In this article we seek to show that prevailing ideological
viewpoints on Black health misinterpret Black behavior, and that
dominant racial ideologies themselves have negative health effects on
African American communities. Second, we show that public policies and
practices reflecting prevailing ideological viewpoints harm African
American communities. Together, these ideologies and policies undermine
Black health by adversely impacting the immune, metabolic, and
cardiovascular systems, fueling the development or progression of
infectious and chronic disease. Third, we argue that health reform
pursued within the same prevailing ideological viewpoints that
misinterpret Black health problems have limited effectiveness. We argue
for culturally appropriate public policies that value African American
social perspectives and coping mechanisms. We suggest that substantive
health reform is best pursued through a democratic movement that
challenges dominant ideological commitments.