The Institute of Medicine identifies equitable care as a key domain of healthcare quality. Disparities in access and delivery stem from socioeconomic status, geographic location, language barriers, and immigration status. Racism, both overt and subtle, further impacts healthcare outcomes. Racial equity is achieved when race no longer influences opportunities, resource allocation, or life outcomes. Social determinants of health, such as social, economic, environmental, and community conditions in which people live, significantly impact people’s health, well-being, and quality of life. Improving healthcare outcomes and well-being requires addressing all aspects of social determinants of health. Despite advancements such as expanded insurance coverage and preventive services, significant barriers persist, especially for rural and low-income populations. Children are particularly vulnerable to these disparities. This chapter examines socioeconomic healthcare inequities, progress made, and existing programs to improve healthcare access for children in the United States.