Structural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. The inequality that Black people and communities of color face is the direct result of centuries of public policy that made Black and Brown skin a liability. We are now in an unprecedented moment in our history as we usher in a new administration which explicitly states: “The moment has come for our nation to deal with systemic racism. . .And to deal with the denial of the promise of this nation—to so many.” The opportunities to create innovative and bold policy must reflect the urgency of the moment and seek to dismantle the systems of oppression that have for far too long left the American promise unfulfilled. The policy suggestions we make in this commentary speak to the structural targets needed to dismantle some of the many manifestations of structural racism to achieve health equity.