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Steven H. Woolf, MD, MPH, Robert E. Johnson, PhD, George E. Fryer, Jr, PhD, MSW, George Rust, MD, MPH and David Satcher, MD, PhD

Steven H. Woolf and Robert E. Johnson are with Virginia Commonwealth University, Richmond. At the time of this study, George E. Fryer Jr was with the American Academy of Family Physicians Robert Graham Center for Policy Studies in Family Practice and Primary Care, Washington, DC. George Rust and David Satcher are with the National Center for Primary Care, Morehouse School of Medicine, Atlanta, Ga.

Correspondence: Requests for reprints should be sent to Steven H. Woolf, MD, MPH, Professor, Departments of Family Medicine, Preventive Medicine, and Community Health, Virginia Commonwealth University, 3712 Charles Stewart Dr, Fairfax, VA 22033 (e-mail: swoolf{at}vcu.edu).

The US health system spends far more on the "technology" of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity may do more for health than perfecting the technology of care.

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