Context: Minority race and ethnicity are associated with poorer health and shortened survival and there are well-documented disparities in the quality of health care that African Americans receive compared to Whites. However, there is little research that looks at disparities in health among family practice patients. Objective: The aim of this cross sectional study is to identify differences in health-related quality of life, health risk factors, and chronic diseases between African American and White patients of family physicians in North Carolina. Methods: Data for this study comes from the North Carolina Health Project (NCHP), a family practice network and research database of family practices in North Carolina. A four-page self- administered questionnaire that included sociodemographic data, health risk factors, chronic conditions, and health-related quality of life measures was completed by 4381 African American and White respondents. Results: Obesity, insufficient exercise, high blood pressure, and diabetes were all found to be more likely to be reported by African Americans than by Whites in our population adjusted for age, gender and education level. African Americans also reported poorer health-related quality of life. Conclusion: This study compliments previous evidence of racial disparities in chronic disease and health risk factors between African Americans and Whites, and it highlights specific factors that may be focused on in the family practice setting. Many risk behaviors associated with chronic disease are modifiable, and counseling for behavior change in primary care has proven to be effective. These data provide evidence that family medicine clinicians should focus on culturally sensitive behavioral interventions and prevention techniques to reduce health disparities.