[영문]During the 1990s, increasing attention was focused on longstanding racial and ethnicdisparities in health and health care. New research and experiences from the front linesdocumented the extent of these differences, their costs to individuals and society, andthe role the health care system plays in perpetuating them. As evidence continued tomount, policymakers, practitioners, and others intensified their interest in improvingthe knowledge base, skills, communication, and training around care for diverse populations.Since then, these and other cultural competence efforts have grown fromtypically small, isolated programs into more sophisticated and potentially far-reachinginitiatives whose value has been strongly reaffirmed in a series of reports and recommendations,including those from the Institute of Medicine (IOM),1 the Department ofHealth and Human Services Office of Minority Health,2 The Agency for Health Researchand Quality,3 the Centers for Medicare qqqamp; Medicaid Services cultural competence/disparities health plan language that was part of the 2003 Quality Assurance/Performance Improvement requirements,4 numerous state issuances, and specific programsundertaken by providers. In many ways, having acknowledged the considerablebody of evidence attesting to racial and ethnic disparities, the field is moving beyonddocumentation to seek and implement models and strategies to reduce them. To date,however, health care professionals and research have not tended to focus specifically onhow to reduce racial and ethnic disparities affecting families and children. Such inattentionexists in spite of the growing documentation that rates for certain conditions, suchas asthma, are disproportionately higher among minority children.5 The consequencesof these disparities can be profound, affecting activities of daily living, schooling, andother areas.The purpose of this article is to use information from research and other workemerging from the field of cultural competence and disparities reduction to suggestdirections for research, practice, and service settings to address the needs of children. Itpresents 1990 and 2000 data from our project that profiled the nation’s 100 largest citiesand their suburban areas (defined as the metropolitan statistical areas [MSAs] surroundingthese cities) for families, children, and maternal/infant health to describe asubset of racial/ethnic disparities.6 Using these indicators and other research to documentprogress as well as significant, continuing challenges, this article identifies fourdimensions that contribute to racial/ethnic disparities: biologic/genetic factors, access,quality of care, and language and communication. Recommendations for future directionsto address these dimensions are intended to guide practitioners and their healthcare settings as well as research focused on reducing disparities and improving culturalcompetence for this patient population