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Advancing Better Health Through Better Understanding for Black and African American Communities: Health Literacy, Health Care Access, and Culturally Appropriate Care 2024 Reading List
This brief bibliography contains resources focused on health and healthcare for Black and African Americans. It aims both to provide a snapshot of health disparities facing Black and African Americans and to highlight how focusing on health literacy and access to culturally appropriate care can mitigate these disparities and improve the health status of this population. The list contains three sections:
- Fact sheets and health materials for consumers.
- Reports and documents for health care providers and other professionals.
- Journal articles.
The resources in this list are available to read and download for free. For more resources on the health of racial and ethnic minority populations, please visit the OMH Knowledge Center online catalog.
Population Characteristics
Black and African Americans are the second-largest minority group in the United States. In 2022, an estimated 40.6 million people identified as Black or African American alone, making up 12.2 percent of the total U.S. population. An additional 7.3 million people identified as Black or African American in combination with one or more other races. The total Black and African American population constitutes 14.3 percent of the total U.S. population. According to 2020 Census data, this demographic makes up over a quarter of the population in the District of Columbia, Mississippi, Louisiana, Georgia, Maryland, Alabama, and South Carolina.
The Black population is a diverse group in terms of language and national origin. According to 2022 estimates, 10.6 percent of the Black or African American alone population was born outside the United States, and 10.0 percent report speaking a language other than English at home, with 3.1 percent speaking English less than “very well.”
Health Status and Disparities
African Americans face significant health disparities across several arenas. Projected life expectancy at birth in 2021 was 70.8 years for non-Hispanic Blacks, compared to 76.1 years for the population at large. In 2021, the age-adjusted death rates per 100,000 for non-Hispanic Black men and women were respectively 1380.2 and 921.9, compared to 1055.3 and 750.6 for non-Hispanic white men and women. The leading causes of death that year for non-Hispanic Blacks were cardiovascular disease, cancer, COVID-19, unintentional injuries, stroke, diabetes, homicide, chronic lower respiratory disease, kidney disease, and Alzheimer’s disease.
Non-Hispanic Blacks face a higher burden than non-Hispanic whites of many chronic and infectious diseases. They are more likely to have high blood pressure, but less likely to have their high blood pressure well-controlled by medication. Non-Hispanic Blacks are about 50 percent more likely than non- Hispanic whites to be diagnosed with diabetes, and were more than twice as likely to die from it in 2020. African Americans are nearly eight times as likely to be diagnosed with HIV than white Americans, and have the highest prevalence of sickle cell disease of any racial or ethnic group.
Certain cancers also have a higher prevalence in Black or African American populations—for instance, colon cancer, prostate cancer, and stomach cancer. Non-Hispanic Black women are equally likely to be diagnosed with breast cancer as non-Hispanic white women, but they are 40% more likely to die from it.
There are also glaring health disparities for Black Americans in terms of maternal health, birth outcomes, and infant health. The maternal mortality rate for Black pregnant people is the highest in the nation, at 69.9 deaths per 100,000 live births. The infant mortality rate among non-Hispanic Blacks is 2.4 times the rate for non-Hispanic whites, and Black pregnant people have higher rates of preterm birth than their white counterparts. The non-Hispanic Black population also has a lower rate of breastfeeding than other racial and ethnic groups.
Homicide, particularly involving gun violence, is another chilling health disparity that faces African Americans. The age-adjusted firearm-related homicide rate for Black males was the highest of any group in 2021, at 52.9 deaths per 100,000.
Barriers to Health Equity
The health disparities facing Black Americans can be attributed in part to several significant structural barriers to health equity. Income inequality challenges many Black households, whose median income in 2022 was $52,860 in comparison to $81,060 for non-Hispanic white households. Black households are twice as likely as white households to be living in poverty. Lack of health insurance is also a key barrier to health care access for the Black population. Non-Hispanic Blacks are about 70 percent more likely than non-Hispanic whites to not have health insurance coverage. In addition, many Black families face geographic barriers, living in areas with limited access to doctor’s offices and other health care facilities.
Limited health literacy (LHL) is an additional barrier to health care access and utilization in African American communities. Because information about health and health insurance is often written at or above a high school reading level, it is often inaccessible to people with LHL, which prevents them from being able to navigate the health insurance system and utilizing available health care. Non-Hispanic Blacks are disproportionately affected by LHL, with 24 percent having below basic health literacy compared to 9 percent of non-Hispanic whites.
It is also crucial not to underestimate the detrimental health effects of racism and the stress of racial discrimination. Anti-Black racism, both interpersonal and structural, has been deeply embedded in American society for generations and has profoundly and negatively impacted African Americans’ social determinants of health—such as economic stability, safe housing, job opportunities, quality education, access to clean air and water, etc.—and this continues to drive health disparities. In addition, research shows that Black people encounter bias and discrimination from health care professionals when seeking out medical care, resulting in a lower quality of care and sometimes outright harm. The stress of racial discrimination has also been shown to be a factor in chronic stress for minority groups, which has known detrimental health effects.
Working against racism and to improve social determinants of health for African Americans is crucial to reducing health disparities, improving health care access and utilization, and achieving health equity long-term. Culturally concordant and culturally competent health care is an important focus area for health care providers. A recent study showed a reduction in mortality disparities between Black and white individuals with higher levels of Black representation in the physician workforce, emphasizing the need to increase diversity within the health workforce. Community health workers that engage with the Black community at the local level and deliver health care where they live have been shown to improve health outcomes for Black people. Research also shows that integration of cultural competence and antiracism training into medical school curricula and professional education can increase health care providers’ cultural sensitivity and awareness of social determinants of health, thus improving their ability to care for their Black and African American patients.
Resources
These resources are intended for Black and African American people, health care providers, and other professionals to learn more about issues that affect this community. Please click on the title to learn more about each topic. Additional related resources in the online catalog may be accessed here.
2020 Profile of African Americans Age 65 and Older. Administration for Community Living (ACL), acl.gov, 2021.
2022 Heart Disease & Stroke Statistical Update Fact Sheet: Black Race & Cardiovascular Diseases. American Heart Association, heart.org, 2022.
Adult Vaccination: Protecting Your Health and Your Heart. Association of Black Cardiologists (ABC), abcardio.org, 2022.
African American People and Cancer. Centers for Disease Control and Prevention (CDC), Division of Cancer Prevention and Control (DCPC), cdc.gov, 2023.
Arthritis in the Black Community: A Wellness Guide. Arthritis Foundation, arthritis.org, 2023.
Health of Black or African American Non-Hispanic Population. Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), cdc.gov, 2023.
Heart Healthy Home Cooking African American Style. National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHBLI), nhlbi.nih.gov, 2021.
How Are African American Men Doing? General Health. African American Behavioral Health Center of Excellence (AABH-CoE), africanamericanbehavioralhealth.org, 2021.
IndexUS: What Healthy Black Women Can Teach Us About Health. Black Women's Health Imperative (BWHI), bwhi.org, 2019.
Mental Health Disparities: African Americans. American Psychiatric Association, psychiatry.org, 2017.
Safe Sleep for Your Baby: Reduce the Risk of Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death. National Institutes of Health (NIH), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 2019.
What About African Americans and High Blood Pressure? American Heart Association, heart.org, 2021.
Addressing Disparities in Access and Utilization of Mental Health and Substance Use Services Among Blacks and African Americans: Solutions from Community Stakeholders. African American Behavioral Health Center of Excellence (AABH-CoE), africanamericanbehavioralhealth.org, 2023.
Cancer Facts & Figures for African American/Black People 2022-2024. American Cancer Society, cancer.org, 2022.
Evidence-Informed and Community-Based Recommendations for Improving Black Maternal Health. Urban Institute, urban.org, 2021.
Improving and Expanding Programs to Support a Diverse Health Care Workforce: Recommendations for Policy and Practice. Urban Institute, urban.org, 2022.
National Veteran Health Equity Report – Black or African American Veteran Chartbook: Focus on Veterans Health Administration Patient Experience and Health Care Quality. U.S. Department of Veterans Affairs (DVA), Veterans Health Administration, Office of Health Equity, va.gov, 2023.
The Opioid Crisis and the Black/African American Population: An Urgent Issue. Substance Abuse and Mental Health Services Administration (SAMHSA), samhsa.gov, 2020.
Physical and Mental Health Interventions for Black Men in the United States. Research, Integration, Strategies and Evaluation for Boys and Men of Color (RISE), issuelab.org, 2017.
Understanding and Addressing the Social Determinants of Health for Black LGBTQ People: A Way Forward for Health Centers. National LGBT Health Education Center, lgbtqiahealtheducation.org, 2019.
African American Participation in Cancer Clinical Trials. Ecancermedicalscience, v. 15 (October 25): Art. 1307, 2021.
Becoming - A Journey to Wellness: Engaging HBCU Students in Developing a Theory-Based YouTube Healthy Lifestyle Intervention. Journal of Health Care for the Poor and Underserved, v. 33, #1 (February), p. 499-505, 2022.
Better Me Within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women. American Journal of Health Promotion, v. 35, #2 (February), p. 202-213, 2021.
Black Men’s Awareness of Peripheral Artery Disease and Acceptability of Screening in Barbershops: A Qualitative Analysis. BMC Public Health, v. 23, #1 (January): Art. 46, 2023.
Black Nurse Scientists and the Undeniable Role of Historically Black Colleges and Universities. Nursing Outlook, v. 70, #1 (January-February), p. 119-126, 2022.
Black Representation in the Primary Care Physician Workforce and Its Association with Population Life Expectancy and Mortality Rates in the US. JAMA Network Open, v. 6, #4 (April): Art. e236687, 2023.
The Clarion Call of the COVID-19 Pandemic: How Medical Education Can Mitigate Racial and Ethnic Disparities. Academic Medicine, v. 96, #11 (November), p. 1518-1523, 2021.
Community Health Workers as Change Agents in Improving Equity in Birth Outcomes in Detroit. PLoS One, v. 18, #2 (February 14): Art. e0281450, 2023.
COVID-19 Vaccine Attitudes Among a Majority Black Sample in the Southern US: Public Health Implications from a Qualitative Study. BMC Public Health, v. 23, #1 (January): Art. 88, 2023.
Cultural Interventions Addressing Disparities in the HIV Prevention and Treatment Cascade Among Black/African Americans: A Scoping Review. BMC Public Health, v. 23 (September 7): Art. 1748, 2023.
Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation. American Journal of Men's Health, v. 14, #4 (July-August): Art. 1557988320951321, 2020.
Designing Culturally Relevant Physical Activity Programs for African American Women: A Framework for Intervention Development. Journal of Racial and Ethnic Health Disparities, v. 4, #3 (June), p. 397-409, 2017.
Effect of Physician-Delivered COVID-19 Public Health Messages and Messages Acknowledging Racial Inequity on Black and White Adults’ Knowledge, Beliefs, and Practices Related to COVID-19: A Randomized Clinical Trial. JAMA Network Open, v. 4, #7 (July): Art. e2117115, 2021.
Health Disparities Among Black Deaf and Hard of Hearing Americans as Compared to Black Hearing Americans. Medicine, v. 101, #2 (January 14): Art. e28464, 2022.
Health Literacy in African-American Communities: Barriers and Strategies. Health Literacy Research and Practice (HLRP), v. 4, #3 (July), p. e138-e143, 2020.
Health Literacy, Smoking, and Health Indicators in African American Adults. Journal of Health Communication, v. 20, #2 (October), p. 24-33, 2015.
Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women. Nursing Clinics of North America, v. 50, #3 (September), p. 545-563, 2015.
The Impact of Culturally-Centered Care on Peripartum Experiences of Autonomy and Respect in Community Birth Centers: A Comparative Study. Maternal and Child Health Journal, v. 26, #4 (April), p. 895-904, 2022.
Impact of Culturally Tailored Shared Medical Appointments on Diabetes Self-Care Ability and Knowledge in African Americans. Primary Health Care Research & Development, v. 24 (April 27): Art. e30, 2023.
“It Was Just One Moment That I Felt Like I Was Being Judged”: Pregnant and Postpartum Black Women's Experiences of Personal and Group-Based Racism During the COVID-19 Pandemic. Social Science & Medicine, v. 322 (April): Art. 115813, 2023.
“Keep it Simple”: Older African Americans’ Preferences for a Health Literacy Intervention in HIV Management. Patient Preference and Adherence, v. 9 (January), p. 217-223, 2015.
Middle-Aged and Older African Americans' Information Use During the COVID-19 Pandemic: An Interview Study. Frontiers in Public Health, v. 9 (October 7): Art. 709416, 2021.
Racial Disparities in HIV Antiretroviral Medication Management Are Mediated by Health Literacy. Health Literacy Research and Practice (HLRP), v. 2, #4 (October), p. e205-e213, 2018.
Racial, Ethnic, and Cultural Resilience Factors in African American Youth Mental Health. Annual Review of Clinical Psychology, v. 19 (May), p. 361-379, 2023.
Reducing COVID-19 Vaccine Hesitancy Among African Americans: The Effects of Narratives, Character’s Self-Persuasion, and Trust in Science. Journal of Behavioral Medicine, v. 46, #1-2 (March 19), p. 290-302, 2023.
A Review of Hip Hop-Based Interventions for Health Literacy, Health Behaviors, and Mental Health. Journal of Racial and Ethnic Health Disparities, v. 5, #3 (June), p. 468-484, 2018.
Rise Up, Get Tested, and Live: An Arts-Based Colorectal Cancer Educational Program in a Faith-Based Setting. Journal of Cancer Education, v. 34, #3 (June), p. 550–555, 2019.
“There's Not Enough Studies”: Views of Black Breast and Ovarian Cancer Patients on Research Participation. Cancer Medicine, v. 12, #7 (April), p. 8767-8776, 2023.
"…[T]his is What We Are Missing": The Value of Communicating Infant Feeding Information Across Three Generations of African American Women. Journal of Human Lactation, v. 37, #2 (May), p. 279-288, 2021.
TRUST: Assessing the Efficacy of an Intervention to Increase HIV Self-Testing Among Young Black Men Who Have Sex with Men (MSM) and Transwomen. AIDS and Behavior, v. 25, #4 (April), p. 1219-1235, 2021.
The Weaponization of Medicine: Early Psychosis in the Black Community and the Need for Racially Informed Mental Healthcare. Frontiers in Psychiatry, v. 14 (February 9): Art. 1098292, 2023.