The issue of health care disparities is an issue of considerable importance in the United States. There are clear disparities in longevity, favoring Americans of European ancestry over African Americans and Hispanics. Compared to whites, blacks have higher incidences of hypertension, diabetes, and perinatal mortality, and worse prenatal care. The most salient and, probably, most important reason for these disparities lies in socioeconomic factors favoring the most advantaged groups in our society. Living in poorer neighborhoods, with less access to healthy food, more environmental exposure to pollutants, and poorer educational opportunities may contribute to these disparities. In addition, there may be some contribution of genetic predisposition to certain conditions such as hypertension. In addition, there are problems with the health care system as a whole. Based on long experience, disadvantaged communities may, with good reason, distrust the health care system to provide appropriate care. There are also problems of access, with disadvantaged communities suffering more from inadequate insurance, transportation, and institutional resources to receive medical care. Patients from disadvantaged communities may present later in the course of critical medical conditions such as acute myocardial infarction (MI), leading to worse outcomes.