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The startling health disparities between whites and racial and ethnic minorities in the United States are partly the result of six major assumptions about health promotion that permeated the Reagan and Bush Administrations. These assumptions, which placed the responsibility for maintaining health on individual Americans, are consistent with policymakers' reliance on market forces to address social issues. While this model may serve persons with a continuum of options and resources to elicit change, it does not benefit the underserved. In contrast, the Clinton Administration's approach, rooted in broad-based participation and multisector planning, is consistent with international models and promises long-overdue recognition that health problems in underserved communities stem from poverty—not the poor.