Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans. The 1998 Presidential Initiative on Race and Health was the first national commitment to eliminate health disparities between majority and minority population groups. Because racial and ethnic minority groups will increase to nearly 40 percent of the U.S. population by 2030 (U.S. Department of Health and Human Services [HHS] 2000), a stronger commitment to better understand health disparities and develop new diagnostic, treatment, and prevention strategies for their elimination is a sound investment. Only rigorous population and epidemiologic research can discern where these disparities exist, define the scope of the problem, and identify and evaluate new interventions to reduce and eliminate them. Sources of these disparities are multivariate, complex, and rooted in an inequitable health care system. Contributing factors include lack of access to health care; barriers to care; increased risk of disability and disease resulting from occupational exposure; biological, socioeconomic, ethnic, and family factors; cultural values and education; social relationships between majority and minority population groups; autonomous institutions within ethnic minority group populations; and culturally insensitive health care systems. This article discusses health disparity problems of African Americans, who have a unique history in the United States, rooted in slavery, emancipation, segregation, racism, and discrimination.