Understanding the factors that most influ ence persistent and widening health dispari ties is vital in designing strategic responses Regardless of race or ethnicity, all Ameri cans are subject to the determinants that con tribute to disparities and poor outcomes just as all Americans will become beneficiaries from the policies implemented to eliminate disparities. Underscoring this need, the World Health Organization established The Commis- sion on Social Determinants of Health in 2005 to reduce them to identify recommendations was issued The Commission's final report in August 2008 and contained 3 overarching for action including to principles