The United States Healthy People 2010 initiative, designed to focus nationally funded health research and care on achieving a set of nationwide goals, was directed toward the elimination of racial and ethnic health disparities. While racial and ethnic disparities are complex (with the health of some minority groups surpassing the national average), the health of black Americans continues to fall short of the national average. By focusing on the presumptions embedded in the design of health disparities research, this chapter addresses why Healthy People 2010 largely failed to reduce racial health inequality. Importantly, in thinking about health inequalities, researchers initially failed to consider how race is socially constructed; how data collection is never value-neutral (see King, chapter 8, this volume); and, finally, the limits of randomized control trials (deductive methods) when it comes to making sense of complex behavioral and structural data. The chapter ends by describing how ethnographic insights can help complicate the assumptions and conclusions of health disparities research.