African American Health Disparities: Causes and Promotion
This paper examines the state of health among African Americans relative to the national average, with a focus on the structural, socioeconomic, and cultural factors driving significant health disparities. It reviews elevated rates of cardiovascular disease, stroke, and type 2 diabetes in this population, as well as the role of systemic racism, redlining, food deserts, and under-insurance in producing worse health outcomes. The paper also discusses cultural factors such as differing attitudes toward obesity and the long-standing mistrust of the healthcare system rooted in events like the Tuskegee Syphilis Study. Finally, it proposes provider-level and systems-level health promotion strategies grounded in the transcultural nursing model.
- Introduction: Health Equity and African Americans: Overview of racial health equity gaps and mistrust
- Healthcare Disparities: Higher rates of heart disease, stroke, and diabetes
- Barriers to Health: Socioeconomic and structural obstacles to wellness
- Common Health Promotion Activities: Cultural attitudes toward obesity and daily stressors
- Approaches to Health Promotion: Provider strategies for equitable patient care
- Cultural Beliefs and Models: Transcultural nursing and building patient trust
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What makes this paper effective
- The paper moves logically from epidemiological evidence to structural causes, then to practical clinical recommendations, giving the argument a clear applied purpose.
- It integrates peer-reviewed sources from the American Heart Association and JAMA to support statistical claims, lending credibility to the health disparity data cited.
- The use of the transcultural nursing model in the final section ties the cultural context directly to a recognized clinical framework, grounding recommendations in theory.
Key academic technique demonstrated
The paper demonstrates effective use of a social determinants of health framework: it avoids reducing disparities to genetic or individual lifestyle factors, instead contextualizing statistics within systemic racism, redlining, income inequality, and provider bias. This framing strengthens the argument and reflects current public health scholarship.
Structure breakdown
The paper opens with an overview of health equity issues for African Americans, moves into specific disease burden data (cardiovascular disease, diabetes), then examines structural barriers (socioeconomic status, food deserts, housing discrimination). The final two sections shift to intervention: first discussing how cultural attitudes toward obesity affect health behavior, then offering concrete provider-level strategies. The paper closes by invoking transcultural nursing theory to reinforce the importance of culturally sensitive care.
Introduction: Health Equity and African Americans
African Americans suffer significant health disparities when compared with their non-Black counterparts. According to Chinn, Martin, and Redmond (2021), health equity among African Americans has suffered because of institutional and individual racism and discrimination — both in terms of socioeconomic discrimination in employment and education, and because of healthcare provider discrimination, as providers may give insufficient weight to higher risk factors for this demographic in areas such as heart disease, stroke, and mental health.
This is particularly evident given a long history of African American mistrust of the healthcare establishment, perhaps most notably exemplified by the Tuskegee Syphilis Study, in which participants were denied appropriate treatment for the sexually transmitted disease without their knowledge. Contributing to this mistrust are statistics indicating that Black women experience postpartum mortality at up to four times the rate of their white counterparts (Chinn et al., 2021). African Americans make up approximately 13.3% of the U.S. population, the second most populous minority group after Hispanics and Latinos (Carnethon et al., 2017). Yet life expectancy for African Americans is measured at 3.4 years shorter than for whites (Carnethon et al., 2017).
Healthcare Disparities
African Americans have significantly higher rates of heart disease and stroke compared with other groups, as well as higher rates of contributing risk factors such as hypertension and obesity (Carnethon et al., 2017). Mortality from cardiovascular diseases is also higher for African Americans than for whites (Carnethon et al., 2017). Although coronary heart disease has declined overall in the American population, these declines have been smaller among African Americans than among other groups (Carnethon et al., 2017). African Americans are also more likely to experience stroke at younger ages than whites. For example, in the 55–74 age group, African Americans are 1.8 times more likely to experience an intracerebral hemorrhage, although the difference becomes more negligible at age 75 or older (Carnethon et al., 2017).
African Americans are also twice as likely to develop type 2 diabetes compared with white Americans, particularly at younger ages (18–30 years), despite the fact that type 2 diabetes was once predominantly considered a disease of middle-aged or older patients (Bancks et al., 2017). Once again, obesity contributes to a heightened risk for diabetes, as well as heart disease and stroke, and elevated BMI is more pronounced among African Americans as a demographic.
Barriers to Health
Socioeconomic disparities — not simply genetic ones — are a significant factor in these poorer health outcomes. Lower socioeconomic status can result in less access to healthy, fresh, and minimally processed foods, particularly in lower-income food deserts, where access to supermarkets and farmers' markets is limited. Similarly, a lack of access to safe spaces for exercise and insufficient leisure time for physical activity can contribute to higher BMI, elevated stress levels, and overall poorer health outcomes. In the United States, being uninsured or underinsured can limit access to primary healthcare and regular monitoring by healthcare professionals, leaving wellness promotion and the early stages of chronic illness poorly managed.
All of these factors are more likely to affect African Americans as a group. For example, in a study of African American women, Chinn et al. (2021) reported that Black women earn an average of $5,500 less per year than their white counterparts and are more likely to be the sole head of household, effectively meaning they must support more dependents with lower income. America's history of redlining — discriminating against African Americans in housing — has led to residential segregation that affects health-related resources (access to supermarkets, exercise facilities, and health clinics) even for middle-class African Americans (Chinn et al., 2021).
References
Bancks, M. P., Kershaw, K., Carson, A. P., Gordon-Larsen, P., Schreiner, P. J., & Carnethon, M. R. (2017). Association of modifiable risk factors in young adulthood with racial disparity in incident type 2 diabetes during middle adulthood. JAMA, 318(24), 2457–2465.
Carnethon, M. R., Pu, J., Howard, G., Albert, M. A., Anderson, C. A. M., Bertoni, A. G., Mujahid, M. S., Palaniappan, L., Taylor, H. A., Willis, M., & Yancy, C. (2017). Cardiovascular health in African Americans: A scientific statement from the American Heart Association. Circulation, 136, e393–e423.
Chinn, J. J., Martin, I. K., & Redmond, N. (2021). Health equity among Black women in the United States. Journal of Women's Health, 212–219.
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