Health equity in genomics and precision medicine is crucial to prevent widening health disparities. Disparities in implementation of genomic medicine, especially for tier 1 applications like familial hypercholesterolemia and hereditary breast and ovarian cancer, are evident among racial and ethnic minorities, rural communities, and those with lower income or education. Public health actions, including community engagement, improving genetic health literacy, and building a diverse workforce, are essential to ensure equitable access and benefits from genomic advancements.