Over the last twenty years a signiﬁcant amount of literature has pointed to the health care inequality suffered by African Americans. African Americans comprise around 13 percent of the U.S. population but, as a group, their health status continues to lag behind that of whites (Kaiser Commission 2000). Despite some of the progress made in ensuring political equality for African Americans through post-Civil War amendments and the civil rights movement, African Americans have not shared equally in the progress made on the economic and health care fronts in American society. The gap in income between African Americans and the rest of the population has essentially remained the same since the 1960s, and 30 percent of African Americans lived below the poverty level in 1990 (Quaye 1994). This has led to the argument that the health care status of African Americans is a function of their marginal position in the U.S. health care system and a direct result of poverty and discrimination (Quaye 1994).