The "cultural competency" approach and other medical models that emphasize cross-cultural understanding of patients are limited. Many health-related factors previously attributed to culture or ethnicity in interactions between doctors and patients also represent the downstream consequences of decisions about larger structural contexts, such as impoverished transit or food delivery systems, oppressive zoning decisions, or the pernicious effects of institutional racisms. This talk will focus on how the "structural competency" model and movement offers a new paradigm and approach to healthcare that can address the biological, socioeconomic, and racial impacts of upstream decisions on structural factors such as expanding health and wealth disparities.