This is a classic article that has guided a great deal of the important research on racial disparities in mental health care services. This article pre-dates the recent national community samples.

First, the author reviews the literature on racial comparisons of rates of disorder, noting that most studies rely on treatment-based samples, which are biased by racial patterns of obtaining psychiatric care. Community studies have focused on comparing racial groups with regard to measures of distress rather than patterns of clinical diagnoses. Such community studies have generally reported that there were no racial differences in distress once factors such as gender and socioeconomic status (SES) were taken into account. However, studies of severe distress have reported less consistent findings – at least one comprehensive study reported that blacks are more likely to suffer "high" distress in a national sample. Thus, it is premature to make conclusions as to whether racial differences exist.

Dr. Neighbors calls for extending mental health research beyond racial comparisons between blacks and whites and makes an argument that, in order to understand the distribution of disorder in the black community, it will be necessary to study mental illness within the black community. Using the National Survey of Black Americans as an example, he points out that SES factors operate in a complex way in the black population, and this phenomenon could not have been elucidated had the study been limited to a comparison of blacks with whites as the "benchmark."

Dr. Neighbors further calls for developing methods for evaluating discrete disorders in the black community. He notes that symptoms and behaviors have different meanings in different cultural groups and that it is risky to "indiscriminately apply diagnostic criteria developed on non-black samples to blacks." It is noteworthy that, as of yet, almost 16 years after this article was published, there has been very little progress in this area.