Chapter 4 focuses on health beliefs, behaviors, and service utilization. We examine how health is defined by different ethnic groups and discuss the influence of their beliefs on health-related behaviors. Health practitioners need to take cultural factors into consideration and encourage elders to add new behaviors essential to health. Elements of diversity (e.g., race/ethnicity, sex, SES) affect health beliefs and behaviors, and thus diversity should be taken into consideration when designing interventions aimed at improving health. We discuss culturally appropriate interventions, their design, their distinctive features, and their outcomes. We also examine cultural competence and sensitivity in health care settings and explore communication issues that have practical relevance for diverse elders. We discuss how health care for older adults is paid for in the United States, providing explanations of Medicare, Medicaid, and the Affordable Care Act.