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Prevalence and correlates of sun protection behaviors among African Americans


Exposure to ultraviolet radiation (UVR) is a key risk factor for skin cancer. Current recommendations include sun avoidance, wearing protective clothing, and using sunscreen with an SPF of 15 during midday sun exposure. Few studies have examined sun protection behaviors among African Americans. The paucity of sun protection literature among this group is likely due to low incidence and misconceptions that darker skin offers protection against damaging effects of UVR. The literature indicates that African Americans suffer from disproportionally high rates of skin cancer mortality. Therefore, it is important to investigate current sun protection behaviors among African Americans given these data. The primary objective of this study was to assess the prevalence and potential correlates of sun protection behaviors among a random community sample of African Americans. An anonymous health survey was administered door-to-door in 12 randomly selected census tracts in Los Angeles and San Diego Counties. African Americans were sampled from random block groups within these tracts, which varied by residential segregation and poverty levels. Participants were asked to report their frequency of sunscreen, wide brim hat, and sunglasses use during the summer on a 5-point Likert scale ranging from "never" to "always". Potential correlates of sun protection behaviors included demographic and phenotypic characteristics, skin cancer risk perception, and contextual factors. A total of 1,453 self-identified African Americans completed the health survey. The mean age was 45 (SD=16.2) ranging from 18 to 94 years. The prevalence of sun protection (% always) was 7.8% for sunscreen, 10.2% for wide brim hat, and 27.1% for sunglasses. Multivariate analyses showed that being female, having higher educational attainment, and higher income were significantly related to sunscreen use; males and older adults were more likely to wear a wide brim hat; and females and individuals with a higher income were more likely to always wear sunglasses. There were no significant associations between the other potential correlates and the three outcomes in the multivariate analyses. The key findings highlight 1) disparities in sun protection prevalence, and 2) predictors of sun protection behaviors among African Americans. Recommendations for future research and practice are discussed

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