The United States is a nation of immigrants. By the year 2050, one-half of the country's population will be members of minority groups, defined as Native Americans and Alaska Natives, African Americans, Asian Americans and Pacific Islanders, and Hispanics. Because racial and ethnic minority populations have poorer health than the general population and suffer disproportionately from the added stresses of poverty, their health care needs are different from those of much of the majority population.

Racial division has been a feature of the American experience, and the health care system reflects the race and class divisions within society. Nonwhites have historically suffered from higher mortality rates, higher incidence of major diseases, and lower availability and use of medical services.

Discrimination may be obvious, for example, in location and number of providers to serve minority groups. In the United States, an insufficent number of physicians choose to practice...