The more than 40 million African Americans who live in the US carry a disproportionate share of the nation's sickness burden. Sociologist David R. Williams, who has written extensively about the black-white health disparity, has repeatedly shown that African Americans not only have higher rates of sickness than Whites, but they also get sick earlier, have more severe diseases, and are more likely to die from their diseases (Williams and Sternthal, 2010; Williams, 2012; Williams and Mohammed, 2013). Black people have higher rates of death than Whites for 13 of the 15 leading causes of death, and they have more nonfatal diseases (Hayward et al, 2000). Heart disease and cancer, the two leading causes of death, strike African Americans at an earlier age and result in more premature deaths. These racial disparities in health start at the moment of birth: black infants are more likely than white infants to be born preterm and underweight, to have more developmental problems, and to die in infancy (Rosenthal and Lobel 2011). The health disadvantages of early childhood persist throughout life, leading to poor health, more functional limitations, and earlier death among African Americans; they also curtail educational attainment and career mobility (Garbarski, 2014; Umberson et al, 2014; Rossin-Slater, 2015).

The earliest systematic data available on race and health date back to the 1800s, and consistently document the black health deficit. Sickness and early death, however, were common during that era, and the fact that African Americans were sicker and died earlier supported theories of their innate, biological inferiority. Sociology emerged during that time as the study of modernity with a focus on how social environmental forces transformed societies, but early theorists expressed little interest in how those forces affected health (Gerhardt, 1989). Many were concerned about the transformations caused by industrialization, such as increases in family and community instability and socially deviant behaviors, but gradually came to understand modernity as evolution toward a more highly developed society. Structural-functionalism became and remained the dominant theoretical paradigm among US sociologists until the late 1950s, focusing on how macro level forces were modernizing societies, institutions, and cultural values.