This chapter presents a discussion of societal factors that affect mental health and illness among African American women. The discussion is guided by the diagram which illustrates that structural location as defined by the triangulation of race, gender, and class can influence mental well-being directly or indirectly by impinging on other more proximate processes. The mental well-being of African American women varies by age, marital status, household headship, parenthood, and employment. Among the social factors that diminish well-being among African American women are stressors resulting from the triangulation of racism, sexism, and low Socioeconomic Status (SES). Access to health care is critical for mental well-being because it contributes to healthier, longer lives. Quality health care for African American women requires access and utilization of mental health services that are culturally appropriate and sensitive to the social context of their lives as well as access and use of primary care.