As a brutal recession picks pockets clean, new research shows minorities are bearing the brunt of it. According to the Pew Research Center, the median wealth of white households is a whopping 20 times that of black households, making this the largest racial wealth gap in 25 years.

In addition, the disparity has created a health crisis for African Americans, a group that’s already disproportionately hit harder by HIV/AIDS, strokes and heart disease. The lack of wealth translates into a lack of health care. Since poor minorities can’t easily afford available health services and meds, such as blood pressure screenings and cholesterol-controlling drugs that could help prevent serious health conditions, they don’t get treated until diseases advance. And when acute illnesses strike, poor African Americans often don’t have insurance to pay for treatment.

And it’s not just health that’s affected: Research shows more poor minorities live in areas exposed to polluted air, water, food and land, and they have less access to parks, playgrounds and fresh food.

While the Affordable Care Act, a.k.a. health care reform, should help narrow the gap, advocates work to end disparities across the board—in health care and services, employment, education, criminal justice—and to focus on correcting their root causes.