This case discusses how the concept of family is a social construct, created and maintained by social norms that inform our individual attitudes, perceptions, and expectations of what a family is or is not. Although there is a strong history of advocacy in the Black queer community, families who identify as more traditional may struggle with acceptance of LGBTQ+ persons. Additionally, systemic racism and homophobia may create barriers to legal protections for individuals and partnerships who sit at that intersection. Being aware of the role of negative social construction on Black individuals’ ability to thrive in society and considering and honoring the roles of persons who are part of one’s chosen family is essential for social work practice. This is especially true in spaces where chosen family are given little to no legal consideration.

The chapter is concerned with racial health disparities in the United States. These disparities are large, significant, and persistent. Black Americans are much more likely to become ill and to die from their illnesses than are White Americans with the same illnesses. Black Americans’ poorer health reflects health disparities that have social, economic, or political causes rather than biological differences between the two groups. The root cause of these racial health disparities is anti-Black racism, which includes individual racism (negative thoughts about and feelings toward Black people) and systemic racism (societal standards, cultural values, and formal laws that systematically disadvantage Black Americans). Both kinds of racism have very long histories in the United States and continue to pose significant threats to the health of and the healthcare received by Black Americans. Specifically, individual and systemic racism cause: (1) chronic stress, which produces physiological and psychological responses that threaten a person’s health; (2) racial housing segregation, which creates poor and under-resourced Black neighborhoods, containing numerous environmental threats to the residents’ health; (3) inequities in the quality of medical care received by Black patients and White patients; and (4) disparities in socioeconomic status, the strongest single correlate of a person’s health status in the United States.