ABSTRACT
Health behaviors appear to be central determinants of health status. The U.S. Surgeon General, for example, has indicated that almost half of U.S. mortality is attributable to unhealthy behavior or lifestyle (U.S. Department of Health, Education and Welfare, 1979). In comparison, 20% is due to environmental factors, 20% to genetic factors, and 10% to inadequate medical care. It has been estimated that the health status improvements possible through increases in healthy behaviors exceed those that would be achieved if an overnight cure were found for heart disease or cancer (Olshansky, 1985). Moreover, health behaviors are primary determinants of the heavy burden of disease in the Black population. The recent report on Black and Minority Health identified six causes of death that are responsible for 80% of the 60,000 annual excess deaths in the Black (or African-American) population (U.S. Department of Health and Human Services, 1985). Table 1 indicates that cigarette smoking and/or alcohol abuse is a risk factor for five of the six causes of death. Dr. James’ insightful and informative chapter highlights the need for more systematic efforts to understand the factors responsible for the social distribution of health behaviors.
