The three leading causes of death in African Americans: barriers to reducing excess disparity and to improving health behaviors.

African Americans suffer disproportionately from several major health problems associated with high morbidity and mortality. The 1985 DHHS Secretary's Task Force Report on Blacks and Other Minorities identified six major disease categories of excess deaths for African Americans compared with whites by applying the lower death rate for whites to the American population. The report provided a stimulus for public and private action to begin to address the health disparities between minority and nonminority populations. This article examines three of the leading causes of death for African Americans and assesses the extent to which the health disparity between African Americans and whites has been reduced. The three leading causes of death for African American males are diseases of the heart, cancer, and HIV infection/AIDS. The conditions are the same for African American females except stroke replaces HIV infection. Three health outcomes measures are discussed: life expectancy, excess death rates, and years of potential life lost. A widening of the gap between the races was found for diseases of the heart and HIV infection for males and for cancer for females. An extensive list of barriers to reducing the disparity are presented from the scientific literature and strategies for reducing the three health problems are recommended.