In this issue, we focus on the most challenging issue we face in ambulatory care management anywhere in the world-how to improve population health for low-income populations. In the United States, low-income populations face additional/increasing challenges such as lack of health insurance. As Dr Larson points out, TennCare, the Medicaid program in Tennessee, has fallen apart. In her important summary article for this set of articles on population health improvement in Nashville, Tennessee, Dr Larson explains that, unfortunately, low-income populations face other challenges, including persisting problems pertaining to race. The Journal of Clinical Oncology has reported that at the national level blacks and whites are treated differently for lung cancer. As reported in The New York Times, "The major point is that African American patients are still getting surgery less often than white patients," said Dr Christopher S. Lathan, the lead author and an instructor in medicine at Harvard. "There is something happening here that is more than access to care."1

The remainder of this issue guest edited byDr Larson details the many efforts that the population health improvement project, called the REACH project, in Nashville, Tennessee, tried to begin and put in place. The issue ranges from involving people of faith to diabetes management among low income African Americans.

We continue with our series of articles pertaining to health status measurement from the VA and guest edited by Lewis Kazis.

This series of articles is followed by the regular column from the Republic of Texas, which only gets more interesting by the day with the debilitating stress that elected officials from Texas are increasingly suffering from. Lastly, Physicians for Human Rights provides us with a column focused on the genocide in Darfur, Sudan.

Norbert Goldfield, MD, Editor

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