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. These and other factors have diminished their overall survival.
Research suggests that culture is a gross variable for other elements of life.
These shared elements lead to a common lifestyle, attitude, and behavior. 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. The reasons cited included forgetting to do so, fear of possible side effects, inconvenience, cost, and a disbelief in effectiveness. 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.