Int. J. Environ. Res. Public Health 2011, 8 4. Conclusions 2513 A high adherence rate was found in this sample of 5301 for diabetes and high blood pressure medication in spite of the fact that African-Americans are less likely than whites to take prescribed medications, and African Americans with type 2 diabetes tend to have comparatively poor clinical outcomes. Even though the adherence rate for diabetes and hypertension medication was high, it is evident that there are still a considerable number of African-Americans who do not adhere to their daily medical regimen. The research also demonstrated that there are many African-Americans who do not trust the utility of the medications prescribed by their doctor. Observed disparities in outcomes for African-Americans could be attributed in part to the low acceptance of evidence-based therapies, resulting in some degree of medication non adherence. It is evident that some participants do not accept the suggestion that daily compliance could reduce the need for subsequent medication and treatment to reduce the risk for complications. Belonging to the female gender and non-adherence of heart and stroke medication have been associated with a greater risk of hospitalization for CVD. In this study, these variables were seen as being most strongly predictive of subsequent hospitalization. The percentage of participants not adherent to medication after being diagnosed with high cholesterol, heart failure, and stroke is high. A possible result of non-adherence is the worsening of medical conditions and other negative health outcomes. A majority of the Jackson Heart Study participants reported that they did not take their medications after having been diagnosed with stroke, cholesterol problems, and heart attacks. Inadequate preventive CVD care has been frequently cited as a contributing factor to negative health outcomes. These results can guide the initiation of quality improvement interventions to target African-American CVD patients who might be in need of strong self-management guidance and support. Medication adherence should be a key component of any disease self-management plan that intends to present intervention strategies to effectively support constructive preventive care. It is imperative that culturally sensitive education material be developed and implemented to effectively manage CVD, and we propose the formation of support groups for promoting adherence to treatment among African Americans. The community should be exposed to information regarding eliminating the factors contributing to non-adherence to medical regimens for CVD as they relate to the reduction in health disparities and the reduction in morbidity, hospitalization and mortality among this African-American population. Our results provide evidence that adherence to prescribed medication is influenced by a multitude of factors, and we advocate strong support for interventions to increase medication adherence and decrease adverse outcomes so that patients can realize the full benefit of prescribed therapies and participate in improving the quality of their lives. Public health officials and medical practitioners must first identify those individuals who are at greatest risk for non-adherence and then develop a proactive management program that highlights daily medical compliance and persistence with the prescribed drug regimen.