Kate Meyers of the Kaiser Permanent Institute for Health Policy has done a comprehensive and insightful review of the research literature on race and health disparities in the US. The goal of her paper is to help develop a clear conceptual and multi-sectoral analytical framework to understand disparities and a platform from which better policy analysis, planning and action can truly impact the problem. She highlights the inter-dependence of a range of factors in four arenas: individuals’ social and economic circumstances, including the interrelationships between race and class; communities’ physical and cultural environments, not just the importance of built environment in neighbourhoods but also of social capital and community capacities; personal health management and behaviour, but always within a social determinants approach; and health care system financing and delivery. She reviews issues such as cultural competency and diversity and their intersection with the increasing focus on patient-centred care. She emphasizes that how issues are framed shapes the kinds of policy directions considered and adopted and argues, for example, that social justice and quality of care lenses are not mutually exclusive, but are different and we do need to be clear about which frame we are using. She then develops a model in which policy directions and actors can be identified on key issues in each of these four arenas, recognizing that many policy directions can have a cross-sectoral impact. The model is very interesting in graphically portraying the complexity and inter-dependence of the policy landscape for tackling health disparities. However, while this may be due to the American context in which the paper is written, a significant gap is the lack of analysis of the role of governments as over-arching policy, regulatory and funding forces across these arenas. A vital foundation for reducing disparities ” and a key focus for community and advocacy groups — is progressive and integrated state policy that supports targeted interventions addressing the roots of disparities and the most disadvantaged communities, and the necessary cross-sectoral collaboration and coordination across the full range of inter-dependent factors and spheres.