 To conclude this section, we shall briefly consider what each of these three approaches to access has to say about some race inequalities in health and health care that are found in the U.S. A first point to note is that these accounts of access to health care do not inform us about the origins of some important inequalities in health. For example, certain health conditions, such as high blood pressure, diabetes, and asthma are more prevalent among African Americans than among other racial groups in the U.S. However the differences are best explained—by income differences, educational differences, lifestyle choices, some other environmental exposure to risks, or biological differences in the susceptibility to those illnesses—if the difference is not the result of differences in access to preventive services or treatments, then inequity in access to care is not the source of the health difference. A higher prevalence rate—or need—should lead to a higher utilization rate for relevant services, or else the use-per-need rates would differ between African Americans and other groups. What the use-per-need approach counsels us to do is to consider whether differences in the use-per-need rate are best accounted for by certain structural features of the system (e.g. inadequate supplies of providers in the areas where the population in need resides, organization of care that induces discontinuity of care, discriminatory attitudes of providers, including conscious or unconscious stereotyping), or by enabling or disposing features of the individuals (income differences, insurance level differences, educational differences, age differences, attitudes toward disease and treatment). If factors other than differences in need affect the use-per-need rate, then we have strong grounds for thinking there is an unfair inequality in access to care.