Much has been written on the existence of racial and ethnic differences in health status and health care access and quality in the United States. Researchers, think tanks, government entities, and advocacy organizations have worked to summarize many of the root causes, environmental and behavioral influences, and health system factors that play a role. Yet sustained and significant change has been elusive. Efforts to reduce disparities will continue to fall short unless the complex interplay of influences are understood and addressed, and synergies among actors who can impact those influences are realized. The Kaiser Permanente Institute for Health Policy has produced this review and synthesis of the literature to spur thinking and discussion among those who inform, influence, and make public and private policy impacting health. Areas of analysis include the landscape of influences on health disparities, which policy actors are best positioned to intervene, and where those actors may have the most impact. Given the complex nature of disparities, to date most action has focused on individual sectors of health or social policy, such as coverage for the uninsured, linguistically appropriate care, or neighborhood improvements to support healthy eating and active living.