African Americans experience mental health disadvantages relative to European Americans with respect to financial barriers, barriers to help seeking, and poorer quality services. This paper provides an overview of these mental health inequalities, and offers recommendations for addressing them.

The primary aim of this study is the exploration of the views of physicians in Barbados on the provision of a patient-focused health service. Qualitative interviews were conducted with fifteen physicians based at a teaching hospital in Barbados. The data was analysed in relation to literature on the physicianpatient relationship with particular reference to ‘patient-focused’ versus ‘provider-focused’ approaches to health care delivery. Results were first, that while the concept of patient-focused care has gained some recognition in Barbados over the last five years, several respondents considered health care delivery was in general not patient-focused. Secondly, with regard to the sample of physicians interviewed, there were different approaches to health care delivery and varying extents to which physicians were ‘patient-focused’ in relation to different issues. Three broad approaches were identified: ‘patient-focused’, ‘provider-focused’ and ‘intermediate’. Thirdly, physicians could also be grouped into three ‘types’ consistent with these three broad approaches; that is, patientfocused, provider-focused, and intermediate.

Multiracial scholarship has long treated Black-White biracial individuals as a homogeneous group, often overlooking how proximity to whiteness influences their lived experiences. This oversight is particularly evident in the case of Black biracial individuals, defined here as those with one Black and one White parent who are socially identified as Black. These individuals experience a dual burden: they are subjected to the same anti-Black racism as monoracial Black individuals and simultaneously encounter monoracism, a mixed-race-specific form of oppression that frequently manifests as identity invalidation (e.g., societal dismissal of multiracial heritage, social pressure to identify with a single racial group). Despite its significance, this form of dual marginalization remains under-theorized within existing literature. The present article addresses this gap. Drawing on critical race theory, critical multiracial theory, and intersectionality theory, I propose a theoretical framework for understanding Black biracial positionality and experiences by considering the intersection of Blackness and biraciality. This framework provides scholars with the analytical tools to examine an overlooked aspect of the multiracial experience and challenges academic discourse to move beyond monolithic conceptions of Black-White biracial identity.

Multiracial scholarship has long treated Black-White biracial individuals as a homogeneous group, often overlooking how proximity to whiteness influences their lived experiences. This oversight is particularly evident in the case of Black biracial individuals, defined here as those with one Black and one White parent who are socially identified as Black. These individuals experience a dual burden: they are subjected to the same anti-Black racism as monoracial Black individuals and simultaneously encounter monoracism, a mixed-race-specific form of oppression that frequently manifests as identity invalidation (e.g., societal dismissal of multiracial heritage, social pressure to identify with a single racial group). Despite its significance, this form of dual marginalization remains under-theorized within existing literature. The present article addresses this gap. Drawing on critical race theory, critical multiracial theory, and intersectionality theory, I propose a theoretical framework for understanding Black biracial positionality and experiences by considering the intersection of Blackness and biraciality. This framework provides scholars with the analytical tools to examine an overlooked aspect of the multiracial experience and challenges academic discourse to move beyond monolithic conceptions of Black-White biracial identity.