Historically, the overall health status as measured by life expectancy and infant mortality of Black and White Missourians has been significantly different. We analyzed birth, death, child death and communicable disease data to determine if Blacks have narrowed the gap in health status. The overall health status of Black and White Missourians improved over the last two decades. However, the gap in health status still remains, and in some cases, has gotten worse. This occurred despite the increase in health care financing through Medicare and Medicaid. To narrow the gap in health status between Blacks and Whites requires addressing prevention and the social problems along with the medical problems.