Poverty and Culture
Source: National Institute on Aging, 1999-2000, p. 3
According to available statistics, one-third of African Americans are poor, and poverty tends to be a proxy for a complex series of negative social events. These include inadequate housing, unemployment, low levels of education, low access to healthcare, poor nutrition, and often a risk-promoting lifestyle. Poor people tend to concentrate on day-to-day survival and often develop a sense of hopelessness and powerlessness. These and other factors have diminished their overall survival.

Research suggests that culture is a gross variable for other elements of life. People of the same culture tend to have common ancestors; a shared communication system; similar physical and social environment; and similar values, beliefs, traditions, and world-views. These shared elements lead to a common lifestyle, attitude, and behavior. It has been suggested that poverty acts through the prism of culture; this gives culture the potential to modify poverty's expected effects.

Some researchers believe that the disproportionate disease burden shared by black Americans is for the most part, an indication of the health consequences that befall a racial group which represents a substantial percentage of the poor and unemployed but is only one-tenth of the population. In order to provide culturally competent healthcare, providers must also be sure to pay careful attention to issues of racism and discrimination.

Research suggests that compared with Whites, a high percentage of Blacks (36%) do not take their medicine. The reasons cited included forgetting to do so, fear of possible side effects, inconvenience, cost, and a disbelief in effectiveness.

Health Beliefs
Source: National Journal Group, 1999
A study released in April 1999 by the Morehouse School of Medicine reveals that ethnic minorities are less likely than Whites to be fully enfranchised into the healthcare system even when they have medical insurance equivalent to that of Whites. The study also found many "malingering beliefs" – including folklore and other cultural beliefs – among members of minority communities that may be "detrimental to health." For instance, "African Americans were the least likely to believe that generic drugs are as good as name-brand medications and more than one-third surveyed, who took a prescription medicine, did not take it as directed."

The Tuskegee Syphilis Study
Source: Thomas & Quinn, 1994, 
The Tuskegee Syphilis Study, wherein hundreds of rural illiterate black syphilitic men were deceptively told that they were receiving treatment for the disease, is the longest non-therapeutic experiment on human beings in medical history. The legacy of this experiment, with its failure to educate the study participants and treat them adequately, laid the foundation for today's pervasive sense of black distrust of public health authorities. The study was intended to last six to nine months. However, the drive to satisfy scientific curiosity resulted in a forty-year experiment that followed these men to death.