Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional cultures and the culture(s) of their new environment, and also exposes populations to other health risks. The black or African American category also does not accurately reflect how health conditions are disproportionately affecting subgroups, specifically black immigrants. Rather than race, using ethnicity as an indicator situates health within a cultural framework and acknowledges a person’s shared sense of membership, ancestral heritage, and cultural affiliation with a specific group. Acknowledging and utilizing cultural strengths in health programming and services can facilitate individual behavior change and improve community health.


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