Blood collection and transfusion are important to the functioning of a self-sufficient community resource-based health care system in the United States and in the world. In the United States, approximately 15 million whole-blood products are collected each year from voluntary, nonremunerated donors. (1,2) African Americans are underrepresented in this donor population; it is estimated that 4.2% of white adults donate versus 2.4% of African American adults. (3) African Americans donate less frequently than whites; African American donors are younger and are more likely to be first-time donors. (4) Because African Americans make up an ever-increasing and now-substantial minority in some United States regions, it is important to understand the reason for the observed difference in blood donation. In addition, African American recipients of blood transfusion have a better chance of receiving phenotype-matched or appropriate blood when there is a significant percentage of products in inventory from African American donors. This includes both the specialized (eg, sickle cell disease) patient and the general hospitalized patient. Therefore, the ability to recruit and retain eligible African American donors is fundamental to a continued adequate blood supply in the United States in general, and for the care of African American patients specifically.