Once again, we emphasize that the division of topics across the following chapters is not meant to imply that these categories of health influences operate independently or contribute in a simple additive fashion to the U.S. health disadvantage. The key dynamic trajectories of health, risk factors, socioeconomic circumstances, and physical and institutional environments are all integrally linked and cannot be decomposed in a reductionist fashion. As the following chapters make clear, these synergistic interactions are central to understanding the U.S. health disadvantage.

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