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This exploratory study of patients in Pennsylvania (PA) and Virginia (VA) hospitals in 1998-1999 measures the segregation of care for Black patients receiving inpatient care for specific medical and surgical conditions. It also examined inpatient mortality risk for Black patients and the impact of treatment in heavily segregated hospitals on mortality for Blacks and non-Blacks. Segregation of hospital care was found across both states but was more pronounced in PA. Blacks did not experience higher mortality rates than non-Blacks either before or after controls for clinical risk factors in either state and for certain admission types had lower mortality. Both Black and non-Black surgical, heart failure, and lung disease patients treated in VA hospitals with more Black patients had poorer outcomes. Future research should examine how access, patient choice, hospital organization, processes of care, and factors related to nursing care might influence hospital outcomes for patients from different racial backgrounds. Keywords: racial segregation; racial disparities; hospital mortality; health services research: outcomes research; Pennsylvania; Virginia

This article explores the adverse conditions Africans, particularly African Americans, face due to racism and how it impacts their health, both physically and mentally. The author argues that African Americans are at higher risk for mental and physical diseases due to the stress of marginalization, and maintains that biomedical ethical research must address and understand African consciousness.

Black males have lesser life expectancy and greater susceptibility toward diseases such as cancer, sickle-cell anemia, tuberculosis, depression and hypertension than whites. Health care services should understand the socio-cultural and emotional concerns when planning treatment programs for black males. An assessment model based on black experiences, beliefs, cultural background and economical condition can help provide effective health care services.

Black health in the UK cannot be analysed and remedied in isolation. Social and economic aspects and the effects of racism have to be examined. Mental illness amongst blacks is caused by unemployment, poor housing, poverty and poor education. Diagnosis and care and treatment is often incorrect because no attention is paid to the reason behind a black patient's behaviour or the affects of racism. Rastafarians are aggressive and refuse to recognise authority. Many are diagnosed as schizophrenic as doctors fail to recognise their cultural and religious beliefs.

The effects of subjective stress and coping resources on blood pressure reactivity in Blacks are examined. The effect of problem- focused coping and emotion- focused coping on blood pressure are also discussed.