This article is part of our Women and Leadership special section, which focuses on approaches taken by women, minorities or other disadvantaged groups challenging traditional ways of thinking.

In the United States, wealth buys health. Consider: In 2000, in Boston’s upscale Back Bay community, a typical resident could expect to live nearly 92 years. But just a few miles away in the South Boston and Roxbury neighborhoods, the average person could not expect to celebrate a 59th birthday.

Access to health care plays a big role in this disparity, said Howard Koh , a professor at the Harvard T.H. Chan School of Public Health who was an assistant secretary for health in the Obama administration . That’s why that administration pushed so hard for the Affordable Care Act, Dr. Koh said. “Poverty is the major driver of health inequities.”

But even in places where people generally have access to medical care, the differences in outcome remain stark, said Thea James , vice president of mission and associate chief medical officer at Boston Medical Center . People with low incomes face financial pressure from all directions: rent, food, transportation, co-payments. If it is a choice between buying medications or food, pretty much all parents would choose their children’s bellies, she said.