Many physicians are skeptical of structural racism, the idea that economic, educational, and other social systems preferentially disadvantage Black Americans and other communities of color. Mitchell Katz, MD, president and chief executive officer of NYC Health + Hospitals, the largest US public health care system, is an expert in health care delivery to disadvantaged populations. He explains how structural racism worsens health outcomes and what health systems can do to address it. Related: Racial and Ethnic Disparities in COVID-19 The Winter COVID-19 Surge in New York and Los Angeles Diversifying Medical Education Surgeon Creates Barrier-Free COVID-19 Testing Service for Philadelphia's Black Residents Taking a Closer Look at COVID-19, Health Inequities, and Racism Recalibrating the Use of Race in Medical Research Responding to COVID-19 With a Structurally Competent Health Care System