Our health status should not be predicated on our place of residence, but that is invariably the case across the country, and particularly true in St. Louis, where the life expectancy living in an inner-city ZIP code is 18 years lower than someone living in a ZIP code less than 10 miles away. There are many factors that have conspired to reduce the health status of Black Americans in the U.S. These include social and structural determinants of health, such as systemic racism and sociocultural barriers, which lead to inadequate social and built environments, inadequate information and knowledge, risk-promoting lifestyles, attitudes and behaviors, exposure to carcinogens, and diminished access to health care. The persistence of unconscionable disparities obligates systemic reform to improve the health of the African American community. Rebuilding our neighborhoods and schools, and eliminating intergenerational poverty would go a long way to improving the health of African Americans in St. Louis.