Objective: This study examined African American college students' perceptions of psychosocial factors that influence racial disparities in health. Methods: We conducted focus groups in two Alabama Black Belt Counties from June to August 2005. Data were collected using a standardized discussion guide, augmented by prompts for clarification. Results: Principal component factor analysis with varimax rotation was used to identify patterns or the dimensionality of psychosocial factors identified by the students. Principal component factor analysis identified three patterns that accounted for more than 64% of the variance of psychosocial factors influencing racial disparities in health. Our findings indicate that many African American college students perceived racism/discrimination targeted at African Americans, mistrust of whites and of medical and public health institutions among African Americans, poverty and lack of health insurance as major psychosocial factors influencing racial disparities in health. Conclusion: Findings from this exploratory study indicate the potential influence of psychosocial variables on racial health disparities deserves further attention. In order to make measurable progress in eliminating racial disparities in health or closing the gap by 2010, policy makers, program planners, and medical practitioners must consider the broader context of racism, mistrust of whites among African Americans and health insurance issues. Government and health care professionals need to work with African Americans and obtain the trust of their communities by addressing current perceived racism within the health care system. In addition, there remains a desperate need for health initiatives that target areas of persistent rural poverty, many of which are also home to concentrated racial/ethnic minority populations. (Contains 3 tables.)