By Tracy Scott, Psy.D.
Why Focus on Chronic Illness and Mental Health in the African American Community?
It’s important to focus on chronic illness and mental health conditions in the African American community because, while we’re more likely to experience conditions like cancer, diabetes, heart disease, or prolonged chronic (long-term) and severely debilitating symptoms of depression and anxiety, we’re less likely to practice preventative self-care or get timely treatment. It’s vital that we work to close that gap so our community can grow and thrive.[1]
The statistics on the prevalence of chronic diseases in African Americans are staggering, and rates of suicide are escalating.
- African Americans face disproportionately high rates of both diagnosis and mortality when it comes to cancer, painting a stark picture of health inequity.[2]
- Among African American adults, the prevalence of diabetes is strikingly pronounced, with a 60% higher likelihood of being diagnosed compared to their white counterparts.[3]
- Heart disease reigns as the foremost cause of death across the United States, yet it impacts African Americans with even greater severity. They are 30% more likely to experience high blood pressure, a critical risk factor, and are consequently 30% more likely to succumb to heart disease than white individuals, illustrating a troubling disparity in health outcomes.[4]
- The suicide rate among Black adolescents is increasing faster than other racial and ethnic groups. From 2007 to 2020, the suicide rate rose 144% among 10- to 17-year-olds who are Black.[5]
- African Americans are more likely to meet the diagnosis for Post Traumatic Stress Disorder (PTSD) than Hispanic, Asian, or White American respondents.[6]
Understanding Clinical Depression
When we talk about depression, everyone feels sad or “blue” sometimes. As Dr. William Lawson states, “African-Americans are the people who gave the blues a name.”[7]
But clinical depression goes further. It brings persistent hopelessness, worthlessness, trouble getting out of bed, concentrating, sleeping, or eating, and even thoughts of suicide or death. When several of these symptoms last at least two weeks and impair daily life, working, studying, caring for family, we call it clinical depression.
Unfortunately, the development of severe clinical depression characterized by symptoms such as anhedonia (lack of joy), sadness, guilt, concentration, and psychomotor symptoms (such as trouble thinking or moving), is significantly higher among people who are Black, Hispanic, or of multiple or unspecified races compared to non-Hispanic white people.[8]
Recognizing Clinical Anxiety
Experiencing stress is normal. Anxiety, in its ordinary form, is that surge of tension before an interview or exam, the tight coil in our chest when bills mount, or the uneasiness you feel when your doctor calls about your lab results. But when worry becomes persistent and out of control for months, we’re in the realm of clinical anxiety. You worry about things you can’t solve, and you can’t shut your mind down. Racing thoughts, insomnia, constant tension, headaches, chronic pain, stomach upset, or an increase in symptoms related to a chronic illness signal that stress has morphed into an anxiety disorder requiring more than everyday coping strategies.
Impact of Recent Events on African American Health
The political climate, which is largely devoid of representation for African Americans in positions of political and economic power, has contributed to significant challenges, including police violence, massive job losses, and strained relations within communities. These issues have intensified the stress experienced by African American people. In addition to financial and housing instability, African Americans also have to carry the stress of historical, contemporary, systemic racism and discrimination, both of which increase the risk of physical illness, depression, and anxiety.[9]
As previously mentioned, the suicide rates for African American youth are of particular concern. The research we do have indicates that harmful effects connected to social media use, exposure to racism, mental health stigma, and exposure to violence and accumulative trauma have all likely played a role.[10]
It is essential that we consider the interplay between culture and power dynamics while also addressing health issues and their effects on individuals and communities. Understanding these factors can enhance our approach to public health and promote more equitable outcomes.
Regrettably, many mainstream political and economic leaders continue to overlook the urgent economic and social issues that disproportionately affect African American communities, despite clear scientific data, even in areas where African Americans make up the majority of the population.
The Weight of Stigma: Language and Cultural Barriers
In general, stigma regarding terms such as “sick,” “not well,” and “mental illness” still runs deep in our community. Studies show many of us fear being labeled “crazy” or “weak,”[11] blame ourselves, doubt treatment will help, and worry providers won’t understand us, especially since nationally, 4% of psychologists, 2% of psychiatrists, 22% of social workers, 7% of marriage and family counselors, 11% of professional counselors and just 5.0% of physicians identified as Black or African American.[12]
Equally concerning is that this low representation of African American or culturally sensitive healthcare professionals might result in misdiagnosis or undertreatment since African American adults perceive racism as a significant issue in healthcare more than White adults do, and they also tend to have less trust in healthcare providers to act in their best interests.[13]
Additional barriers to receiving preventative and timely medical care can also stem from cultural beliefs that our struggles will resolve on their own, or that we can “pray them away.” While prayer and meditation are helpful, untreated issues often worsen over time.
Common Barriers to Counseling
Five main barriers keep African American folks from visiting a medical doctor or seeking counseling: believing that having faith and praying is all that’s needed, not knowing the counselor, not trusting them, worrying about cost, and fearing the diagnosis or “crazy” label. If you choose to see your doctor or receive therapy, let them know how it’s going and what support you need.
In Zulu culture, the greeting “Sawubona” literally means “We-I see you.” More than words of politeness, “Sawubona” carries the importance of recognizing the worth and dignity of each person. It says, “We-I” see the whole of you, your family, your experiences, your passions, your love, your pain, your strengths and weaknesses, and your future. You are valuable to me. The value of being seen cannot be understated. This is community healing.
Be patient with the process. Medical treatment, therapy, or counseling can sometimes be the slowest form of change; progress can be slow, but honest communication and persistence ultimately pay off.
Everyday Steps to Improve Mental Health
While we work toward more diverse medical and mental health professionals, there are everyday steps you can take to bolster your well-being:
- Be in community with others. Tough times can hit anyone, and it’s good to know that you don’t have to go through them alone.
- Keep a regular routine. Try to wake up, sleep, and work at roughly the same times daily.
- Set clear boundaries around your schedule.
- Get outside daily for fresh air and sunshine.
- Stay active to counter sedentary habits.
- Maintain balanced eating and exercise.
These practices won’t replace professional treatment for clinical disorders, but they strengthen your resilience as you seek the help you deserve.
You Are Not Alone
In 2023, 76.4% (representing 194 million) of US adults reported one or more chronic conditions,[14] and nearly half of all people will face a mental health condition in their lifetime.[15] Proof we’re not alone. If you need help, discussing your concerns with a Jenga, trusted friend, mentor, family member, community elder, or clergy member can help guide you to professional care and a support network and may feel less stigmatizing than consulting a specialist right away.
Sharing personal stories with trusted comrades can also help normalize your experiences. Having a trustworthy friend to confide in can also be beneficial when you decide to seek help from your primary care doctor. Arriving for a medical appointment and discussing your troubles can be scary. Having a supportive ally in your presence during these moments can ease the tension.
It’s essential to remember that everyone is dealing with something that others may know nothing about. But if you are willing to listen and let somebody in, you will discover that you are not alone.
Finally, check with your local health department or community center for resources in your area. If you are insured, review with your insurance company for in-network physicians, therapists, psychologists, social workers, or counselors to find a healthcare provider who might suit you. Organizations such as the National Medical Association, the Association of Black Psychologists, and the National Association of Black Social Workers are available to help.
Endnotes
- [1] Villines, Z. (2020, July 27). What to know about depression in Black communities. https://www.medicalnewstoday.com/articles/black-depression
- [2] Cancer and African American people. (2025, February 13). Cancer. https://www.cdc.gov/cancer/health-equity/african-american.html?CDC_AAref_Val=https://www.cdc.gov/cancer/health-equity/groups/african-american.htm
- [3] Diabetes and Black/African Americans. (n.d.). Office of Minority Health. https://minorityhealth.hhs.gov/diabetes-and-blackafrican-americans
- [4] Heart disease and Black/African Americans. (n.d.). Office of Minority Health. https://minorityhealth.hhs.gov/heart-disease-and-blackafrican-americans
- [5] Akkas, F., & Corr, A. (2024, April 22). Black adolescent suicide rate reveals urgent need to address mental health care barriers. The Pew Charitable Trusts. https://www.pew.org/en/research-and-analysis/articles/2024/04/22/black-adolescent-suicide-rate-reveals-urgent-need-to-address-mental-health-care-barriers
- [6] Asnaani, A., Richey, J. A., Dimaite, R., Hinton, D. E., & Hofmann, S. G. (2010). A Cross-Ethnic comparison of lifetime prevalence rates of anxiety disorders. The Journal of Nervous and Mental Disease, 198(8), 551–555. https://doi.org/10.1097/nmd.0b013e3181ea169f
- [7] Crute, S. (1997). Health & healing for African-Americans: Straight Talk and Tips from More Than 150 Black Doctors on Our Top Health Concerns. Rodale Books.
- [8] Vyas, C. M., Donneyong, M., Mischoulon, D., Chang, G., Gibson, H., Cook, N. R., Manson, J. E., Reynolds, C. F., & Okereke, O. I. (2020). Association of race and ethnicity with Late-Life Depression severity, symptom burden, and care. JAMA Network Open, 3(3), e201606. https://doi.org/10.1001/jamanetworkopen.2020.1606
- [9] Artiga, S., Hill, L., & Presiado, M. (2024, February 22). How Present-Day Health Disparities for Black People are linked to past policies and events | KFF. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/
- [10] Kogan, S. M., Reck, A. J., Curtis, M. G., & Oshri, A. (2024). Childhood adversity and racial discrimination forecast suicidal and death ideation among emerging adult Black men: A longitudinal analysis. Cultural Diversity & Ethnic Minority Psychology. https://doi.org/10.1037/cdp0000641; Akkas, F., & Corr, A. (2024b, April 22). Black adolescent suicide rate reveals urgent need to address mental health care barriers. The Pew Charitable Trusts. https://www.pew.org/en/research-and-analysis/articles/2024/04/22/black-adolescent-suicide-rate-reveals-urgent-need-to-address-mental-health-care-barriers; Hataway, L. (2024, March 26). Young Black men are dying by suicide at alarming rates. UGA Today. https://news.uga.edu/young-black-men-dying-by-suicide-at-alarming-rates/
- [11] Forge Health. (2023, October 16). The Connection Between Black History and Mental Health | Forge Health. https://forgehealth.com/blog/the-connection-between-black-history-and-mental-health/
- [12] Black Mental Health Workforce | ABPSI. (2025, February 19). ABPsi. https://abpsi.org/blackmhworkforce/; Figure 18. Percentage of all active physicians by race/ethnicity, 2018 | AAMC. (n.d.). AAMC. https://www.aamc.org/data-reports/workforce/data/figure-18-percentage-all-active-physicians-race/ethnicity-2018
- [13] Artiga, S., Hill, L., & Presiado, M. (2024b, February 22). How Present-Day Health Disparities for Black People are linked to past policies and events | KFF. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/
- [14] Watson, K. B., Wiltz, J. L., Nhim, K., Kaufmann, R. B., Thomas, C. W., & Greenlund, K. J. (2025). Trends in multiple chronic conditions among US adults, by life Stage, Behavioral Risk Factor Surveillance System, 2013–2023. Preventing Chronic Disease, 22. https://doi.org/10.5888/pcd22.240539
- [15] McGrath, J. J., Al-Hamzawi, A., Alonso, J., Altwaijri, Y., Andrade, L. H., Bromet, E. J., Bruffaerts, R., De Almeida, J. M. C., Chardoul, S., Chiu, W. T., Degenhardt, L., Demler, O. V., Ferry, F., Gureje, O., Haro, J. M., Karam, E. G., Karam, G., Khaled, S. M., Kovess-Masfety, V., . . . Zaslavsky, A. M. (n.d.). Age of Onset and Cumulative Risk of Mental Disorders: A cross-national analysis of population surveys from 29 countries. The Lancet Psychiatry, 10(9), 668–681. https://doi.org/10.1016/s2215-0366(23)00193-1
