The public's health, its national identity, and the continuing dilemma of minority status

Racial and ethnic disparities in health status are persistent phenomena well described in the arena of public health. Such disparities are perhaps best understood in their full social, political, and historical context. While recognizing the rich literature on social determinants of health, this paper provides a specific discussion of the status of "the minority" in the United States. The dynamic nature of the American identity is first presented, along with implications for differential health status. Next discussed are emerging paradigms in research and intervention that incorporate the dynamic nature of the American identity as both an explanation and an opportunity for remedy of health status disparities. Finally, a critical leadership role for the public health profession is proposed as urgently needed and as yet incompletely embraced.