Overcoming Obstacles to Health: a Report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America1 was issued from the foundation to the commission at the commission’s 2008 public launch. The purpose was to present the foundation’s rationale for establishing the commission and provide a conceptual framework and scientifıc guidance for the commission’s work, summarizing and translating current knowledge about the social determinants of health for an audience of policymakers and advocates. Adapted from that report, this paper is intended to lay the foundation for this supplement to the American Journal of Preventive Medicine by providing a statement of the problem addressed by the commission and a framework for seeking the solutions that are explored more fully in the articles that follow.