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Purpose – The purposes of this chapter are to describe both the within-group and between-group variance in Black Americans’ (Blacks’) prevalence of mental illness. This chapter also comments on the impact that poorer mental health has on this group's subsequent social mobility and explores recommendations for the reduction of these inequities.

Methodology/approach – This chapter reviews Black's history in America. It also outlines the influence of this history and related factors on Black Americans' current rates of illness and subsequently vulnerable upward mobility.

Research implications – The history of Blacks in America is tumultuous and has contributed to their vulnerable state. Blacks, on average, are poorer and sicker than Whites, and Blacks’ higher rates of illness are due to a number of factors. As a result, Blacks’ social mobility is precarious. Future research should continue to explore mental health care programs that are specifically designed to address Blacks’ unique culture and worldview.

Social implications – In addition to culturally competent and culturally responsive health care, future initiatives should focus on improving the accessibility and quality of health care, and alleviating socioeconomic disparities, racism, and racism-related stress. These initiatives, in conjunction, are the best approach to improving Blacks’ rates of mental illness.