This study examined risk factors associated with self-reported health (SRH) in a genetically informative sample of older African American female twins. An interview was conducted with a national sample of 180 African American female twin pairs. Questions included: SRH, demographics, health behaviors, chronic diseases, and functional status. SRH was dichotomized into negative (fair/poor) and positive (good/very good/excellent). Logistic regression for clustered data was used to estimate the odds ratios and 95% confidence intervals. In multivariable analyses, IADL limitations (OR = 1.5, 95% CI = 1.7-2.0) and a chronic disease index (OR = 1.9, 95% CI = 1.4-2.5) were associated with negative SRH. In multivariate within-twin pair analysis, controlling for genetics/shared familial environment, IADLs (OR = 1.8, 95% CI = 1.1-2.7), and increasing numbers of chronic diseases (OR = 2.0, 95% CI = 1.3-3.2) remained significantly associated with negative SRH.