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Blacks in the United States tend to be discussed in terms of generalities, whereas in fact they come from many different cultural backgrounds. Many blacks in urban areas such as New York City immigrate from the Caribbean, Great Britain, Latin America, and the African Continent. This book describes a cross-sectional survey, using secondary data, to determine whether there are differences in the factors that affect use of formal social supports by elderly American-born and West Indian-born blacks. This unique study also addresses some of the sociocultural differences between the two groups, dealing with the differences and similarities in socioeconomic status, class, family structure, church affiliation, informal social support, and acculturation. The population from which the sample of 388 black respondents wasdrawn consisted of 1,570 individuals whose names were listed on New York City's Medicare List. A modified adaptation of Andersen's (health), and Ward's (social) service models was used to organize the variables in predisposing, enabling and need factors. Multivariate techniques were used to analyze the data. Although the findings showed no differences in service use, it found that there are some inherent cultural differences that affect other areas of life and help-seeking behavior among the study groups.