Dressler, William W.African Americans are at a higher risk of having a variety of health problems and have less access to health care than white Americans. This article explores these health inequalities and their explanations. Three conventional models of health inequalities—a racial-genetic model, a health behavior or lifestyle model, and a socioeconomic status model—are examined and found to be insufficient to account for observed disparities. A fourth alternative, termed a “social structural model,” is proposed. In this model, it is argued that the primary index of ethnic status, namely skin color, serves as a criterion of social class in color-conscious societies such as that of the United States. This alters social mobility processes and creates health inequalities for African Americans.Health EquityAccess To HealthcareDisparitiesAfrican Americansaccess to health carehealth inequalitiesdisparitiessocial structural modelethnicityArticle