Race/Ethnicity 547leisure time physical activity (Ransdell & Wells, 1998). This
may be due, in part, to differences in body perception and
visual cues suggesting the need to regulate weight. For exam-
ple, in a study by Neff, Sargent, McKeown, Jackson, and
Valois (1997), Caucasian adolescents were more likely to per-
ceive themselves as being overweight as compared to African
American adolescents. This difference in perception could
translate into unhealthy weight management practices during
adulthood that impact long-term consequences for health
(Neff, Sargent, McKeown, Jackson, & Valois, 1997).
Sexual Behavior. Young African Americans are emerg-
ing as a group at signi“cant risk for contracting human im-
munode“ciency virus (HIV; Maxwell, Bastani, & Warda,
1999). Data from the National Health and Social Life Survey
(NHSLS) showed that African Americans were almost “ve
times more likely to be infected by sexually transmitted dis-
eases (STDs) than the other racial/ethnic group (Laumann &
Youm, 1999). In another study, Cummings, Battle, Barker,
and Krasnovsky (1999) found that 64% of African American
women surveyed did not express AIDS-related worry. Their
results indicated that African American women were not pro-
tecting themselves by using condoms or by careful partner
selection.
AlcoholAbuse. Alcohol-related problems are strong pre-
dictors of intimate partner violence among African Americans
(Cunradi, Caetano, Clark, & Schafer, 1999). Using data from
two nationwide probability samples of U.S. households be-
tween 1984 and 1995, Caetano and Clark (1999) found that the
rates of frequent heavy drinking and alcohol-related problems
have remained especially high among African American and
Hispanic men. In a study by Black, Rabins, and McGuire
(1998), African Americans with a current or past alcohol
disorder were 7.5 times more likely than others to die during a
28-month follow-up period.
Social Support. Social factors such as social support
(e.g., Cohen, & Syme, 1985; Dressler, Dos-Santos, Viteri, 1986;
House, Landis, & Umberson, 1988; Strogatz & James, 1986;
Williams, 1992) and religious participation (Livingston, Levine,
& Moore, 1991) have been found to be important predictors of
health outcomes. Health is also adversely in”uenced by psycho-
logical factors such as hostility (Barefoot et al., 1991), anger
(e.g., Kubzansky, Kawachi, & Sparrow, 1999), perceived stress
(Dohrenwend, 1973; McLeod, & Kessler, 1990), and stress
coping styles (S. James, Hartnett, & Kalsbeek, 1983). Some
previous research suggests associations between health and
social support in African Americans (e.g., J. Jackson, 1988;
J. Jackson, Antonucci, & Gibson, 1990; S. James, 1984). From
this research, three conclusions can be drawn: (a) Social disorga-
nization is related to elevated stroke mortality rates, (b) individ-
uals in cohesive families are at reduced risk for elevated
blood pressure, and (c) social ties and support play a positive role
in reducing elevated blood pressure (J. Jackson et al., 1990;
S. James, 1984).Major Biobehavioral Risk FactorsThe most studied biobehavioral risk factor for poor health
among African Americans is cardiovascular reactivity. Re-
search by V. Clark, Moore, and Adams (1998) showed that
both low and high density lipoprotein cholesterol (LDL,
HDL) were signi“cant predictors of blood pressure responses
in a sample of African American college students. They also
found a positive correlation between total serum cholesterol
and LDL, and stroke volume, contractile force, and blood
pressure reactivity. These “ndings suggest that cardiovascu-
lar reactivity to stress may be a new risk factor for heart and
vascular diseases. (V. Clark et al., 1998).
Research suggests that neighborhoods and socioeconomic
status (SES) act as risk factors for stress reactivity for African
Americans. Lower family SES and lower neighborhood SES
have been found to produce greater cardiovascular reactivity to
laboratory stressors in African Americans (Gump, Matthews,
& Raikkonen, 1999; R. Jackson, Treiber, Turner, Davis, &
Strong, 1999).Asian Americans/Pacific IslandersMorbidity and MortalityHeart disease and cancer are leading causes of death for Asians
and Paci“c Islanders (APIs). Hoyert and Kung (1997) found a
great variation in the leading causes of deaths by age among
the API subgroups, which included Samoan, Hawaiian, Asian
Indian, Korean, and Japanese. They also found that age-
adjusted death rates were the greatest and life expectancy was
the lowest for Samoan and Hawaiian populations (Hoyert &
Kung, 1997).
Prevalence of diabetes has been found to be high among
Hawaiians, which suggests that other Asian and Paci“c
Island populations may share similar susceptibility to dia-
betes (Grandinetti et al., 1998).Major Behavioral Risk and Protective FactorsTobacco Use. Relatively little is known about Asian
American tobacco and alcohol use patterns. The little that is
known suggests that Chinese use less tobacco than other