islands or are now just getting back in touch with their roots. The descendants are individuals who were born and raised in other parts of the country and recently have discovered their ancestry and connection with Gullah Geechee.

For the purpose of this paper, the focus will be on traditional and modern Gullah Geechee people who live in what is called the “lowcountry” of South Carolina or areas from Hilton Head Island up to Charleston. It will examine the historical events that have shaped the people and their current environment, politics, socioeconomic status, and health. Provide insight into their culture and traditions that make them unique and an influence on the area. Finally, it will examine the health disparities and aging issues that impact the Gullah Geechee people.

Historical Events that have affected the Gullah Geechee

The Gullah Geechee people and culture would have never existed without the African slave trade. Slavery began back in 1619 when they were brought to Jamestown, Virginia to help early colonies become established settlements (Provost, 2019). In Charleston or back then Charles Towne, the slave trade took off after the development of the port in 1670 (Pollitzer, 1999). Charleston became almost like the capital of the slave trade industry, especially in the 1700s and early 1800s. In the 1700s in Charleston, blacks outnumbered whites three to one not only in rural areas, but even in the urban area of Charleston as slaves built the city and created the economy (Pollitzer, 1999). Sullivan’s Island, an island right off Charleston, became the place where at least forty percent of enslaved Africans entered which is why some refer to it as the “Ellis Island of Slavery” (Provost, 2019). Slaves were taken to Sullivan’s Island and put into slave houses to ensure that they did not have any diseases or carrying any parasites prior to being sold (Pollitzer, 1999). Slaves in the Lowcountry mostly worked on rice plantations as rice became a major crop in the area due to the ideal climate and water systems to grow it. On these plantations is where the Gullah Geechee culture developed along with the distinct creole language they used for communication.

The Civil War became a pivotal event for the Gullah Geechee and enslaved people all over the United States. The end of the war and the Emancipation Proclamation outlawed slavery and provided the opportunity for blacks to make money and own land if they desired. Although in the reconstruction period directly following this, blacks were offered land in which they and their family had been working on and cultivating for over 100 years, which many did. After Lincoln’s assassination many of these laws were reversed and whites in the area came back and took the land again from the blacks (Jones-Jackson, 1989). At this time many of the Gullah Geechee retreated back to the Sea Islands and started communities where they could be free with each other (Pollitzer, 1999). The Gullah Geechee were completely self-sustainable using the knowledge and skills passed down from family surrounding cooking, fishing, hunting, and farming. Up until the 1950s the only way to access these islands was by boat allowing for isolation. The hot and humid climate in the summer months along with mosquitos (which carry diseases) also kept white people from inhabiting these islands.

However, starting in the 1950s through the 1960s many bridges were built that connected the islands and main lands to allow for free travel to and from. At first, this opened up some new opportunities for Gullah Geechee to sell their crops, arts, and fish at markets and make money. They could more easily access healthcare and other services. Of course, this was during the Jim Crow era so they faced extreme racism and discrimination by the white people of Charleston and surrounding areas. This is what caused many to move north to try and escape this discrimination and violence in what history calls the Great Migration.

During this time, the invention and availability of air condition made living in hot and humid climates more comfortable for white affluent people. These individuals started setting sights on these gorgeous islands and beaches and began to start to come in and develop the land on the island where the Gullah Geechee were living. From the 1970s up until current times luxury resorts and gated communities started being built on these islands attracting white affluent retirees or vacationers. Gentrification of the areas forced many of the Gullah Geechee off these islands due to rise in land values and property taxes which they could not afford (Hargrove, 2009). Many Gullah Geechee owned land under what legally is known as “heirs property” meaning it was passed down from generation to generation so the deed does not have one person’s name on it. Unless they go through a complicated and costly legal process to obtain the deed and title to the land, financial institutions will not let those residing on the property to take out loans for improvements or building. This leaves many Gullah Geechee in a position where they are unable to capitalize on equity of the land, but are still subject to the high tax rate forcing them to sell and move (Derickson, 2016). Racism and discrimination still continue today in 2020 leaving the Gullah Geechee like many black people in America at an extreme disadvantage.

Socioeconomic and Political Status

The heirs property remains a major issue for Gullah Geechee communities that are left around the lowcountry. Preserving the land and culture of the Gullah Geechee has become a platform that the community advocates and late senator Clementa Pinckney pushed for. Clementa Pinckney was one of nine people murdered by Dylann Roof while at a Bible Study on June 17, 2015 (Derickson, 2016). Before his murder, he and James Clyburn, were able to establish the Gullah Geechee Corridor which is a federal initiative overseen by the National Parks Department to preserve the land and culture of the Gullah Geechee along highway 17. The Gullah Geechee Corridor has been providing a voice to the people and raise money to help individuals maintain land that has been in their family for hundreds of years.

The Gullah Geechee elected Cheiftess and Head of State of the Gullah Geechee nation known as Queen Quet. She represents the Gullah Geechee in political arenas and has testified at the United Nations on behalf of the Gullah Geechee bringing awareness the discrimination their unique culture faces (Derikson, 2016). She also advocates for the archival of the history and culture of the enslaved Africans. The focus of much of her work is the preservation of land and history.

Most of the Gullah Geechee today are still socioeconomically disadvantaged due to discrimination in all facets of life and barriers put in place by white lawmakers to inhibit success of black Americans. Most Gullah Geechee men hold blue collar work or still fish or farm to sell the fruits of their labor at markets. Many women are seen as the main caregivers of children, grandchildren, and older adults who need care. The art of making sweetgrass baskets passed down from generations can also be a major source of income for some Gullah Geechee. If you drive on highway 17 in Mount Pleasant, South Carolina you can see many stands selling sweetgrass baskets along the way. You will also pass stands further south selling fish, seafood, or produce.

Elements of Diversity and Culture

One of the most studied aspects of the Gullah Geechee culture is the language which is completely unique to them. Researchers have been unable to find anywhere else in the world that speaks this particular language and dialect, although there are some similarities between it and the language spoken in Sierra Leone (Jones-Jackson, 1989). Today, most do not speak the language anymore it is a dying part of the culture that acculturation into white schools and what is considered proper English has produced. The Gullah Geechee remain very community oriented in helping one another and providing social support. Religious praise houses used to be central to the community before many of them have been closed, but they still frequent churches with their values and beliefs (Jackson-Jones, 1989). Church remains one of the most important social organizations among the Gullah Geechee people. Just as Mehrotra and Wagner (2009) discuss that religiousness and spirituality lead to positive mental health this is seen in the Gullah Geechee. These individuals are less depressed and feel as though they have adequate social support (Troutman, Nies, & Bentley, 2011).

The health beliefs of the Gullah Geechee have changed over time, but many still turn to herbal remedies, prayer, and healers when they are ill. When they were living isolated on the Sea Islands before the bridges were built this was their main healthcare. A physician would come by boat about once a month to address any issues of the population. Midwives who were trained by family or other midwives in the community were how babies were delivered. Today, Gullah Geechee women still want a midwife alongside their doctor to deliver their baby. They also believe that ailments and illness can be caused by an ancestor being angry with you which is why healers and prayer are paired with treatment by a physician (Jones-Jackson, 1989).

The Gullah Geechee believe that when someone dies only the soul goes to heaven and the body and spirit remain here on earth. They believe that the spirit can leave the body and roam the earth. According to Jones-Jackson (1989), there is a belief in voodoo or hoodoo where rituals can call on spirits to offer predictions, kill enemies, or perform cures for problems ranging from a broken heart to cancer and infertility. When it comes to traditions surrounding death and dying, they consider it unacceptable not to have funeral arrangements made and paid for prior to dying; therefore, they make payments throughout their life to ensure all is taken care of upon their death (Jones-Jackson, 1989). They also believe that you should be buried among your ancestors as it gives someone spiritual nourishment and to also be buried in densely wooded areas. Gullah Geechee people place pottery, spoons, and dishes on the grave in case the deceased’s spirit may need them in the afterlife (Jones-Jackson, 1989). Funerals are religious services and used to pay respect to the surviving family members. After the funeral a big gathering is held where they eat traditional foods and celebrate the person’s life.

Trends and Implications for Older Gullah Geechee People

As mentioned previously, gentrification and the development of the Sea Islands has made a big impact on the Gullah Geechee people and their culture. It has created several social problems that effect this population especially those who are aging. Many younger people have started moving away from the sea islands for jobs and education, leaving older family members. This has been creating a lack of informal caregiving support which traditionally has been the cultural norm for Gullah Geechee.

As they lose land due to not being able to afford it anymore many are forced into urban areas where affordable housing is available or rural areas where there is a lack of services available. Grandparents are also facing the more common event of raising their grandchildren whether their children were victims of drug addiction or incarcerated or just sharing a household to afford to live (Ruiz, Zhu, & Crowther, 2003). This caregiving in later life can cause an increase in health problems and the severity of the issue (Ruiz, Zhu, & Crowther, 2003). The Gullah Geechee face unique health issues and continue to suffer from health disparities comparable to blacks from other parts of the United States.

Health and Health Disparities

The Gullah Geechee for some time were completely self-sufficient on the sea islands. They would eat the foods they farmed, hunted, or fished. This made their diets consist of lots of rice and rice based foods, meats, and seafood. If we think of the southern cooking of collard greens, macaroni and cheese, shrimp and grits, biscuits, and more it really is the influence of the Gullah Geechee. Today we know that consuming many of these foods in high quantity can cause high blood pressure, high cholesterol, and diabetes. Therefore, it is not a surprise that many Gullah Geechee experience these health conditions as they age (Pollitzer, 1999). As convenience grew available and people no longer had to go out and farm for their own food they could just go to the grocery store, health promotion behaviors such as exercise had never been a central part of the culture. It was in the 1990s when local physicians and researchers at the Medical University of South Carolina realized the higher than normal incidence rate of type II diabetes in Gullah Geechee people (Sale, et al., 2009).

The researchers knew that their diet and lifestyle factors contributed to the diagnosis but the incidence rate was so high they wanted to see if they carried a genetic predisposition for diabetes. The Medical University of South Carolina along with many local organizations launched Project SuGAR (Sea Islands Genetic African American Registry). As many Gullah Geechee referred to diabetes as “having the sugar”. This research not only set out to work with the Gullah Geechee in finding effective interventions to help promote healthy diets and lifestyle, but also examines the genetic aspects that could be influencing the development of diabetes. Sale and colleagues (2009) did find a genetic link on chromosome 7 and 14 to diabetes that has not been found in other African American populations. In an interview with Sherman Pyatt a commissioner with the Gullah Geechee Cooridor he mentioned that diabetes and the complications that come from it have significantly affected the life expectancy of these people to the point that over the last 200 years life expectancy among them has not really increased. In other words, the Gullah Geechee still face stark health disparities and gaps compared to white Americans.

The health disparities have been there since their enslaved ancestors arrived in America. They were exposed to many diseases that were often left untreated by white slave owners or sellers (Pollitzer, 1999). Once they were able to get medical treatment only black doctors could treat other black people. During segregation up until the late 1960s, black people in Charleston had to use a separate hospital system and doctors. This was a norm across the south in this time. Freedman hospitals were set up to serve black people and of course they were not given the same funding, equipment, and supplies as white hospitals (Provost, 2019). Even if the white hospital was closer or had the equipment to save the black person’s life they still were unable to enter or receive treatment there.

Today, some Gullah Geechee communities remain in very rural settings on the sea islands and quality healthcare and facilities require a long drive into more populated areas. There is also no public transportation that services these rural areas, so if older adults cannot drive or do not have a car they have to find someone else to rely on for this transportation. This is just the start of major issues that face aging Gullah Geechee in the Lowcountry.

Aging in the Gullah Geechee Culture

Access to quality healthcare and services remains a major issue for older adults in the Gullah Geechee community. Once they do get access to services research shows that black older adults still face discrimination from physicians and hospitals (Mehrotra & Wagner, 2009). The culture traditionally relied on family to provide the care and support one might need as they age. Gullah Geechee rarely, if ever, were placed in nursing homes or had to reach out to formal health care agencies for help. However, with the trend of many children moving away or having to work full-time jobs to make ends meet they have not been available to provide this care. This leaves older Gullah Geechee members to have to turn to formal supports.

Home care agencies that serve rural areas that many Gullah Geechee live, can be hard to find and in most cases these agencies will charge more money because the caregivers have to travel a further distance to provide service. For most living in poverty they cannot afford this care, let alone another extra charge on top of that. South Carolina also has limited funding for home and community based services funded by Medicaid and put in place by the local Area Agency on Aging. There are limited services and most services have a wait list for obtaining them. Therefore, most Gullah Geechee elders are forced into moving into nursing homes were Medicaid will cover the cost and their care is provided.

However, these nursing homes also provide another example of a health disparity facing the Gullah Geechee. In general blacks enter nursing homes at higher rates than whites (Mehrotra & Wagner, 2009). Here in the lowcountry, the nursing homes they enter are primarily funded with Medicare and Medicaid reimbursement resulting in shortfalls in equipment, supplies, and staffing (sound somewhat familiar). The quality of care that individuals receive in these facilities is not as good as those nursing homes that are Medicare and private pay only or filled with mostly white residents (Mor, et al., 2004). This disparity has been highlighted by the recent COVID-19 pandemic where nursing homes with a majority black resident population were twice as likely to be hit with the virus compared to nursing homes with a majority of white residents (Gebeloff, et al., 2020).

The older adults of Gullah Geechee have also seen a significant amount of their culture fade away with time and upon a move into a facility it could be even more difficult to continue ties with their traditions. Mehrotra and Wagner (2009) point out that many times facilities are not culturally sensitive to everyone’s beliefs and traditions and residents can struggle with finding identity in this new space. It also does not help that many of our testing in research or even with the doctor is racially biases and set up for white, middle class individuals. For example, Morgan and Marsiske (2008) conducted a study to explore the differences of cognitive test performance between black and white older adults. They found that black individuals were more likely to possess a lower education level and reading level. When the researchers controlled for this in the study they found the results to be consistent, concluding that tests are biases towards individuals who are more educated with a higher reading level (Morgan & Marsiske, 2008). This type of bias can lead to misdiagnosis of cognitive impairment.

The older Gullah Geechee people have been through so much change and strife, living through many significant historical events that have changed their way of life. They built the city of Charleston and developed the lucrative economy only to be failed by the system on which was developed on the backs of their ancestors. Gentrification has taken away the land that their families have cultivated and lived on for generations leading the way for a slew of other social problems that most black Americans face throughout the country. Not only do they have a unique culture, but they also have a unique genetic makeup that influences their health. There is a major gap in continuing to support older Gullah Geechee people in a way that will honor their culture and traditions.