ifestyle influences that ultimately reduce the effectiveness of interventions or treatments (Alcorn, 1991, pp. 334-335).Statistics will now be given to highlight differences in mortality and morbidity for various groups with respect to different diseases and health risk factors.In the United States, the 1990 death rates for stroke were 28% for White males and 56% for Black males, 24% for White females, and 43% for Black females. In 1990, coronary heart disease death rates were 1.3% higher for Black males than White males and 29.4% higher for Black females than White females. It is important to note, however, that of those with coronary heart disease, 88.2% are White, 9.5% are Black, and 2.4% are of other races (American Heart Association, 1993).Livingston (1993) noted that young Black American men are particularly vulnerable to high blood pressure: “Overall, more than 10% of Black American male children, 1% of Black American female children, and no White female children or male children had systolic blood pressure greater than 140 mmHg” (p.134). Livingston focused primarily on the relationship between stress and hypertension and specifically on the sources of tension for young Black men in the United States. Racial differences in hypertension are clearly related to socioeconomic status (Kotchen, Kotchen, and Schwertman, 1974).Cancer rates differ dramatically among various races in the United States. Because Blacks are less likely to have early diagnosis and intervention, Whites have higher 5-year survival rates than Blacks when all types of cancer are considered. Blacks have significantly higher rates of incidence and mortality than Whites in multiple myeloma and in cancers of the esophagus, uterus, cervix, stomach, liver, prostate, and larynx. Hispanics have lower incidence and mortality rates than do White or Black Americans for all cancers (American Cancer Society, 1993). African Americans have a higher incidence ...
