The current systems for the delivery of health services in the United States often fall short of addressing the health needs of many people living in the communities they cover and in so doing contribute to health status disparities. The objective of this course is to help students develop a framework to understand the needs of traditionally under-served populations and the challenges facing the delivery systems that handle these groups. This course has two major foci. The first is understanding who the "vulnerable" populations are as it relates to access to needed health services and disparities in health status. The interaction between health care systems and health care disparities will be explored. Particular attention will be paid to issues surrounding poverty, literacy, immigrant health care and several vulnerable sub-populations including the homeless, elderly, prison, LGBT and disabled. The second focus is service delivery for individuals traditionally under-served. This component includes an examination of organizations and provider (particularly physician)-patient relationships. Students will have the opportunity to move from the classroom to the street, observing, first-hand, hospital and community-based arrangements. In order that the course is in synch with current healthcare events, such as the passionate healthcare reform debate, a fifteen minute "Current Healthcare Events" session will held at the start of each session, hosted by two students.