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Although gender, racial and ethnic differences in health in the USA are well documented, it is less clear how race and gender intersect to produce large and consistently poor health outcomes for men of colour, particularly Black American men. This paper will illustrate how race and gender intersect at multiple levels to shape men’s health and health behaviours, and function as fundamental social determinants of health. The paper will conclude by discussing the need to attend to the role of male gender in pathways and processes underlying racial health disparities, and the challenges of developing health promotion interventions for Black American men.