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This study assessed the extent to which a belief in fate or destiny might explain certain health behaviors among African Americans. A survey of 1,253 African Americans in Alabama churches was conducted. Fifty-nine percent of the total sample indicated that they believe in fate or destiny. The findings of this study suggest that fate/destiny may influence health decisions. The study found a statistically significant difference between men and women regarding their belief in fate or destiny. Women reported believing in fate and destiny more than men. Surprisingly people with more education (i.e., college or postgraduate) believed in fate and destiny significantly more than high school dropouts and high school graduates. A belief in fate or destiny also varied by income level. Respondents who made more in annual income were more likely to believe in fate and destiny than people who made less. One behavior, breast exam had a statistically significant association with a belief in fate and destiny. Women who reported never having a breast exam were more likely to believe in fate and destiny than women who did not have a belief in fate or destiny. These findings highlight the need for practitioners to examine more closely the definition of fate and destiny and determine how this belief influences or does not influence health behaviors as once believed. The research suggests a closer examination of the role culture plays in health decision making which may be independent of a belief in fate and destiny. [ABSTRACT FROM AUTHOR]