Racial segregation and uneven access to opportunity are powerful obstacles to upward mobility in the US, contributing significantly to health inequities, as well as to gaps in income, education, and employment. In 70 of the 100 largest US metropolitan areas, more than half the black or white residents would need to move in order to integrate the area, according to the Brookings Institution. Concentrated poverty spawns poor health not only in rural and urban black communities but also in the ethnic enclaves of Chinatown, on Native American lands, and in Hispanic barrios throughout the country. Why is the US still a separate and unequal land, and how can we eliminate health inequities?