The CMS Framework for Health Equity provides a strong foundation for our work as a leader and trusted partner dedicated to advancing health equity, expanding coverage, and improving health outcomes. This includes strengthening our infrastructure for assessment, creating synergies across the health care system to drive structural change, and identifying and working together to eliminate barriers to CMS-supported benefits, services, and coverage for individuals and communities who are underserved or disadvantaged and those who support them.

In 2020, there were 46.9 million Americans who identified as Black or African American, accounting for 14.2% of the total US population.1, 2 The Black population is the third-largest racial/ethnic group following White and Hispanic people and primarily resides in the South . The population includes ancestors of individuals brought to the US as slaves who largely identify as African American, as well as nearly 10% who are recent immigrants, mostly of African or Caribbean descent. The Black immigrant population has increased 5-fold over the past four decades, from 816,000 in 1980 to more than 4.3 million in 2019.3. Although racial classification is a social construct based on appearance, it remains useful for describing health patterns in the US because long-standing structural racism has contributed to inequalities in the social determinants of health. Although some cancer-associated genetic mutations are inherited, most health differences between population groups do not stem from biology, but from variations in socioeconomic status and access to medical care.