Health care for black Americans: the public sector role.

Most of the improvement--both absolute and relative--in the health status of black Americans over the past two decades can be traced to major gains in access to health care services. Public payment programs, most notably Medicaid and Medicare, have not only reduced financial barriers, but have also combatted those of racial discrimination. Other federal programs supporting targeted local services have been especially effective in reducing infant mortality. But the redistributive effects have been uneven and unequal across populations; many categorical gaps remain and increasing numbers are potentially without access to essential primary care services.