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Bronx Health REACH, a coalition of community-and faith-based groups, health care providers, and an academic institution, recently examined the causes of racial and ethnic health disparities in the southwest Bronx and identified separate systems of care for uninsured and publicly insured patients, who are predominantly people of color, and those with private insurance.We found evidence that patients are sorted into segregated pathways of care, a system of medical apartheid in which differential care contributes to disparities in health care and health outcomes. I. BACKGROUNDIn 1999, the Institute for Urban Family Health, in collaboration with three community organizations and an academic partner, received a grant from the Centers for Disease Control and Prevention (CDC) to develop Bronx Health REACH, a coalition that would examine racial and ethnic health disparities in the southwest Bronx and work to eliminate them. 1 The members of the coalition were aware that people of color in general and residents of the southwest Bronx in particular suffered from poorer health status than other residents of New York City.An extensive review of the literature provides evidence of widespread racial and ethnic disparities in health care and health outcomes for people of color nationally.2 .
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