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In this study ethnic and gender differences in occupational prestige of health care workers are used to measure the extent of inequality in the health care delivery systems of large SMSAs. Aggregate characteristics of these communities and of their health care delivery systems are used to explain variations in occupational prestige among health workers. The analysis is guided by Blau's macrostructural theory of intergroup relations. It employs 1980 U.S. Census information on the number of men, women, whites, blacks, and Hispanics in 19 health occupations in the 31 largest SMSAs. The results include a description of the size of the health care delivery systems and the proportions of women and minority workers in the systems, as well as the average occupational prestige of categories of respondents, their level of concentration among the occupations, and the relative presence of respondents in the occupations of physicians and registered nurses. Multivariate regression analysis is used to explore intergroup differences in occupational prestige. As deduced from Blau's theory, groups with greater relative occupational dispersion, greater political participation, advanced education, and higher sex ratios have greater relative occupational prestige in the health care delivery system.

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