Subproblems	Direct causes of subproblem	Indirect causes of subproblem
Health disparities in African-Americans in the state when compared with other groups in the state	Different rates of health care coverage, average annual income lower than other groups, different lifestyle factors	Less trust in health care system and providers due to historical context of unethical treatment, groups residing in rural areas have less access to health care providers, including specialists, may be reluctant or uninformed about getting regular screenings (cancer, cholesterol, blood sugar, blood pressure, etc.)
Higher rates of morbidity and mortality due to cancer, cardiovascular disease, and diabetes for African-Americans, especially in the eastern rural region of the state	Lifestyle factors such as nutrition-The African-American typical diet in this region consists of vegetables prepared with fatty meats, with less fruits, higher prevalence of physical inactivity among certain groups of African-Americans, higher prevalence of poverty associated with less frequent health screenings and use of health care system	Cultural traditions related to food preparation and preferences, lack of availability of healthy foods in communities or stores, misperceptions or lack of knowledge about nutrition and healthy foods and physical activity