The field of health psychology has grown dramatically in the last
decade, with exciting new developments in the study of how
psychological and psychosocial processes contribute to risk for and
disease sequelae for a variety of medical problems. In addition,
the quality and effectiveness of many of our treatments, and health
promotion and disease prevention efforts, have been significantly
enhanced by the contributions of health psychologists (Taylor,
1995). Unfortunately, however, much of the theo rizing in health
psychology and the empirical research that derives from it continue
to reflect the mainstream bias of psychology and medicine, both of
which have a primary focus on white, heterosexual, middle-class
American men. This bias pervades our thinking despite the
demographic heterogeneity of American society (U. S. Bureau of the
Census, 1992) and the substantial body of epidemiologic evidence
that indicates significant group differences in health status,
burden of morbidity and mortality, life expectancy, quality of
life, and the risk and protective factors that con tribute to these
differences in health outcomes (National Center for Health
Statistics, 1994; Myers, Kagawa-Singer, Kumanyika, Lex, & M-
kides, 1995). There is also substantial evidence that many of the
health promotion and disease prevention efforts that have proven
effective with more affluent, educated whites, on whom they were
developed, may not yield comparable results when used with
populations that differ by eth nicity, social class, gender, or
sexual orientation (Cochran & Mays, 1991; Castro, Coe,
Gutierres, & Saenz, this volume; Chesney & Nealey, this
volume)."
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