OBJECTIVE: To identify differences in self-reported health status and prevalence of chronic disease between African American and white patients. STUDY DESIGN: A representative sample of African American and white adult patients from a stratified sample of family practices in North Carolina completed a questionnaire that included self-reported racial status, certain sociodemographic data, health risk factors, chronic conditions, and health status measures. DATA SOURCE: The North Carolina Health Project, a practice-based cohort of adult patients from a representative sample of family practice offices in North Carolina. PRINCIPAL FINDINGS: African Americans report poorer general health status than whites. Obesity insufficient exercise, high blood pressure, and diabetes are more prevalent among African American than white family practice patients, even after adjusting for age, gender, and educational attainment. CONCLUSIONS: This study complements previous evidence of disparities in chronic disease and health risk factors between African Americans and whites, and it highlights specific factors that may be important in the primary care setting. RELEVANCE: By focusing clinical attention on the prevention or treatment of specific factors that are known to be more prevalent among certain racial groups, primary care providers may help to reduce racial differences in healthcare.