The Underutilization of Health Services in the Black Community An Examination of Causes and Effects

This article examines the effects of the institutional legacy of African slavery on the utilization of health services among Blacks. Religiosity, spirituality, and apprehension of Eurocentric institutions are discussed as both potential causes of underutilization of health services by Blacks and effects of past and present economic repression and societal oppression. Two new theories within Black studies discourse are introduced: internal pseudo-harmony and interracial dissonance. Terrell and Terrell's notion of cultural mistrust is also utilized in introducing the interracial dissonance theory. Implications and recommendations are offered to healthcare providers, health advocates, and the Black community. Healthcare providers are urged to support religious and spiritual beliefs as sources of resilience and a way to link the Black community to healthcare institutions.