Black Americans continue to have large numbers of premature and excess deaths, measured against white experience, from seven major causes. Major differences in chronic disease, disability and case fatality rates persist despite similarities in the amount of health care received; the nature and quality of care is likely to be dissimilar. Epidemiological and clinical evidence suggests various strategies to reduce these differentials through well-designed public health efforts at prevention. These will have to deal with harsh realities of sociocultural, economic, and political contexts.

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The degree to which migration decisions of the elderly are influenced by health status is largely unknown. Two seemingly contradictory influences of health on migration are possible within the older cohort. First, those elderly in good health would appear more likely to make discretionary moves, such as to retirement homes in the Sunbelt, than elderly who are in poor health. Alternatively, those elderly in declining health, such as stroke victims, seem more likely to be involved in a move to a long-term care facility. While both types of migration related to health occur, the size of the first relative to the second and the distance of the moves of each type need to be determined. Both types of health-related migration have policy implications which are briefly addressed in this article.

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